1.Evaluating clinical experience from a case of hepatocellular carcinoma with combinated therapy of transarterial chemoembolization and percutaneousethanol injection afterward emerging metatasis caused by fine needle aspiration cytology
Long Cong Nguyen ; Truong Xuan Bui ; Thong Minh Pham ; Ho Thi Thu Pham ; Hung Quoc Nghiem ; Phuong Minh Tran ; Long Van Dao ; Trach Khanh Nguyen
Journal of Medical Research 2007;47(2):69-73
Background: Hepatocellular carcinoma (HCC) is the most common primary hepatic tumor and one of the most common cancers worldwide. HCC is a primary malignancy of hepatocellular origin. Objectives:The aim of study is to combinate therapy of transarterial chemoembolization and percutaneousethanol injection afterward emerging metatasis caused by fine needle aspiration cytology. Subjects and method: A 50 years old male patient with hepatocellular carcinoma having a diameter of tumor more than 5 cm was treated by combination of transarterial chemoembolization and percutaneous ethanol injection from December 2000. Results & Conclusion: Results of study showed that: Transarterial chemoembolization and percutaneous ethanol injection are the two of non-surgical methods for treatment of hepatocellular carcinoma which are most commonly available in applied clinical activities at present. Up to now, the patient's life expectancy after therapy is more than 6 years that means the result of treatment is very good. However, the emerging metatasis into the anterior-right-Iower chest wall that was caused by fine needle aspiration cytology should be reviewed for further evaluating clinical experience, especially in cases with quite clear imaging features of untrasonography and significantly elevated AFP level higher than 200 ng/rnl.
Carcinoma
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Hepatocellular/ pathology
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therapy
2.Status and challenges of neoadjuvant immunotherapy for hepatocellular carcinoma.
Yong Xiang XIA ; Heng Song CAO ; Wei Wei TANG ; Xue Hao WANG
Chinese Journal of Surgery 2023;61(1):7-12
With the development of modern liver surgical techniques and the progress of perioperative management,the survival rate after resection of hepatocellular carcinoma has been greatly improved,but the high recurrence and metastasis rate still limits the long-term survival after surgery. Preoperative neoadjuvant therapy has been confirmed to significantly reduce the postoperative recurrence rate and prolong survival in other types of cancer,but there has been a lack of effective systemic therapy for hepatocellular carcinoma for a long time,so the efficacy and regimen of neoadjuvant therapy for hepatocellular carcinoma are still controversial. PD-1/PD-L1 monoclonal antibody combined with anti-angiogenic targeted drugs has become a first-line regimen in systemic therapy for advanced hepatocellular carcinoma. This regimen has definite efficacy and high safety,bringing hope for neoadjuvant therapy of hepatocellular carcinoma. Recently,three clinical trials of neoadjuvant immunotherapy for hepatocellular carcinoma have been published internationally,which preliminarily suggest the efficacy and safety of neoadjuvant immunotherapy for hepatocellular carcinoma and lay a solid foundation for carrying out larger sample clinical studies in the future.
Humans
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Carcinoma, Hepatocellular/pathology*
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Neoadjuvant Therapy
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Liver Neoplasms/pathology*
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Immunotherapy
5.The companion diagnostics of targeted therapy and immunotherapy for hepatocellular carcinoma.
Xiao Wen HUANG ; Shu Hong LIU ; Jing Min ZHAO
Chinese Journal of Hepatology 2022;30(9):912-917
Hepatocellular carcinoma (HCC) has a high incidence and low five-year survival rate in China. There is a lack of effective therapeutic approaches available for unresectable patients with advanced HCC. Recently, the development of targeted and immunotherapy agents and their application in the therapy of various solid tumors have brought new options and benefits to patients with advanced HCC. Companion diagnostics (CDx) emerged with the development of targeted agents, and its roles in selecting eligible patients for specific targeted/immunotherapy agents and improving prognosis are getting more prominent. This article focuses on the CDx technologies and applications related to HCC targeting and immunotherapy, in order to provide inspiration for the precise diagnosis and treatment of HCC.
Humans
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Carcinoma, Hepatocellular/pathology*
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Liver Neoplasms/pathology*
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Immunotherapy
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Antineoplastic Agents/therapeutic use*
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Molecular Targeted Therapy
6.Standard therapy for primary hepatocellular carcinoma.
Chinese Journal of Hepatology 2004;12(8):449-450
7.Chinese expert consensus on neoadjuvant therapy for hepatocellular carcinoma (2023 edition).
Chinese Journal of Surgery 2023;61(12):1035-1045
Recurrence of hepatocellular carcinoma (HCC) after surgery is a major factor affecting the efficacy of the treatment of patients. Neoadjuvant treatment is an effective therapeutic method to reduce postoperative recurrence and prolong patient survival. However,there is no generally accepted neoadjuvant treatment regimen that has been proven to be effective so far. Recently,with the progress in systemic antitumor therapies,represented by targeted molecular agents and immune checkpoint inhibitors,and the improvement in local regional therapies,these treatment approaches have shown promising efficacy and safety in the field of neoadjuvant treatment for HCC. Under the organizational leadership of Committee of Digestive Surgery of Chinese Research Hospital Association and Committee of Liver Cancer of Chinese Anti-Cancer Association,Alliance of Chinese Expert Consensus on Neoadjuvant Therapy for Hepatocellular Carcinoma has discussed and revised several times and finally formulated the Chinese expert consensus on neoadjuvant therapy for hepatocellular carcinoma (2023 edition). This consensus aimed to review the Chinese characteristics of the diagnosis and treatment of HCC,to provide specific guidance and suggestions for preoperative treatment strategies for HCC,and further promote the management of the clinical pathway for neoadjuvant treatment of HCC.
Humans
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Antineoplastic Agents/therapeutic use*
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Carcinoma, Hepatocellular/surgery*
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China
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Consensus
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Liver Neoplasms/pathology*
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Neoadjuvant Therapy
8.Novel therapeutic strategies for treatment of hepatocellular carcinoma: targeting intervention on liver cancer stem cells.
Xiaoming LI ; Qing LUO ; Guanbin SONG
Journal of Biomedical Engineering 2013;30(4):894-898
Hepatocellular carcinoma (HCC) is one of the most common human malignant tumors worldwide; it is also hard to prevent its metastasis and recurrence by traditional treatments. Up to now, how to prevent and treat HCC is still a challenging problem in clinic. Cancer stem cells (CSCs) are cells within malignant tumor that possess the capacity to self-renew and differentiate to lead to the heterogeneous lineages of cancer cells that comprise the tumor, and are the root to cause metastasis, recurrence and bad prognosis of the cancer. Targeting CSCs is a novel therapeutic strategy for management and treatment of the cancer. In recent years, targeting intervention on liver cancer stem cells (LCSCs) gradually became a novel strategy for HCC treatment, and some exciting research results in the treatment of HCC were also achieved. In this review, we introduce the biological characteristics of LCSCs and highlight the therapeutic strategies for hepatocellular carcinoma by targeting intervention on LCSCs.
Animals
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Antineoplastic Agents
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therapeutic use
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Carcinoma, Hepatocellular
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therapy
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Humans
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Liver Neoplasms
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therapy
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Molecular Targeted Therapy
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Neoplastic Stem Cells
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metabolism
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pathology
10.Prevalence and prognostic impact of hepatopulmonary syndrome in patients with unresectable hepatocellular carcinoma undergoing transarterial chemoembolization: a prospective cohort study.
He ZHAO ; Jiaywei TSAUO ; Xiaowu ZHANG ; Huaiyuan MA ; Ningna WENG ; Zhengqiang YANG ; Xiao LI
Chinese Medical Journal 2022;135(17):2043-2048
BACKGROUND:
To determine the prevalence and prognostic impact of hepatopulmonary syndrome (HPS) in patients with unresectable hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE).
METHODS:
Fifty-four patients with unresectable HCC undergoing TACE between December 2014 and December 2015 were prospectively screened for HPS and were followed up for a maximum of 2 years or until the end of this prospective study.
RESULTS:
Nineteen of the 54 (35.2%) patients were considered to have HPS, including one (5.3%) with severe HPS, nine (47.4%) with moderate HPS, and nine (47.4%) with mild HPS. The median overall survival (OS) was 10.1 (95% confidence interval [CI], 3.9-16.3) months for patients with HPS and 15.1 (95% CI, 7.3-22.9) months for patients without HPS, which is not a significant difference ( P = 0.100). The median progression-free survival was also not significantly different between patients with and without HPS (5.2 [95% CI, 0-12.8] vs. 8.4 [95% CI, 3.6-13.1] months; P = 0.537). In the multivariable Cox regression analyses, carbon monoxide diffusing capacity (hazard ratio [HR] = 1.033 [95% CI, 1.003-1.064]; P = 0.028) and Child-Pugh class (HR = 1.815 [95% CI, 1.011-3.260]; P = 0.046) were identified to be the independent prognostic factors of OS.
CONCLUSION
Mild or moderate HPS is common in patients with unresectable HCC undergoing TACE, but it does not seem to have a significant prognostic impact.
Humans
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Carcinoma, Hepatocellular/pathology*
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Chemoembolization, Therapeutic
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Prospective Studies
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Liver Neoplasms/pathology*
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Prognosis
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Hepatopulmonary Syndrome/therapy*
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Prevalence
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Treatment Outcome
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Retrospective Studies