Hepatic venous pressure gradient in the preoperative assessment of patients with resectable hepatocellular carcinoma

Cucchetti, Alessandro; Cescon, Matteo; Golfieri, Rita; Piscaglia, Fabio; Renzulli, Matteo; Neri, Flavia; Cappelli, Alberta; Mazzotti, Federico; Mosconi, Cristina; Colecchia, Antonio; Ercolani, Giorgio; Pinna, Antonio Daniele

doi:10.1016/j.jhep.2015.08.025

Cited by 87 publications

(75 citation statements)

References 30 publications

(60 reference statements)

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“…We confined our model to the serum albumin and log 10 ICG R15(%) to focus on the variables related to the liver function. A Cox regression equation based on only the serum albumin and log 10 ICG R15(%) was built for the Japanese training set, and the equation for the linear predictor was as follows: linear predictor = (0.663 × log 10 …”

Section: Resultsmentioning

confidence: 99%

“…Many attempts have been made to develop criteria of liver function for safe liver resection [2][3][4][5]. Portal hypertension (PH) is listed as a contraindication for liver resection in Western countries, and the indocyanine green (ICG) test is widely used in East Asian countries to decide whether patients with HCC are candidates for surgery [6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of preoperative liver function in patients with hepatocellular carcinoma: The albumin-indocyanine green evaluation (ALICE) grade.

Kobayashi

Hasegawa

Amikura

et al. 2016

JCO

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of preoperative liver function in patients with hepatocellular carcinoma: The albumin-indocyanine green evaluation (ALICE) grade.

Kobayashi

Hasegawa

Amikura

et al. 2016

JCO

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“…On the other hand, such restrictive selection criteria might exclude a large proportion of potentially resectable patients, since liver function has recovered markedly 3 months post-surgery. Therefore, the authors conclude that HPVG measurement should rather facilitate the modulation of treatment planning, avoiding highly extended resection in patients with significant portal hypertension [13], rather than preventing surgery in general.…”

Section: Curative Treatment Optionsmentioning

confidence: 99%

Novel implications in the treatment of hepatocellular carcinoma

Best

Schotten

Theysohn³

et al. 2016

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Worldwide hepatocellular carcinoma remains one of the leading causes of cancer-related death, associated with a poor prognosis due to late diagnosis in the majority of cases. Physicians at care are frequently confronted with patients who are ineligible for curative treatment such as liver resection, transplantation or radiofrequency ablation. Besides established palliative locoregional therapies, such as ablation or chemoembolization, new treatment options, such as microwave ablation, drug-eluting bead transarterial chemoembolization or selective internal radiation therapy, are emerging; however, data from randomized controlled trials are still lacking. In order to achieve optimal tumor control, patients should receive tailored treatment concepts, considering their tumor burden, liver function and performance status, instead of strictly assigning patients to treatment modalities following algorithms that may be partly very restrictive. Palliative locoregional pretreatment might facilitate downstaging to ensure later curative resection or transplantation. In addition, the combined utilization of different locoregional treatment options or systemic co-treatment has been the subject of several trials. In cases where local tumor control cannot be achieved, or in the scenario of extrahepatic spread, sorafenib remains the only approved systemic therapy option. Alternative targeted therapies, such as immune checkpoint inhibitors have shown encouraging preliminary results, while data from phase III studies are pending.

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“…These surrogate signs can be inaccurate, since some patients diagnosed indirectly with portal hypertension turn out not to meet the pressure cut-off of ≥ 10 mmHg [107] . A promising non-invasive indirect marker of portal hypertension may be liver stiffness estimated by transient elastography [108] , [109] , [110] . Ideally, the pressure gradient in the hepatic vein should be measured directly before surgery in patients with clinically significant portal hypertension.…”

Section: Hcc Involving Portal Hypertensionmentioning

confidence: 99%

Controversies and evidence of hepatic resection for hepatocellular carcinoma

et al. 2016

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Symptoms of early hepatocellular carcinoma (HCC) often go unnoticed, so more than half of patients with primary HCC are diagnosed after their disease has already reached an intermediate or advanced stage, or after portal hypertension has appeared. While hepatic resection is widely recognized as a first-line therapy to treat very early or early HCC, its use in treating intermediate or advanced HCC or HCC involving portal hypertension remains controversial. Here we review PubMed-indexed literature covering the use of hepatic resection for such patients. The available evidence strongly suggests that, as a result of improvements in surgical techniques and perioperative care, hepatic resection can benefit many patients with intermediate or advanced HCC or with HCC associated with portal hypertension.

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Hepatic venous pressure gradient in the preoperative assessment of patients with resectable hepatocellular carcinoma

Cited by 87 publications

References 30 publications

Assessment of preoperative liver function in patients with hepatocellular carcinoma: The albumin-indocyanine green evaluation (ALICE) grade.

Assessment of preoperative liver function in patients with hepatocellular carcinoma: The albumin-indocyanine green evaluation (ALICE) grade.

Novel implications in the treatment of hepatocellular carcinoma

Controversies and evidence of hepatic resection for hepatocellular carcinoma

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