The Multidisciplinary Management of Hepatocellular Carcinoma

Salgia, Reena; Mendiratta, Vivek

doi:10.1002/cld.1068

Cited by 12 publications

(11 citation statements)

References 21 publications

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“…Although TACE is the recommended first-line therapy for patients with unresectable intermediate stage HCC (stage B), it has a poor long-term outcome with the reported five-year survival rates ranging from 1-8% (Bruix and Llovet, 2002;Kong et al, 2018;Salgia and Mendiratta, 2021). Given the extreme variability of patients' responses to TACE, it is important to find markers that allow for the identification of responders from non-responder patients to design better treatment strategies.…”

Section: Discussionmentioning

confidence: 99%

Possible Use of miR-223-3p as a Prognostic Marker in Transarterial Chemoembolization Treatment of Hepatocellular Carcinoma Patients

Abdelaziz

El-Guendy

Radwan

et al. 2022

Asian Pac J Cancer Prev

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Introduction and Objectives: Transcatheter chemoembolization (TACE) is the recommended therapy for intermediate stage hepatocellular carcinoma patients. Unfortunately, one of the main reasons for its failure is the emergence of multidrug resistance (MDR). Therefore, this study explored the possibility of using MDR-related miRNA as a response biomarker in HCC patients treated with doxorubicin drug-eluting bead TACE (DEB-TACE). Patients and Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to evaluate the expression level of 14 MDR-related miRNAs in doxorubicin-resistant HepG2 cells (HepG2/Dox) developed by single-dose of doxorubicin mimicking the situation of liver cells surviving TACE. The sera level of miR-223-3p, which was the most significantly downregulated in the HepG2 cells, was determined in 60 primary HCC patients undergoing TACE. Restoring miR-223-3p in HepG2/Dox cell line was achieved by its mimic transfection. Cell sensitivity was measured by SRB assay. Cell apoptosis and doxorubicin uptake were assessed by flow cytometry. The expression of miR-223-3p target protein, P-glycoprotein, was evaluated using qRT-PCR and western blotting. Results: We detected a significant downregulation of circulating miR-223-3p in patients non-responders to TACE treatment compared with responders. The expression of miR-223-3p was markedly decreased in resistant HepG2/Dox cells compared to the parental control. In addition, the expression of miR-223-3p was found to be inversely correlated with P-glycoprotein expression thus confirming the role of miR-223-3p in MDR. Furthermore, overexpression of miR-223-3p suppressed P-glycoprotein which promoted cellular uptake of doxorubicin and increased apoptosis. Conclusions: Our data suggest a potential role for miR-233-3p as a prognostic as well as a therapeutic target for HCC.

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Section: Discussionmentioning

confidence: 99%

Possible Use of miR-223-3p as a Prognostic Marker in Transarterial Chemoembolization Treatment of Hepatocellular Carcinoma Patients

Abdelaziz

El-Guendy

Radwan

et al. 2022

Asian Pac J Cancer Prev

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“…However, in our experience, it is not rare to find bile duct injury changes [Figure 3] manifesting in the late phase, probably due to chemical arteritis of the peribiliary capillary plexus induced by high chemotherapy drugs concentration. The finding of small cystic biliary dilatations, bilomas and portal vein branches narrowing at follow-up imaging should not be overlooked after TACE, even if asymptomatic [71] , and must prompt the IRs to avoid TACE repetition, in order to limit further parenchymal cirrhosis and serious complications such as liver abscess formation and portal vein thrombosis [72] .…”

Section: Safety and Efficacy Of Dsm-tace For Hccmentioning

confidence: 99%

Chemoembolization with Degradable Starch Microspheres (DSM-TACE): expanding indications in HCC multidisciplinary tumor board

Rozzanigo,

Gatti,

Luppi

et al. 2023

Hepatoma Res

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The role of transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) management has changed over the last twenty years. There has been a trend towards an overall decline in TACE procedures, but with a more aggressive approach, repeating multiple TACE sessions in case of tumor response. The survival of treated patients was prolonged because of better patient selection and advancements in TACE techniques aimed at preserving liver function. At present, TACE is approved by the International Guidelines also outside of the BCLC intermediate stage after evaluation of a multidisciplinary tumor board (MDTB), permitting a customized treatment for every patient. An alternative therapeutic strategy is represented by hepatic chemoembolization with Degradable Starch Microspheres (DSM-TACE), which is based on the chemotherapeutic effect rather than on the ischemic damage to the liver tumor, requiring multiple cycles of treatment. The higher safety profile of DSM-TACE has broadened the indications to patients waiting for liver transplantation (with bridging or downstaging intention), at high risk of liver failure and ineligible for systemic therapies. This review summarises the scientific publications supporting the use of DSM-TACE and illustrates its indications depending on the disease stage from the Interventional Radiologist’s perspective.

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“…A multidisciplinary approach to HCC diagnosis and management is associated with improved overall survival. 50,51 A recent systematic review and meta-analysis also demonstrated that multidisciplinary care is associated with a nonsignificant increase in receipt of curative treatment. 50 Curative therapies, including tumor resection, ablation (such as radiofrequency ablation [RFA] and microwave ablation [MWA]), and LT, are often limited by the extent of the tumor, considering factors such as size, location, multifocal nature, vascular invasion, and metastases.…”

Section: Staging and Prognosismentioning

confidence: 99%

Hepatocellular Carcinoma from a Hepatologist's Perspective

Roldan,

Blomker,

Aby

2023

Semin intervent Radiol

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Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, represents a growing health challenge worldwide. The incidence of HCC is rising, which, in turn, has led to a corresponding increase in the associated number of deaths. HCC will become the third leading cause of cancer-related deaths in the United States by 2030. HCC usually develops in the setting of chronic liver disease. Individuals at increased risk of HCC are recommended to undergo surveillance with ultrasound every 6 months along with serum α-fetoprotein testing. Computed tomography (CT) and magnetic resonance imaging (MRI) are considered alternatives based on specific patient factors. Lesions suspicious for HCC are recommended to undergo a diagnostic testing, which includes contrast-enhanced multiphase CT or MRI and liver biopsy when findings are indeterminate. The Barcelona Clinic Liver Cancer prognosis and treatment strategy is the most used assessment for patients with HCC (Fig. 2). Curative therapies include resection, liver transplantation, and ablation. Locoregional therapies, such as transarterial chemoembolization and radioembolization, can be used for patients with intermediate-stage HCC. For patients with advanced-stage HCC, systemic therapy is often used. This review aims to provide an overview of HCC from a hepatologist's perspective, including epidemiology, screening, surveillance, diagnosis, and management.

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The Multidisciplinary Management of Hepatocellular Carcinoma

Cited by 12 publications

References 21 publications

Possible Use of miR-223-3p as a Prognostic Marker in Transarterial Chemoembolization Treatment of Hepatocellular Carcinoma Patients

Possible Use of miR-223-3p as a Prognostic Marker in Transarterial Chemoembolization Treatment of Hepatocellular Carcinoma Patients

Chemoembolization with Degradable Starch Microspheres (DSM-TACE): expanding indications in HCC multidisciplinary tumor board

Hepatocellular Carcinoma from a Hepatologist's Perspective

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