Hepatic Resection With Thrombectomy in the Treatment of Hepatocellular Carcinoma Associated With Macrovascular Invasion

Cortese, Sergio; Morales, José Luís; Martín, Laura Serrano; Kayser, S; Rodríguez, Arturo Colón; Enrique, Rafael; Tellado, Jose M.

doi:10.1016/j.cireng.2019.12.011

Cited by 5 publications

(4 citation statements)

References 39 publications

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“…Several studies have underscored the low concentrations of glucose in the TME compared with plasma 28 or in the interstitial fluid of advanced tumors. 29 Glucose is crucial to the antitumor function, and its depletion can lead to drastically dampened T-cell proliferation, cytokine production, and cytotoxicity, 30 impairing an effective immune response against the tumor. Most studies demonstrated the limited availability of glucose to T cells in the TME, 31 though a recent study also showed that tumor-infiltrating T cells may harness similar amounts of glucose compared with tumor cells, but these lymphocytes still exhibited defective glycolysis.…”

Section: Discussionmentioning

confidence: 99%

Genetically engineering glycolysis in T cells increases their antitumor function

Toledano Zur,

Atar,

Barliya

et al. 2024

J Immunother Cancer

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BackgroundT cells play a central role in the antitumor response. However, they often face numerous hurdles in the tumor microenvironment, including the scarcity of available essential metabolites such as glucose and amino acids. Moreover, cancer cells can monopolize these resources to thrive and proliferate by upregulating metabolite transporters and maintaining a high metabolic rate, thereby outcompeting T cells.MethodsHerein, we sought to improve T-cell antitumor function in the tumor vicinity by enhancing their glycolytic capacity to better compete with tumor cells. To achieve this, we engineered human T cells to express a key glycolysis enzyme, phosphofructokinase, in conjunction with Glucose transporter 3, a glucose transporter. We co-expressed these, along with tumor-specific chimeric antigen or T-cell receptors.ResultsEngineered cells demonstrated an increased cytokine secretion and upregulation of T-cell activation markers compared with control cells. Moreover, they displayed superior glycolytic capacity, which translated into an improved in vivo therapeutic potential in a xenograft model of human tumors.ConclusionIn summary, these findings support the implementation of T-cell metabolic engineering to enhance the efficacy of cellular immunotherapies for cancer.

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Section: Discussionmentioning

confidence: 99%

Genetically engineering glycolysis in T cells increases their antitumor function

Toledano Zur,

Atar,

Barliya

et al. 2024

J Immunother Cancer

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“…(2) no clinical or radiological evidence of ascites, nor previous history of liver decompensation; (3) possibility to perform a complete R0 tumor resection leaving a sufficient liver remnant; and (4) no evidence of extrahepatic disease. These conditions being satisfied, we also considered for resection patients with macrovascular invasion, as previously reported 3 , or with multinodular disease. None of the patients had a previous surgical or radiological portosystemic shunt.…”

Section: Surgical Criteriamentioning

confidence: 99%

Impact and outcomes of liver resection for hepatocellular carcinoma in patients with clinically significant portal hypertension

Cortese,

Tellado

2024

CIRUE

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Objective: Clinically significant portal hypertension (CSPH), although not a contraindication for liver resection in cirrhosis, is considered a determinant prognostic factor for post-surgical outcomes. This study aims to investigate the effects of CSPH on short and long-term results after hepatic resection for hepatocellular carcinoma (HCC). Methods: Single-center retrospective analysis of 126 consecutive hepatic resections for HCC in Child-Pugh A patients, performed between 2008 and2018. Patients were divided according to the presence of CSPH, defined as a hepatic venous pressure gradient ≥ 10 mmHg. To overcome selection bias, 42 patients with CSPH were matched through propensity score with 42 patients without CSPH. Intraoperative and post-operative outcomes, along with overall and disease-free survival, were compared between the matched groups. Results: Liver decompensation was four-fold in the CSPH group (28.6% vs. 7.1%, p = 0.010), while rate of severe complications, including 90-days mortality, was not statistically different between patients with and without CSPH. Overall and recurrence-free survival was not inferior in patients with CSPH compared to non-CSPH group. Conclusions: The present study has demonstrated acceptable outcomes of liver resection for HCC in carefully selected Child-Pugh A cirrhotic patients, even in the presence of elevated portal pressure.

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“…Surgical candidates should fulfill all of the following criteria: (1) Preserved liver function (Child-Pugh A); (2) no clinical or radiological evidence of ascites, nor previous history of liver decompensation; (3) possibility to perform a complete R0 tumor resection leaving a sufficient liver remnant; and (4) no evidence of extrahepatic disease. These conditions being satisfied, we also considered for resection patients with macrovascular invasion, as previously reported 3 , or with multinodular disease. None of the patients had a previous surgical or radiological portosystemic shunt.…”

Section: Surgical Criteriamentioning

confidence: 99%

Impacto y resultados de la resección hepática por carcinoma hepatocelular en los pacientes con hipertensión portal clínicamente significativa

Cortese¹,

Tellado²

2022

CIRU

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Purpose: Clinically significant portal hypertension (CSPH), although not a contraindication for liver resection in cirrhosis, is considered a determinant prognostic factor for post-surgical outcomes. This study aims to investigate the effects of CSPH on short and long-term results after hepatic resection for hepatocellular carcinoma (HCC). Methods: Single-center retrospective analysis of 126 consecutive hepatic resections for HCC in Child-Pugh A patients, performed between 2008 and2018. Patients were divided according to the presence of CSPH, defined as a hepatic venous pressure gradient ≥ 10 mmHg. To overcome selection bias, 42 patients with CSPH were matched through propensity score with 42 patients without CSPH. Intraoperative and post-operative outcomes, along with overall and disease-free survival, were compared between the matched groups. Results: Liver decompensation was four-fold in the CSPH group (28.6% vs. 7.1%, p = 0.010), while rate of severe complications, including 90-days mortality, was not statistically different between patients with and without CSPH. Overall and recurrence-free survival was not inferior in patients with CSPH compared to non-CSPH group. Conclusions: The present study has demonstrated acceptable outcomes of liver resection for HCC in carefully selected Child-Pugh A cirrhotic patients, even in the presence of elevated portal pressure.

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Hepatic Resection With Thrombectomy in the Treatment of Hepatocellular Carcinoma Associated With Macrovascular Invasion

Cited by 5 publications

References 39 publications

Genetically engineering glycolysis in T cells increases their antitumor function

Genetically engineering glycolysis in T cells increases their antitumor function

Impact and outcomes of liver resection for hepatocellular carcinoma in patients with clinically significant portal hypertension

Impacto y resultados de la resección hepática por carcinoma hepatocelular en los pacientes con hipertensión portal clínicamente significativa

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