Recent advances in the surgical management of hepatocellular carcinoma

Glantzounis, Georgios K.; Karampa, Anastasia; Peristeri, Dimitra; Pappas-Gogos, George; Tepelenis, Kostas; Τζίμας, Πέτρος; Cyrochristos, D.

doi:10.20524/aog.2021.0632

Cited by 15 publications

(13 citation statements)

References 107 publications

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“…In the near future, there is a need to identify reliable prognostic markers to help us choose the best treatment option for each patient [ 62 ]. Furthermore, novel treatments such as immunotherapy and anti-angiogenetic therapy should have a role in the neo-adjuvant setting in choosing a radical surgical treatment (resection or transplantation) for the patients who respond well to the neo-adjuvant therapies.…”

Section: Discussionmentioning

confidence: 99%

“…The number of patients included is relatively low, in order to have a clear conclusion regarding predictive markers such as TBS or selection criteria for liver resection in BCLC B and C patients. Moreover, the percentage of laparoscopic liver resections in this study was low, and this is an area which requires improvement in the near future, as significant advances have taken place in the era of laparoscopic and robotic surgery in recent years and patients with HCC have a significant benefit in postoperative morbidity with these approaches [ 62 , 70 , 71 , 72 , 73 , 74 ].…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…To date, the most effective treatment for HCC is surgical resection, liver transplantation, or radiofrequency ablation for early and selected cases of intermediate stage HCC according to Barcelona Clinic Liver Cancer (BCLC) classification and treatment strategy criteria. Surgical management offers long-term survival with good quality of life [96,97]. However, the current therapeutic options regarding the advanced stage are multikinase inhibitors, such as sorafenib, regorafenib, or a combination of immunotherapy and anti-angiogenetic therapy, with expected survival ranging from 10 to 14 months [98].…”

Section: Autophagy Mechanism Involved In Hcc Therapy Resistancementioning

confidence: 99%

The Role of Macroautophagy and Chaperone-Mediated Autophagy in the Pathogenesis and Management of Hepatocellular Carcinoma

Karampa

Goussia

Glantzounis

et al. 2022

Cancers

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Hepatocarcinogenesis is a long process with a complex pathophysiology. The current therapeutic options for HCC management, during the advanced stage, provide short-term survival ranging from 10–14 months. Autophagy acts as a double-edged sword during this process. Recently, two main autophagic pathways have emerged to play critical roles during hepatic oncogenesis, macroautophagy and chaperone-mediated autophagy. Mounting evidence suggests that upregulation of macroautophagy plays a crucial role during the early stages of carcinogenesis as a tumor suppressor mechanism; however, it has been also implicated in later stages promoting survival of cancer cells. Nonetheless, chaperone-mediated autophagy has been elucidated as a tumor-promoting mechanism contributing to cancer cell survival. Moreover, the autophagy pathway seems to have a complex role during the metastatic stage, while induction of autophagy has been implicated as a potential mechanism of chemoresistance of HCC cells. The present review provides an update on the role of autophagy pathways in the development of HCC and data on how the modulation of the autophagic pathway could contribute to the most effective management of HCC.

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“…Fast pace advances in the field however are underway with MIS approach being successfully used for hepatectomies (even in cirrhotic patients), distal pancreatectomy, pancreaticoduodenectomy (PD), and in resection of complex perihilar cholangiocarcinomas in experienced centers. Robotic platforms offer the additional advantage of an endowrist with 7 degrees of freedom enabling easier access to postero-superior liver segments (like IVa, VII, VIII, I) and in hilar dissection although at a much higher cost [1].…”

Section: Expanding the Limits In Hpb Surgerymentioning

confidence: 99%

Hepato-pancreato-biliary (HPB) Surgery: Pushing the Boundaries with Technology

Tewari

2022

Indian J Surg

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Recent advances in the surgical management of hepatocellular carcinoma

Cited by 15 publications

References 107 publications

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

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

The Role of Macroautophagy and Chaperone-Mediated Autophagy in the Pathogenesis and Management of Hepatocellular Carcinoma

Hepato-pancreato-biliary (HPB) Surgery: Pushing the Boundaries with Technology

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