Undefined/non-malignant hepatic nodules are associated with early occurrence of HCC in DAA-treated patients with HCV-related cirrhosis

Sangiovanni, A.; Alimenti, Eleonora; Gattai, Riccardo; Filomia, Roberto; Parente, Elisabetta; Valenti, Luca; Marzi, Luca; Pellegatta, Gaia; Borgia, Guglielmo; Gambato, Martina; Terreni, N.; Serio, Ilaria; Belli, Luca; Oliveri, Filippo; Maimone, S.; Brunacci, Matteo; D’Ambrosio, Roberta; Forzenigo, L.V.; Russo, Francesco Paolo; Rumi, M.G.; Barone, M.; Fracanzani, Anna Ludovica; Raimondo, Giovanni; Giannini, Edoardo G.; Brunetto, M.R.; Villa, Erica; Biganzoli, Elia; Colombo, Massimo; Lampertico, Pietro

doi:10.1016/j.jhep.2020.03.030

Cited by 45 publications

(40 citation statements)

References 36 publications

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“…The risk of HCC in non-cirrhosis patients is low, however, those with a high Fibrosis-4 (Fib-4) score, which represents cirrhotic status, have higher risk and require strict care [57,58]. A higher incidence of early occurrence of HCC after DAA treatment in patients with cirrhosis complicating undefined/non-malignant hepatic nodules has also been reported, indicating a new risk factor for HCC [59].…”

Section: Hcv-related Chronic Hepatitis Recent Advances In the Managemmentioning

confidence: 99%

Oxidative Stress Management in Chronic Liver Diseases and Hepatocellular Carcinoma

et al. 2020

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Chronic viral hepatitis B and C and non-alcoholic fatty liver disease (NAFLD) have been widely acknowledged to be the leading causes of liver cirrhosis and hepatocellular carcinoma. As anti-viral treatment progresses, the impact of NAFLD is increasing. NAFLD can coexist with chronic viral hepatitis and exacerbate its progression. Oxidative stress has been recognized as a chronic liver disease progression-related and cancer-initiating stress response. However, there are still many unresolved issues concerning oxidative stress, such as the correlation between the natural history of the disease and promising treatment protocols. Recent findings indicate that oxidative stress is also an anti-cancer response that is necessary to kill cancer cells. Oxidative stress might therefore be a cancer-initiating response that should be down regulated in the pre-cancerous stage in patients with risk factors for cancer, while it is an anti-cancer cell response that should not be down regulated in the post-cancerous stage, especially in patients using anti-cancer agents. Antioxidant nutrients should be administered carefully according to the patients’ disease status. In this review, we will highlight these paradoxical effects of oxidative stress in chronic liver diseases, pre- and post-carcinogenesis.

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Section: Hcv-related Chronic Hepatitis Recent Advances In the Managemmentioning

confidence: 99%

Oxidative Stress Management in Chronic Liver Diseases and Hepatocellular Carcinoma

et al. 2020

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“…According to the findings of a study performed by Siano (2016), only certain amounts of synthetic estrogens in special circumstances can affect the liver (36). According to the findings of another study conducted by Sangiovanni et al (2020), hepatic dysfunction was observed in women using estrogen-containing steroids for contraceptive purposes (37). In the present study, the hydro-alcoholic extract of pumpkin seeds had no harmful effects on the hepatic tissues in the adult and immature experimental groups, while the estrogen levels significantly increased in the adult and immature experimental groups 3 and in the immature experimental group 2 in comparison with the control group.…”

Section: Discussionmentioning

confidence: 97%

Effects of Hydro-alcoholic Extract of Pumpkin Seeds on Oogenesis Pathway, Liver, and Kidney of Female Rats : The Effects of hydro-alcoholic extract of pumpkin

Jahromi

jahromi²

2020

ircmj

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Background and Objectives: Pumpkin seed extract can be a good alternative to hormone replacement therapy since it is rich in phytoestrogens. In this regard, the present research aimed to investigate the effect of hydro-alcoholic extract of pumpkin seeds on the oogenesis pathway, liver, and kidney of female rats. Materials and Methods: This experimental study was performed on 64 Wistar female rats (including 32 adults and 32 immature rats). The adult rats were randomly divided into three experimental and one control groups (n=8 per group). Moreover, the immature rats were allocated to groups in a similar manner. The experimental groups 1, 2, and 3 received a hydro-alcoholic extract of pumpkin seed in doses of 20, 50, 100 mg/kg, respectively, via intraperitoneal injection for 21 consecutive days. For the purposes of the study, blood samples were taken one day after the last injection to determine the serum levels of female hormones as well as renal and hepatic factors. The ovaries, livers, and kidneys of the rats were also separated for histological tests. Results: Based on the results, significant increases were observed in the bodyweight of all immature rats; estrogen levels in the adult experimental group 3 and immature experimental groups 2 and 3; progesterone and creatinine levels in the immature experimental group 3; aspartate aminotransferase, total protein, unstable angina (UA), and the renal diameter in the immature experimental groups 1 and 2; follicle-stimulating hormone in the adult experimental group 3 and the immature experimental groups 1 and 2; luteinizing hormone and Graafian follicles in the adult experimental group 3; and atretic follicles in the immature experimental group 1 and 3 (P<0.05). Moreover, significant decreases were observed in the alkaline phosphatase in the adult experimental group 3; total protein, UA, and renal diameter in the immature experimental group 3; diameters of proximal and distal tubule as well as Henle’s loop in all immature rats; diameter of glomerular in the immature experimental groups 1 and 2; diameter of the renal cortex, glomerular, and Bowman's capsule in the adult experimental groups 2 and 3; secondary follicles in the adult experimental group 1, immature experimental groups 1 and 3; and primitive and early follicles in all the adult rats, compared with the control group (P<0.05). Conclusion: Based on the findings, it can be concluded that the pumpkin seeds provide the nutritional needs of the body at the onset of sexual maturity, prepare the body for sexual maturity, and regulate female sex hormones without having adverse effects on the hepatic tissues. However, it must be noted that its consumption at the onset of sexual maturity requires dosage determination and further studies.

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“…Other reports from Conti et al in 2016 and Sangiovanni et al in 2020 demonstrated early and aggressive HCC recurrence (28.8% and 32%) after DAA therapy in those with prior resection or local ablation for HCC. 4 , 6 However, there were some limitations with these studies, including the small sample size, the variability of HCC treatment modalities, and immortal time bias.…”

Section: Discussionmentioning

confidence: 99%

Direct-Acting Antiviral Therapy in Liver Transplant Patients With Hepatocellular Carcinoma and Hepatitis C

Tse

Yang

Mousa

et al. 2020

Transplantation Direct

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Background: Direct-acting antivirals (DAA) are highly effective for the treatment of hepatitis C (HCV), although there are limited data on the safety and efficacy of DAA therapy in hepatitis C-positive individuals awaiting liver transplantation for hepatocellular carcinoma (HCC). Methods: We conducted a retrospective cohort study of HCV-positive patients who underwent liver transplantation for HCC at 3 liver transplant centers across the United States from 2014 to 2017 with follow-up to July 2018. Transplant recipients who received DAA before transplant were compared with those who did not (DAA naive) for posttransplant HCC recurrence rate, sustained virological response (SVR), allograft failure, and death using Kaplan-Meier analysis and Cox proportional hazard models. Results: A total of 171 HCV-HCC transplant recipients (99 pretransplant DAA; 72 DAA naive controls) were included, with a median follow-up of 24 months. The overall posttransplant HCC recurrence rate was 9% (15/171). Pretransplant DAA was not associated with HCC recurrence (5% versus 14%; P = 0.07), graft failure (7% versus 3%; P = 0.21), or death (12% versus 19%; P = 0.19) as compared with DAA naive patients. SVR rates were significantly lower (P < 0.01) with pretransplant DAA (75%, 39/52) than posttransplant DAA (97%, 59/61) therapies. Those who received pretransplant DAA and those who did not were not statistically different in age, gender, alpha fetal protein levels, model for end-stage liver disease scores, or transplant wait time. Conclusions: Pretransplant DAA for HCV was not associated with an increased risk of posttransplant HCC recurrence, though pretransplant DAA had lower efficacy than posttransplant DAA in HCV-HCC transplant recipients.

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Undefined/non-malignant hepatic nodules are associated with early occurrence of HCC in DAA-treated patients with HCV-related cirrhosis

Cited by 45 publications

References 36 publications

Oxidative Stress Management in Chronic Liver Diseases and Hepatocellular Carcinoma

Oxidative Stress Management in Chronic Liver Diseases and Hepatocellular Carcinoma

Effects of Hydro-alcoholic Extract of Pumpkin Seeds on Oogenesis Pathway, Liver, and Kidney of Female Rats : The Effects of hydro-alcoholic extract of pumpkin

Direct-Acting Antiviral Therapy in Liver Transplant Patients With Hepatocellular Carcinoma and Hepatitis C

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