Carcinoma, Hepatocellular ; surgery ; Catheter Ablation ; adverse effects ; Humans ; Liver Neoplasms ; surgery ; Postoperative Complications ; etiology ; prevention & control

Cancer prevention is a challenging project both in the basic and clinical medicine. In particular, prevention of liver cancer is the most urgent task in countries where the incidence of hepatitis virus-related liver cancer is rising. As reviewed in this article, liver cancer is going to be the first cancer that will be actually prevented by primary and secondary interventions. Even the improvement of absolute survival of the patients can be expected by successful prevention, as already demonstrated in a few clinical trials. Thus, prevention of liver cancer is promising to provide not only cost-effectiveness by morbidity reduction but also cost-benefit by mortality improvement.
Animals ; Chemoprevention ; Hepatitis B/complications/drug therapy ; Human ; Liver Neoplasms/etiology/*prevention & control ; Retinoids/*therapeutic use

OBJECTIVETo explore the role of green tea in decreasing the risks of gastric cancer, liver cancer, esophageal cancer among alcohol drinkers or cigarette smokers.

METHODSA population based case-control study was conducted in Taixing, Jiangsu province.

RESULTSIn Taixing city, identified cases of stomach, liver and esophageal cancers were chosen with informed consent. The numbers were 206, 204, 218 respectively. Controls were chosen from normal population having lived in the area for longer than 10 years, also with informed consent. Green tea drinking seemed to have decreased 81%, 78%, 39% risk for the development of gastric cancer, liver cancer and esophageal cancer among alcohol drinkers. It might also have decreased 16%, 43%, 31% on the risks of developing the three kinds of cancers among cigarette smokers. Interaction assessment showed that drinking green tea could significantly decrease the risk of gastric cancer and liver cancer among alcohol drinkers, with ORs of interaction item 0.23 (95% CI: 0.10 - 0.55) and 0.25 (95% CI: 0.11 - 0.57) respectively.

CONCLUSIONHabit of drinking green tea seemed to have significant protective effects on the development of both gastric and liver cancer among alcohol drinkers while, green tea also having some protective effect on esophageal cancer among alcohol drinkers and on three kinds of cancers among cigarette smokers.

Adult ; Aged ; Alcohol Drinking ; adverse effects ; Case-Control Studies ; China ; epidemiology ; Digestive System Neoplasms ; epidemiology ; etiology ; prevention & control ; Esophageal Neoplasms ; etiology ; Female ; Flavonoids ; administration & dosage ; Humans ; Liver Neoplasms ; epidemiology ; etiology ; prevention & control ; Male ; Middle Aged ; Phenols ; administration & dosage ; Polyphenols ; Risk ; Smoking ; adverse effects ; Stomach Neoplasms ; epidemiology ; etiology ; prevention & control ; Tea ; chemistry

Carcinoma, Hepatocellular ; pathology ; surgery ; Humans ; Liver Neoplasms ; pathology ; surgery ; Liver Transplantation ; Neoplasm Recurrence, Local ; etiology ; prevention & control ; therapy ; Prognosis ; Treatment Outcome

This study evaluated the incidence of hepatic toxicity after stereotactic ablative radiotherapy (SABR) using 3 fractions to the liver, and identified the predictors for hepatic toxicity. We retrospectively reviewed 78 patients with primary and metastatic liver cancers, who underwent SABR using 3 fractions between 2003 and 2011. To examine the incidence of hepatic toxicity, we defined newly developed hepatic toxicity> or =grade 2 according to the National Cancer Institute Common Terminology Criteria for Adverse Events v4.0 within 3 months after the end of SABR as a significant adverse event. To identify the predictors for hepatic toxicity, we analyzed several clinical and dosimetric parameters (rV(5Gy)-rV(35Gy): normal liver volume receiving or =grade 2 occurred in 10 patients (13%): grade 2 in 9 patients and grade 3 in 1 patient. On univariate analysis, baseline Child-Pugh (CP) score (5 vs. 6-8), normal liver volume, and planning target volume were the significant clinical predictors. All dosimetric parameters were significant: rV(20Gy) was the most significant predictor. On multivariate analysis, baseline CP score (hazard ratio, 0.026; P=0.001) was the only significant predictor. In conclusion, SABR using 3 fractions in primary and metastatic liver cancers produces low hepatic toxicity, especially in patients with a baseline CP score of 5. However, further studies are needed to minimize hepatic toxicity in patients with baseline CP scores> or =6.
Aged ; *Dose Fractionation ; Female ; Hepatitis/*etiology/pathology/prevention & control ; Humans ; Liver Neoplasms/complications/pathology/*surgery ; Male ; Middle Aged ; Neoplasm Metastasis ; Radiation Injuries/*etiology/pathology/prevention & control ; Radiosurgery/*adverse effects/*methods ; Radiotherapy Dosage ; Treatment Outcome

OBJECTIVETo study the clinical features and treatment of recurrent hepatocellular carcinoma after liver transplantation.

METHODSClinical data of 95 patients with recurrent hepatocellular carcinoma (HCC) after liver transplantation from January 2003 to November 2005 were analyzed retrospectively.

RESULTSDuring follow-up, 42 patients (43.2%) were diagnosed HCC recurrence. The predominant sites of recurrence were liver graft (32 cases), lung (21 cases), bone (7 cases). Tumor size, tumor distribution, liver cirrhosis, pre-transplant AFP level, tumor differentiation, macrovascular invasion were considered risk factors of both post-transplant survival and HCC recurrence in univariate analysis. Tumor distribution, tumor differentiation, macrovascular invasion were considered independent risk factors of both overall post-transplant survival and HCC recurrence in multivariate analysis. Intervention therapy and internal radiation of recurrent HCC could delay tumor progression and resection of recurrent HCC in selected patients can significantly prolong post-recurrence survival.

CONCLUSIONSCarefully selection of HCC patients as candidates for liver transplantation can significantly reduce HCC recurrence. At the present stage, surgical resection of recurrent HCC is the best treatment method in selected patients.

Carcinoma, Hepatocellular ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; pathology ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Neoplasm Metastasis ; prevention & control ; therapy ; Neoplasm Recurrence, Local ; etiology ; prevention & control ; therapy ; Postoperative Period ; Prognosis ; Retrospective Studies ; Survival Analysis ; Treatment Outcome

OBJECTIVETo study the prevention and treatment of complications after hepatectomy.

METHODSFrom January 1998 to December 1999, 1 762 patients with pathologically proven primary liver cancer underwent hepatectomy. The types of resection included lobectomy, segmental resection and local hepatectomy.

RESULTSThe total complication rate was 4.09% and the total mortality was 0.40%. The rates of intraoperative bleeding, postoperative bleeding, hepatic failure, stockpiling fluid of the pleural cavity, residual fluid under the diaphragm, bile leakage and infection of incision were 0.96%, 0.28%, 0.51%, 1.87%, 0.17%, 0.17% and 0.11% respectively. The mortality of the former three complications were 0.06%, 0.06% and 0.28% respectively.

CONCLUSIONSThe complications can be prevented effectively and the mortality can be decreased markedly after hepatectomy by strict control of the indications, sufficient preoperative preparation, better surgical skills and close observation of postoperative state and comprehensive postoperative treatment.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; mortality ; surgery ; Female ; Hepatectomy ; adverse effects ; methods ; Humans ; Liver Neoplasms ; mortality ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; mortality ; prevention & control

OBJECTIVETo explore the risk factors for hepatoblastoma.

METHODSA case-cohort study using Logistic regression multiple variables analysis of medical record data sets was conducted to examine infant and perinatal risk factors for hepatoblastoma.

RESULTSBirth weight less than 1,000 g was associated with a strongly increased risk of hepatoblastoma (odds risk, OR = 26.0, 95% confidence interval, CI: 14.0 to 65.7). After adjustment of birth weight, a moderately increased risk of hepatoblastoma was found for older maternal age ( > 35 years vs. 20 to 34 years: OR = 2.6, 95% CI: 0.9 to 5.9), maternal smoking (OR = 2.9, 95% CI: 1.1 to 4.2) and higher maternal pregnancy body mass index (OR = 3.2, 95% CI: 1.0 to 6.7).

CONCLUSIONVery low birth weight and maternal characteristics including overweight, smoking are associated with hepatoblastoma risk.

Case-Control Studies ; Child ; Child, Preschool ; Confidence Intervals ; Female ; Follow-Up Studies ; Hepatoblastoma ; epidemiology ; etiology ; prevention & control ; Humans ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Liver Neoplasms ; epidemiology ; etiology ; prevention & control ; Male ; Overweight ; Pregnancy ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects

OBJECTIVETo study the cost-effectiveness, benefit and utility of infant hepatitis B vaccination in Shanghai from 1992 to 2001.

METHODSTo calculate the cost of hepatitis B vaccination by cost analysis method. Both the numbers of persons with HBsAg positive and patient with hepatitis B, cirrhosis and liver cancer decreased as the index of direct effect. To study the sick-time and the cost of treating hepatitis B, cirrhosis and liver cancer patients, a face to face questionnaire was used and quasi method was adopted to understand the effect of cure and the course of hepatitis B. The cost benefit analysis method was also used to calculate the cost benefit of HBV vaccine. The disability adjusted life years (DALY) was regarded as an index of utility to measure the disease burden.

RESULTSInput of 501,129.49 Yuan might have the result of reducing one liver cancer patient, ten cirrhosis patients, one hundred chronic hepatitis B patients and one thousand HBsAg positive people. The cost of hepatitis B vaccination was 0.24 hundred million Yuan during the past ten years in Shanghai, which had obtained the total benefit value of 41.22 hundred million Yuan, with a cost benefit ratio of 1:172 Yuan. It was estimated that the total disease burden of hepatitis B, cirrhosis and liver cancer patients was 59,762.55 DALY in order to reduce one DALY loss cost of 402.50 Yuan.

CONCLUSIONHBV vaccine inoculation in infants seemed to be a low-cost input and high-effect output strategy.

Adult ; Cost-Benefit Analysis ; Female ; Hepatitis B ; complications ; economics ; prevention & control ; Hepatitis B Vaccines ; economics ; therapeutic use ; Humans ; Immunization Programs ; economics ; Infant, Newborn ; Liver Cirrhosis ; economics ; etiology ; Liver Neoplasms ; economics ; etiology ; Male ; Markov Chains ; National Health Programs ; Quality of Life ; Surveys and Questionnaires ; Vaccination

OBJECTIVETo evaluate the efficacy of intraoperative radiofrequency ablation and 125I therapy for preventing local recurrence in hepatocellular carcinoma (HCC) after hepatectomy.

METHODSSeventy-eight HCC patients with a tumor close to the first or the second hepatic portal underwent hepatectomy with a resection margin less than 1 cm from 1999 to 2001. All patients were randomly divided into control group and combined treatment group according to their check-in date (odd or even). In the control group, 38 patients were treated with hepatectomy alone, whereas in the combined group, 40 patients were treated with hepatectomy plus radiofrequency ablation and 125I implantation on surgical margin. All patients were followed up regularly.

RESULTSthe 1-, 3- and 5-year recurrent rate was 7.5%, 30.0% and 45.0% in the combined treatment group versus 18.4%, 60.5% and 86.8% in the control group, respectively, with a significant difference in the 3-year (chi2 = 7.340, P < 0.01) and 5-year recurrent rates (chi2 = 15.740, P < 0.01). The 1-, 3- and 5-year survival rate was 92.5%, 67.5% and 30.0% in the combined group versus 81.5%, 39.4% and 18.4%, respectively.

CONCLUSIONIntraoperative radiofrequency ablation and 125I therapy on the resection margin is effective to prevent local recurrence in HCC patients after hepatectomy, and to prolong their postoperative tumor free survival.

Adult ; Aged ; Alanine Transaminase ; blood ; Arrhythmias, Cardiac ; etiology ; Carcinoma, Hepatocellular ; blood ; radiotherapy ; surgery ; Catheter Ablation ; adverse effects ; methods ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Intraoperative Period ; Iodine Radioisotopes ; therapeutic use ; Liver Neoplasms ; blood ; radiotherapy ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Survival Rate