Liver Tumor Microenvironment

Tsilimigras, Diamantis I.; Ntanasis‐Stathopoulos, Ioannis; Moris, Demetrios; Pawlik, Timothy M.

doi:10.1007/978-3-030-59038-3_14

Cited by 11 publications

(14 citation statements)

References 122 publications

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“…26 Hypoxia may induce genomic instability and alter DNA damage pathways, resulting in increased tumor resistance to treatment and, in turn, poor outcomes. 25 In line with these findings, individuals with tumor necrosis experienced worse RFS and OS compared with individuals without histologic necrosis. In particular, patients with tumor necrosis were more likely to have simultaneous intra-and extrahepatic recurrence, as well as very early recurrence following ICC resection, which has been associated with a median survival of 13.8 months.…”

Section: Discussionsupporting

confidence: 57%

“…Tumor necrosis attenuates local and systemic inflammatory response, remodeling the tumor microenvironment to promote immune evasion. 24,25 Tumor necrosis might also interfere with the process of neo-angiogenesis in cancer, providing routes for tumor cells to disseminate. 26 Hypoxia may induce genomic instability and alter DNA damage pathways, resulting in increased tumor resistance to treatment and, in turn, poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Tumor Necrosis Impacts Prognosis of Patients Undergoing Resection for T1 Intrahepatic Cholangiocarcinoma

et al. 2022

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Background. The prognostic impact of tumor necrosis among patients undergoing resection for intrahepatic cholangiocarcinoma (ICC) remains ill-defined. Methods. Patients who underwent curative-intent resection for ICC between 2000 and 2017 were identified using a multi-institutional database. The association of pathologic tumor necrosis with overall survival (OS) and recurrence-free survival (RFS) was examined.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Tumor Necrosis Impacts Prognosis of Patients Undergoing Resection for T1 Intrahepatic Cholangiocarcinoma

et al. 2022

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“…Even though primary site resection isn't curative, it slows disease spread and prevents complications such as small bowel obstruction. Furthermore, liver de-bulking surgery in these patients increased pooled 5-year overall survival from 36.6% to 73.1%, compared to resection of the primary tumour alone 17 . Techniques such as thermal ablation can treat metastatic sites while sparing liver parenchyma, preventing post-operative liver failure caused by excessive resection.…”

Section: The Resection Of Both the Primary Tumour And Liver Metastase...mentioning

confidence: 89%

“…This raises the question: is resection of both the primary tumour site and liver metastases justified in these patients? A systematic review by Tsilimigras et al found that in patients with SBNETs and unresectable liver metastases, resection of the primary tumour was associated with a decreased risk of death at 5 years (Hazard Ratio = 0.36) 17 . Even though primary site resection isn't curative, it slows disease spread and prevents complications such as small bowel obstruction.…”

Section: The Resection Of Both the Primary Tumour And Liver Metastase...mentioning

confidence: 99%

Advances in the diagnosis and management of small bowel neuroendocrine tumours

Nezhentsev

2022

JNDS

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Small bowel neuroendocrine tumours (SBNETs) are neoplasms arising from the neuroendocrine cells of the small intestine. SBNETs are the most common tumours of the small bowel. Their often unspecific symptoms mean that many patients present late with metastatic disease, most commonly to local lymph nodes, small bowel mesentery, and the liver. Although Somatostatin Analogues (SSAs) can relieve symptoms and slow disease progression, surgical resection remains the only curative option. In this case report, a patient undergoes surgical resection of her primary SBNET and several liver metastases. During the operation it becomes apparent that much of the metastatic liver spread is unresectable, and the aim of the surgery becomes tumour de-bulking. This report reveals the limitations of current SBNET imaging, biomarkers and surgical techniques, and explores recent advances.

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“…Risk factors are hepatitis C virus (HCV) and hepatitis B virus (HBV), infection, alcoholic liver disease, aflatoxins, non-alcoholic fatty liver disease (NAFLD), and steatohepatitis (NASH) [ 5 ]. Hepatocarcinogenesis is a long process in which multiple molecular mechanisms are implicated [ 4 , 6 , 7 , 8 , 9 , 10 ]. Although effective antiviral agents for HBV and HCV and effective preventive measures, such as vaccination at birth against HBV infection, are available, the incidence of HCC is increasing [ 11 ].…”

Section: Introductionmentioning

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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Liver Tumor Microenvironment

Cited by 11 publications

References 122 publications

Tumor Necrosis Impacts Prognosis of Patients Undergoing Resection for T1 Intrahepatic Cholangiocarcinoma

Tumor Necrosis Impacts Prognosis of Patients Undergoing Resection for T1 Intrahepatic Cholangiocarcinoma

Advances in the diagnosis and management of small bowel neuroendocrine tumours

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

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