BACKGROUNDDespite being the world’s most widely used system for staging and therapeutic guidance in hepatocellular carcinoma (HCC) treatment, the Barcelona clinic liver cancer (BCLC) system has limitations, especially regarding intermediate-grade (BCLC-B) tumors. The recently proposed Hong Kong liver cancer (HKLC) staging system appears useful but requires validation in Western populations.AIMTo evaluate the agreement between BCLC and HKLC staging on the management of HCC in a Western population, estimating the overall patient survival.METHODSThis was a retrospective study of HCC patients treated at a university hospital in southern Brazil between 2011 and 2016. Demographic, clinical, and laboratory data were collected. HCC staging was carried out according to the HKLC and BCLC systems to assess treatment agreement. Overall survival was estimated based on the treatment proposed in each system.RESULTSA total of 519 HCC patients were assessed. Of these, 178 (34.3%) were HKLC-I; 95 (18.3%) HKLC-IIA; 47 (9.1%) HKLC-IIB; 29 (5.6%) HKLC-IIIA; 30 (5.8%) HKLC-IIIB; 75 (14.4%) HKLC-IV; and 65 (12.5%) HKLC-V. According to the BCLC, 25 (4.9%) were BCLC-0; 246 (47.4%) BCLC-A; 107 (20.6%) BCLC-B; 76 (14.6%) BCLC-C; and 65 (12.5%) BCLC-D. The general agreement between the two systems was 80.0% - BCLC-0 and HKLC-I (100%); BCLC-A and HKLC-I/HKLC-II (96.7%); BCLC-B and HKLC-III (46.7%); BCLC-C and HKLC-IV (98.7%); BCLC-D and HKLC-V (41.5%). When sub-classifying BCLC-A, HKLC-IIB, HKLC-IIIA and HKLC-IIIB stages according to the up-to-7 in/out criterion, 13.4, 66.0, 100 and 36.7%, respectively, of the cases were classified as up-to-7 out.CONCLUSIONIn a Western population, the general agreement between the two systems was 80.0%, although in BCLC-B cases the agreement was low, suggesting that some individuals could be candidates for the curative treatment recommended by the HKLC. The authors suggest that the BCLC system should be routinely employed, although for BCLC-B cases it should be associated with the HKLC system.

Introduction: Sorafenib (SOR) has proved to be effective in patients with advanced hepatocellular carcinoma (HCC), since overall survival was higher in phase III clinical trials; however, disease progression can occur. Objectives: The study aimed to describe real-life experience in advanced HCC treatment with SOR at a university hospital in Brazil and to estimate the number of patients with indication of second-line therapy. Methods: This is a retrospective study that included cases of HCC with prescription of SOR based on real-life practice between 2011 and 2016. Demographic, clinical, and laboratory data were collected. Results: From 572 patients with HCC, SOR was prescribed in 103 cases. From them, 62.1% were classified as Child-Pugh (CP)-A, 54.4% as Barcelona Clinic Liver Cancer (BCLC)-C, and 74 (71.8%) started treatment. Overall survival was 25.5 (95% CI 17.0–34.1) months and 1-year survival was greater in patients who received SOR than in non-treated (88.7 vs. 44.4%, p < 0.001). There was no difference in survival between BCLC-B and C (p = 0.405), as well as CP-A and B (p = 0.919). In 21.6% of the patients, a second-line therapy with regorafenib was indicated. Conclusion: In this real-life study, SOR significantly increased the survival rate by 1 year in patients with advanced HCC regardless of BCLC staging and CP score. Second-line therapy would be indicated in 21.6% of cases.

The valorisation of agro-industrial residues presents a challenge in obtaining economically sustainable and environmentally friendly industrial processes. Olive pomace is a by-product generated in large quantities, from olive oil extraction. This residue mostly consists of lignocellulosic materials. The aim of this study was to evaluate the potential use of extracted olive pomaces (EOP) obtained from olives with different ripening indexes (RI) and from different cultivars (Cobrançosa; RI = 2.5; 3.3 and 4.7; and Galega Vulgar; RI = 1.8; 2.9 and 4.8), to produce bioactive oligosaccharides from hemicelluloses by autohydrolysis. The hydrothermal treatment conditions were optimized by Response Surface Methodology, following a central composite rotatable design (CCRD), as a function of temperature (T: 142–198 °C) and time (t: 48–132 min), corresponding to severity factor (SF) values from 3.2 to 4.9. For all pomace samples, soluble sugar production was described by concave surfaces as a function of temperature and time. Autohydrolysis with SF equal or higher than 4.0 produced higher sugar yields, with maximum values around 180 g glucose equivalent/kg EOP for SF of 4.7 (190 °C/120 min) or 4.9 (198 °C/90 min). These values were similar for both cultivars and were not dependent on the ripening stage of the olives. Maximum oligosaccharide (OS) yields of 98% were obtained by autohydrolysis with SF of 4.0. The increase in SF to 4.9 resulted in a decrease in OS yield to 86–92%, due to the release of monomeric sugars. The monosaccharides were mostly xylose (55.8–67.7% in Galega; 50.4–69.0% in Cobrançosa liquid phases), and glucose, galactose, arabinose and rhamnose, in smaller quantities. Therefore, the production of bioactive xylo-oligosaccharides (XOS) from olive pomaces mainly depends on the hydrothermal conditions used.

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