Hepatectomy Versus Sorafenib in Advanced Nonmetastatic Hepatocellular Carcinoma

Famularo, Simone; Donadon, Matteo; Cipriani, Francesco; Giuliante, Felice; Ferri, Silvia; Celsa, Ciro; Ferrero, Alessandro; Foschi, Francesco Giuseppe; Baiocchi, Gian Luca; Biasini, Elisabetta; Campani, Claudia; Valle, Raffaele Dalla; Pelizzaro, Filippo; Baroni, G. Svegliati; Raimondo, Giovanni; Mega, Andrea; Chiarelli, Marco; Maestri, Marcello; Gasbarrini, Antonio; Jovine, Elio; Grazi, Gian Luca; Rapaccini, Gian Ludovico; Ruzzenente, Andrea; Morisco, Filomena; Sacco, Rodolfo; Méméo, Riccardo; Crespi, Michele; Antonucci, Adelmo; Bernasconi, Davide Paolo; Romano, Fabrizio; Griseri, G.; Aldrighetti, Luca; Torzilli, Guido; Trevisani, Franco

doi:10.1097/sla.0000000000005373

Cited by 29 publications

(23 citation statements)

References 35 publications

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“…Hepatectomy is still the most effective treatment for HCC, and CTC counts can be used as an effective method in evaluating postoperative efficacy and monitoring tumor progression [ 28 , 29 ]. Preoperative CTC analyses can better guide the resection of HCC.…”

Section: Discussionmentioning

confidence: 99%

“…The results showed that the combination scheme has the advantages of low toxicity, strong specificity (96.94%), high sensitivity (98.12%) and a high detection rate (98.64%), which can specifically, accurately and efficiently enrich CTCs in blood, with an average number of CTCs of 24.15 ± 4.47/2 mL. Hepatectomy is still the most effective treatment for HCC, and CTC counts can be used as an effective method in evaluating postoperative efficacy and monitoring tumor progression [28,29]. Preoperative CTC analyses can better guide the resection of HCC.…”

Section: Discussionmentioning

confidence: 99%

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A clinically feasible circulating tumor cell sorting system for monitoring the progression of advanced hepatocellular carcinoma

Huang

Zhang

et al. 2023

J Nanobiotechnol

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Background Hematogenous metastasis is essential for the progression of advanced hepatocellular carcinoma (HCC) and can occur even after patients receive multidisciplinary therapies, including immunotherapy and hepatectomy; circulating tumor cells (CTCs) are one of the dominant components of the metastatic cascade. However, the CTC capture efficiency for HCC is low due to the low sensitivity of the detection method. In this study, epithelial cell adhesion molecule (EpCAM)/vimentin/Glypican-3 (GPC3) antibody-modified lipid magnetic spheres (LMS) were used to capture tumor cells with epithelial phenotype, mesenchymal phenotype and GPC3 phenotype, respectively, in order to capture more CTCs with a more comprehensive phenotype for monitoring tumor metastasis. Results The novel CTC detection system of Ep-LMS/Vi-LMS/GPC3-LMS was characterized by low toxicity, strong specificity (96.94%), high sensitivity (98.12%) and high capture efficiency (98.64%) in vitro. A sudden increase in CTC counts accompanied by the occurrence of lung metastasis was found in vivo, which was further validated by a clinical study. During follow-up, the rapid increase in CTCs predicted tumor progression in HCC patients. Additionally, genetic testing results showed common genetic alterations in primary tumors, CTCs and metastatic tissues. The proportion of patients predicted to benefit from immunotherapy with the CTC detection method was higher than that for the tissue detection method (76.47% vs. 41.18%, P = 0.037), guiding the application of clinical individualized therapy. Conclusions The Ep-LMS/Vi-LMS/GPC3-LMS sequential CTC capture system is convenient and feasible for the clinical prediction of HCC progression. CTCs captured by this system could be used as a suitable alternative to HCC tissue detection in guiding immunotherapy, supporting the clinical application of CTC liquid biopsy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A clinically feasible circulating tumor cell sorting system for monitoring the progression of advanced hepatocellular carcinoma

Huang

Zhang

et al. 2023

J Nanobiotechnol

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“…The BCLC staging system is the most popular for prognosis and therapeutic guidance in patients with HCC [ 42 ]. However, it is considered to be very restrictive regarding indications for surgical management, including resection and transplantation, and for this reason, it has been heavily questioned by the HPB community [ 20 , 43 , 44 , 45 , 46 , 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

Individualized Approach in the Surgical Management of Hepatocellular Carcinoma: Results from a Greek Multicentre Study

Glantzounis

Korkolis

Sotiropoulos

et al. 2022

Cancers

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Background: Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause of death worldwide. The management of HCC is complex, with surgical treatment providing long-term survival in eligible patients. This study aims to present the experience of aggressive surgical management of HCC in Greece. Methods: This is a retrospective multicentre clinical study with 242 patients. Results: Most patients were male (79%) and had a median age of 71 yrs. According to the most recent BCLC criteria, 172 patients (71.1%) were classified as BCLC 0-A stage, 33 patients (13.6%) were classified as BCLC B, and 37 (15.3%) were classified as BCLC C. A total of 54% of the patients underwent major hepatectomy. Major postoperative morbidity was 15.6%, and the 90-day postoperative mortality rate was 4.5%. The median follow-up was 33.5 months. Three- and five-year overall survival was 65% and 48%, respectively. The median overall survival was 55 months. Significantly, five-year survival was 55% for BCLC A, and 34% and 21% for BCLC B and C, respectively. In univariate analysis, cirrhosis, type of resection (R status), and BCLC stage were associated with overall survival. Multivariate analysis indicated that R1 and R2 resections compared to R0, and BCLC C compared to BCLC 0-A, were independently associated with increased mortality. Conclusions: Aggressive surgical treatment of HCC offers satisfactory long-term survival prospects. A significant percentage (29%) of HCCs that underwent liver resection were of the intermediate and advanced BCLC stage. The management of patients with HCC should be discussed in multidisciplinary tumour board meetings on a case-by-case basis to be more effective.

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“…VEGFA combined with VEGFR2 triggers signalling cascade pathways and ultimately induces endothelial cell proliferation, survival and migration to promote tumour progression 22,23 . Sorafenib, a commonly used targeted drug in HCC, also inhibits angiogenesis as an important mechanism 24,25 . Recent studies have illustrated that VEGFA is highly expressed in malignant tumours, including HCC 26,27 .…”

Section: Introductionmentioning

confidence: 99%

Vascular endothelial growth factor A is a potential prognostic biomarker and correlates with immune cell infiltration in hepatocellular carcinoma

Song

Cai

et al. 2023

J Cellular Molecular Medi

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Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths among cancer patients. Vascular endothelial growth factor A (VEGFA) is involved in regulating biological processes, such as angiogenesis and vascular permeability, and is very closely related to the pathogenesis of various tumours, especially vascular-rich, solid tumours. Clinical data of patients with HCC and other tumours were analysed through public databases, such as the TCGA database, Gene Expression Omnibus database, Human Protein Atlas database, STRING, Tumour Immune Estimation Resource and Kaplan-Meier Plotter. The tumour tissues and adjacent normal tissues of patients with HCC from Hunan Provincial People's Hospital were collected to verify the expression of VEGFA by immunohistochemistry, immunofluorescence, Western blotting and qPCR. VEGFA expression is elevated in multiple tumour types and correlates with the prognosis of tumour patients. VEGFA is involved in regulating the tumour microenvironment and immune cell function in tumour development. Inhibition of VEGFA reduces proliferation, invasion, and migration and promotes apoptosis in HCC cells.VEGFA is a potential predictive biomarker for the diagnosis and prognosis of HCC.

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Hepatectomy Versus Sorafenib in Advanced Nonmetastatic Hepatocellular Carcinoma

Cited by 29 publications

References 35 publications

A clinically feasible circulating tumor cell sorting system for monitoring the progression of advanced hepatocellular carcinoma

A clinically feasible circulating tumor cell sorting system for monitoring the progression of advanced hepatocellular carcinoma

Individualized Approach in the Surgical Management of Hepatocellular Carcinoma: Results from a Greek Multicentre Study

Vascular endothelial growth factor A is a potential prognostic biomarker and correlates with immune cell infiltration in hepatocellular carcinoma

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