Advances in resection and transplantation for hepatocellular carcinoma

Abstract

It would be impossible to summarise all of the significant developments in the surgical management of hepatocellular carcinoma (HCC), even just over the past year, in a manuscript of this scope. Thus, we have selected topics for discussion that are the subject of current controversy and have attempted to present balanced points of view. Hepatic resection and transplantation are both mature modalities, and for the most part technical advances and improvements in candidate selection are incremental. The ability to readily cure hepatitis C stands out as the most impactful development in the field over recent years, especially in Western countries where hepatitis C has long been the chief aetiology underlying HCC and a predictor of poor outcomes after surgery, but its full implications remain to be clarified. The rising incidence of non-alcoholic steatohepatitis-related HCC and what it means with regard to surgical HCC management is an area of great current interest. With advancing technology, non-surgical locoregional treatments are gaining increasing application as potentially curative therapies. In addition, the advances in molecular and genomic assessment of HCC hold promise for personalising treatment and prognostication. The possible role of immunotherapy as an adjuvant to resection is being aggressively investigated. While liver surgery maintains an important role, the care of patients with HCC is more and more a team effort and needs to take place in the context of a well-integrated interdisciplinary programme to achieve the best outcomes for patients.

PRIM1 promotes the proliferation of hepatocellular carcinoma cells in vitro and in vivo

“…In East and South Asia the morbidity of liver cancer is highest in the world due to the prevalence of hepatitis B, which is continuously increasing [20,21]. The standard treatment for liver cancer includes surgical resection, liver transplantation and radiofrequency ablation, however at present only the early-stage patients or the patients undergo liver transplantation have 5-years survival [22,23], thus exploring an effective method to treat liver cancer is urgent.…”

miR-361-3p Regulates Liver Tumor-initiating Cells Expansion and Chemo-resistance

“…Various numbers of Huh7/HepG2 miR-361-3p mimic or miR-361-3p sponge and their control cells were digested and seeded into 96-well ultra-low attachment (2,4,8,16,32, 64 cells per well, n = 8) and cultured in DMEM/F12 (Gibco) supplemented with 1% FBS, 20 ng/mL bFGF and 20 ng/mL EGF for seven days.…”

“…However, the early symptoms of HCC are not obvious. Most HCC patients are diagnosed at advanced stage (2). Due to high grade invasive HCC can develop to life threatening metastases and less than 20% patients with Portal vein thrombus-only have 2-year overall survival (3).…”

Milestones in the pathogenesis and management of primary liver cancer

“…However, the times when cirrhosis was considered an almost absolute contraindication for liver resection are over, and Vibert et al summarise the recent advances in surgical treatment of HCC. 65 Lower morbidity rates associated with the laparoscopic approaches, and personalised prognostication based on the volume and quality of the future liver remnant, the degree of portal hypertension, and the risk of tumour recurrence have changed the way surgery is considered in the treatment paradigm for HCC. 66,67 Along this line, the concept of transplant benefit is now at the heart of multidisciplinary team discussions even when living donation removes the barrier of organ availability.…”