Influence of preoperative transcatheter arterial chemoembolization on gene expression in the HIF-1α pathway in patients with hepatocellular carcinoma

Xu, Weiguang; Kwon, Jung‐Hee; Moon, Young Ho; Kim, Young Bae; Yu, Yun Suk; Lee, Namgyu; Choi, Kwan Yong; Kim, Yun Soo; Park, Yong Keun; Kim, Bong-Wan; Wang, Hee Jung

doi:10.1007/s00432-014-1713-4

Cited by 24 publications

(16 citation statements)

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“…We focused on the pharmacokinetics of sorafenib during the period within 72 hours after transarterial chemoembolization. Transarterial chemoembolization induces immediate hypoxia of the HCC cells and can upregulate angiogenesis (3,4). A clinical study of combined transarterial chemoembolization and oral administration of sorafenib investigated the possibility that "rebound" may result from 3-4 days of sorafenib interruption, before and after transarterial chemoembolization (17).…”

Section: Discussionmentioning

confidence: 99%

“…If transarterial chemoembolization does not induce complete necrosis of the tumor, the residual surviving cancerous tissue overexpresses vascular endothelial growth factor (VEGF) (3). A more recent study revealed that preoperative transarterial chemoembolization confers a poor prognosis in patients with HCC through activation of hypoxia-inducible factor 1α (HIF-1α) (4). Thus, inhibition of angiogenesis is critical for successful treatment of HCC.…”

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confidence: 98%

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Transarterial Chemoembolization Using Sorafenib in a Rabbit VX2 Liver Tumor Model: Pharmacokinetics and Antitumor Effect

Kim

et al. 2016

Journal of Vascular and Interventional Radiology

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Section: Discussionmentioning

confidence: 99%

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confidence: 98%

Transarterial Chemoembolization Using Sorafenib in a Rabbit VX2 Liver Tumor Model: Pharmacokinetics and Antitumor Effect

Kim

et al. 2016

Journal of Vascular and Interventional Radiology

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“…It is worried that if tumors cannot achieve complete pathological response after chemoembolization, the residual intrahepatic tumor cells may develop resistance toward chemotherapeutic agents and become more invasive than those receiving no TACE treatment. [27,28] The intratumoral necrosis induced by TACE may weaken the adhesive potential of the tumor and subsequently facilitate the release of cancer cells from the primary tumor and dislodgment into the bloodstream, thus increasing the risk of postoperative recurrence. [29] Our study showed that: for patients from mean tumor diameter >5 cm subgroup, the complete necrosis rate was all below 20%.…”

Section: Discussionmentioning

confidence: 99%

Preoperative transarterial chemoembolization for resectable hepatocellular carcinoma in Asia area: a meta-analysis of random controlled trials

Chen

et al. 2016

Scandinavian Journal of Gastroenterology

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Objective: We aimed to systematically evaluate the influence of preoperative transarterial chemoembolization (TACE) for resectable hepatocellular carcinoma (HCC) on long-term prognosis and perioperative safety. Materials and methods: Databases including PubMed, Embase, Cochrane, Wanfang, CNKI, VIP data were searched, combined with Manual Retrieval and Cited Reference Search to collect the published randomized controlled trial (RCT) about the influence of pre-TACE for curative resection of HCC. The searching cutoff date was 2016/02/25, all the data obtained were statistically analyzed using RevMan5.2 software recommended by Cochrane Collaboration. Results: A total of 5 RCT including 430 (pre-TACE group: 212, surgery alone group: 218) patients were included. The results of meta-analysis showed that: there was no difference between the 2 groups on overall survival (OS) rate [HR 1.25, 95%CI (0.92–1.68)], disease free survival (DFS) rate [HR 0.95 (0.76–1.19)], perioperative mortality rate [OR 0.70 (0.22–2.30)], or blood loss [SMD 0.07 (−0.14–0.29)], whereas the subgroup analysis revealed that pre-TACE would result in longer operation time [SMD 0.31 (0.06–0.57)], higher postoperative morbidity rate [OR 1.90 (1.02–3.53)] and combined resection rate of perihepatic organs [OR 5.46 (2.73–11.78)] in subgroup with mean tumor diameter >5cm. Conclusions: According to our study, pre-TACE treatment cannot improve the long-term prognosis of resectable HCC. With the growth of the tumor diameter, especially when it is over 5cm, it might add difficulties to surgery and affect the perioperative safety.

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“…Instead, a combination with HAC or HAC alone was superior to other methods in advanced stages (C, D). This finding may be related to the metabolism of tumors in the hypoxic environment [20–21]. Based on these results, it is possible to conclude that LT (if possible) was the best option for patients at Stage 0, whereas TACE+RFA, SR, PEI might be potential best options for patients at Stage 0 (if LT is not possible).…”

Section: Discussionmentioning

confidence: 94%

The best strategy for HCC patients at each BCLC stage: a network meta-analysis of observational studies

et al. 2017

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Background and AimsCurrently, the Barcelona Clinic Liver Cancer staging system remains huge controversies in the management of hepatocellular carcinoma. To determine the best therapeutic strategy for patients at each stage, we conducted a network meta-analysis and aimed to provide a new treatment concept.Materials and MethodsPubMed, Embase and Cochrane Library database were searched for observational studies up to August 31, 2016. We extracted data on overall survival rate from studies that compared various strategies for use with patients at different stages. Network meta-analysis was conducted by evaluating the different overall survival rate of each stage. Cumulative probability value was utilized to rank the strategies under examination. A node-splitting model was employed to assess consistency and inconsistency.ResultsA total of 198 observational studies were included in the network meta-analysis with a focus on Stages 0-D. By comparing the overall survival rate of each stage, the results revealed that liver transplantation and liver transplantation plus transcatheter arterial chemoembolization were the best options for patients with Stages 0 and A. The applications of surgical resection plus transcatheter arterial chemoembolization and surgical resection plus sorafenib were the best strategies for Stages B and C. For Stage D, whole net connection could not be established, but intra-arterial infusion chemotherapy and liver transplantation could be potential primary options.ConclusionsThe existing therapeutic flowchart needs to be updated. Potential best strategies relating to all stages were identified and should be used as references for clinical treatments.

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Influence of preoperative transcatheter arterial chemoembolization on gene expression in the HIF-1α pathway in patients with hepatocellular carcinoma

Abstract: Our findings collectively demonstrate that preoperative TACE confers poor prognosis in HCC patients through activation of HIF-1α.

Cited by 24 publications

References 41 publications

Transarterial Chemoembolization Using Sorafenib in a Rabbit VX2 Liver Tumor Model: Pharmacokinetics and Antitumor Effect

Transarterial Chemoembolization Using Sorafenib in a Rabbit VX2 Liver Tumor Model: Pharmacokinetics and Antitumor Effect

Preoperative transarterial chemoembolization for resectable hepatocellular carcinoma in Asia area: a meta-analysis of random controlled trials

The best strategy for HCC patients at each BCLC stage: a network meta-analysis of observational studies

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