Liver Function Assessment Using Albumin–Bilirubin Grade for Patients with Very Early-Stage Hepatocellular Carcinoma Treated with Radiofrequency Ablation

Oh, In Soo; Sinn, Dong Hyun; Kang, Tae Wook; Lee, Min Woo; Kang, Wonseok; Gwak, Geum‐Youn; Paik, Yong–Han; Choi, Moon Seok; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon

doi:10.1007/s10620-017-4775-8

Cited by 45 publications

(28 citation statements)

References 26 publications

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“…Many scholars are gradually focusing on demographic and laboratory data, which are secure, repeatable, and easily available for predicting the recurrence of patients with HCC receiving only TACE or ablation therapy. Various studies showed that several predictors might indicate poor RFS, some of which are as follows: (1) noninvasive fibrosis markers such as aspartate APR index and age-to-platelet index; 13,14 (2) liver function markers such as albumin and albumin-to-bilirubin index; 15,16 (3) tumor-related markers such as tumor number, AFP, lens culinaris agglutinin-reactive fraction of AFP-L3, and des-gamma-carboxy prothrombin; [17][18][19] (4) inflammatory Abbreviations: RFA, radiofrequency ablation; MWA, microwave ablation; AHC, argon-helium cryoablation; HBV, hepatitis B virus; HCV, hepatitis C virus; ALD, alcohol liver disease; AFP, alpha-fetoprotein; ALT, alanine aminotransferase; AST, aspartate aminotransferase; γ-GT, gamma-glutamyltransferase; APR, albumin-to-prealbumin ratio, the APR was estimated as the albumin divided by the prealbumin. Abbreviations: RFA, radiofrequency ablation; MWA, microwave ablation; AHC, argon-helium cryoablation; HBV, hepatitis B virus; HCV, hepatitis C virus; ALD, alcohol liver disease; AFP, alpha-fetoprotein; ALT, alanine aminotransferase; AST, aspartate aminotransferase; γ-GT, gamma-glutamyltransferase; APR, albumin-to-prealbumin ratio, the APR was estimated as the albumin divided by the prealbumin.…”

Section: Discussionmentioning

confidence: 99%

<p>A Novel Scoring System for Patients with Recurrence of Hepatocellular Carcinoma After Undergoing Minimal Invasive Therapies</p>

Wang¹,

Ma²,

Li³

et al. 2019

CMAR

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Background: The higher recurrence rate of hepatocellular carcinoma (HCC) needs to be urgently controlled. However, definitive markers are lacking for patients with recurrence of HCC after undergoing minimal invasive therapies-local ablation combined with transcatheter arterial chemoembolization (TACE). Materials and methods: Demographic and clinicopathological data of 234 subjects receiving combined therapies as the initial treatment were retrospectively analyzed. Univariate and multivariate Cox regression analysis was used to assess independent risk factors of recurrence. Selected variables were divided into low-, intermediate-, and high-risk groups of recurrence according to the scores assigned to them based on their respective hazard ratio (HR) values. The area under the curve (AUC) was used to evaluate the predictive value of the scoring system. Cumulative recurrence-free survival (RFS) and overall survival rates were calculated by the Kaplan-Meier estimator. Finally, a correlation analysis was performed on demographic and clinical data among the three groups. Results: The AUC of predicting 1-, 2-, and 3-year recurrence rates was 0.680, 0.728, and 0.709, respectively. The cumulative RFS rate in the low-risk group at 1, 2, and 3 years after undergoing combined treatments was 4%, 12.2%, and 30.6%, while that in the intermediaterisk group and high-risk group was 23.4%, 51.6%, 60.0%, and 47.3%, 78.2%, 83.6%, respectively. Gamma-glutamyltransferase (γ-GT), blood urea nitrogen (BUN), and total cholesterol (TC) levels among the three groups were statistically different. Conclusion: The scoring system of the present study for patients with the recurrence of HCC after undergoing TACE combined with local ablation may help physicians make a reasonable clinical decision, providing ideal management for diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

<p>A Novel Scoring System for Patients with Recurrence of Hepatocellular Carcinoma After Undergoing Minimal Invasive Therapies</p>

Wang¹,

Ma²,

Li³

et al. 2019

CMAR

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“…HCC is the dominant form of primary liver cancer in patients with chronic liver disease and cirrhosis (2). Patients with early-stage HCC can be treated with surgery to remove part of the liver can undergo or transplantation, which contributes toward a 5-year survival rate of >70% (3). However, for the majority of patients with advanced-stage HCC whose disease is too advanced for them to undergo surgical treatment, the 5-year survival rate is extremely low at ~15% (4).…”

Section: Introductionmentioning

confidence: 99%

Resveratrol inhibited the progression of human hepatocellular carcinoma by inducing autophagy via regulating p53 and the phosphoinositide�3‑kinase/protein kinase�B pathway

2018

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Resveratrol, a natural product, has been revealed to exert antitumor effects in multiple types of tumors. However, the antitumor effects of resveratrol on hepatocellular carcinoma (HCC) and its potential underlying mechanisms have not yet been elucidated. The present study demonstrated that resveratrol inhibited viability, proliferation, invasion and migration of HCC cells significantly in a time‑ and dose‑dependent manner, indicating that resveratrol exerted antitumor effects in HCC. Furthermore, relative expression of autophagy‑related proteins Beclin1 and LC3 II/I ratio was increased while p62 expression was decreased by resveratrol treatment dose‑dependently. The LC3+ puncta formation, which represented autophagosome formation was also markedly dose‑dependently upregulated by resveratrol treatment, suggesting that resveratrol induced autophagy in HCC cells. In addition, treatment with autophagy inhibitor 3‑methyladenine (3‑MA) counteracted the inhibitory effect of resveratrol on HCC cell proliferation, invasion and migration, indicating that suppressing autophagy may hamper the antitumor effect of resveratrol in HCC. It was revealed that resveratrol upregulated the expression of p53 while decreasing the ratio of phosphorylated protein kinase B (p‑Akt)/Akt in HCC cells. Treatment with p53 inhibitor pifithrin‑α and Akt activator insulin‑like growth factor‑1 decreased the expression of Beclin1 while significantly promoting cell proliferation, invasion and migration compared with the resveratrol treatment group. Taken together, the results of the present study revealed that resveratrol inhibited the proliferation and mobility of HCC cells through inducing autophagy via activating p53 and inhibiting phosphoinositide 3‑kinase/Akt. Enhancing autophagy can augment the antitumor effects of resveratrol in HCC. Therefore, combining resveratrol with an autophagy inducer may be a viable option for treating HCC.

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“…Among the present 115 naïve HCC patients who had multiple countable tumors (≤5) and unmet needs, hepatic function in the Comb group was worse as compared to that in the SR group when assessed by ALBI grade (ALBI grade 1: 42.4 vs. 64.6%, p = 0.034) as well as Fib-4 index (6.30 ± 5.34 vs. 3.75 ± 2.10, p = 0.019), whereas OS and DFS rates were not significantly different between the groups. In previous studies, ALBI grade has shown better prognostic predictive value as compared to Child-Pugh class for various therapeutic modalities, including surgical resection [29, 30], RFA [31, 32], TACE [33], and sorafenib [28], as well as in ALBI-T [14] and mALBI-T [10, 11] scores as total scoring systems. Clinical unmet needs such as those seen in our patients might be resolved by complementary use of low invasive RFA in combination with resection.…”

Section: Discussionmentioning

confidence: 99%

Combination of Resection and Ablative Treatment for Hepatocellular Carcinoma: Usefulness of Complementary Radiofrequency Ablation

et al. 2019

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Aim/Background: In HCC patients with multiple tumors in separate segments, monotherapy with surgical resection is often difficult when the estimated residual liver volume after surgery is thought to be inadequate. We evaluated the usefulness of resection combined with low invasive radiofrequency ablation (RFA) for treatment of such cases. Materials/Methods: We analyzed 115 HCC patients with countable multiple tumors (≤5) without vascular invasion and/or extrahepatic metastasis, and treated solely with resection (SR group: n = 82), or with both resection and RFA (Comb group: n = 33) from January 2000 to December 2017. Clinical characteristics, overall survival rate (OSR), and disease-free survival rate (DFSR) were analyzed in a retrospective manner. Results: There were 88 males (76.5%) and the average age of all patients was 67.8 ± 8.9 years. The average number of tumors and average maximum tumor size were 2.4 ± 0.7 and 4.1 ± 2.1 cm, respectively. Forty-two (36.5%) patients were classified as beyond up-to-7 criteria. The 3- and 5-year OSRs in the SR group were 82.0 and 67.0%, respectively, and in the Comb group were 75.2 and 65.6%, respectively (p = 0.244), while the 3- and 5-year DFSRs in the SR group were 45.2 and 28.0%, respectively, and those in the Comb group were 37.3 and 23.3%, respectively (p = 0.257). Conclusion: The combination of surgical resection and complementary RFA may be an effective strategy for treating HCC patients with countable multiple tumors, who are otherwise difficult to treat with surgical resection or RFA alone.

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Liver Function Assessment Using Albumin–Bilirubin Grade for Patients with Very Early-Stage Hepatocellular Carcinoma Treated with Radiofrequency Ablation

Abstract: Among patients with very early-stage HCC treated with RF ablation, ALBI grade was a good stratifying biomarker. ALBI grade was better tool for assessing liver function than Child-Pugh score for very early-stage HCC treated with RF ablation.

Cited by 45 publications

References 26 publications

<p>A Novel Scoring System for Patients with Recurrence of Hepatocellular Carcinoma After Undergoing Minimal Invasive Therapies</p>

<p>A Novel Scoring System for Patients with Recurrence of Hepatocellular Carcinoma After Undergoing Minimal Invasive Therapies</p>

Resveratrol inhibited the progression of human hepatocellular carcinoma by inducing autophagy via regulating p53 and the phosphoinositide�3‑kinase/protein kinase�B pathway

Combination of Resection and Ablative Treatment for Hepatocellular Carcinoma: Usefulness of Complementary Radiofrequency Ablation

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