Hepatocellular carcinoma with extrahepatic metastasis: clinical features and prognostic factors.
Koji Uchino,Ryosuke Tateishi,Shuichiro Shiina,Miho Kanda,Ryota Masuzaki,Yuji Kondo,Tadashi Goto,Masao Omata,Haruhiko Yoshida,Kazuhiko Koike +9 more
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TLDR
The objective of this study was to further elucidate the clinical course and prognostic determinants of patients with hepatocellular carcinoma who have extrahepatic metastasis.Abstract:
BACKGROUND:
Despite significant advances in the treatment of intrahepatic lesions, the prognosis for patients with hepatocellular carcinoma (HCC) who have extrahepatic metastasis remains poor. The objective of this study was to further elucidate the clinical course and prognostic determinants of patients with this disease.
METHODS:
In total, 342 patients who had HCC with extrahepatic metastasis were enrolled. The metastases were diagnosed at initial presentation with HCC in 28 patients and during follow-up in the remaining patients. The authors analyzed clinical features, prognoses, and treatments and established a scoring system to predict prognosis using a split-sample method with a testing set and a training set.
RESULTS:
The most frequent site of extrahepatic metastasis was the lung followed by lymph nodes, bone, and adrenal glands. These metastases were related directly to death in only 23 patients (7.6%). The median survival after diagnosis of extrahepatic metastasis was 8.1 months (range, 0.03-108.7 months). In univariate analysis of the training set (n = 171), performance status, Child-Pugh classification, the number and size of intrahepatic lesions, macroscopic vascular invasion, symptomatic extrahepatic metastases, α-fetoprotein levels, and complete responses to treatment were associated significantly with prognosis. On the basis of multivariate analysis, a scoring system was developed to predict prognosis that assessed uncontrollable intrahepatic lesions, extent of vascular invasion, and performance status. This scoring system was validated in the testing set (n = 171) and produced a concordance index of 0.73.
CONCLUSIONS:
The controllability of intrahepatic lesions and performance status were identified as important prognostic factors in patients with advanced HCC who had extrahepatic metastasis. Cancer 2011. © 2011 American Cancer Society.read more
Citations
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Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial
Valérie Vilgrain,Valérie Vilgrain,Helena Pereira,Eric Assenat,Boris Guiu,Alina Diana Ilonca,Georges-Philippe Pageaux,Annie Sibert,Mohamed Bouattour,Rachida Lebtahi,Wassim Allaham,Hélène Barraud,Valérie Laurent,Elodie Mathias,Jean-Pierre Bronowicki,Jean-Pierre Tasu,Rémy Perdrisot,Christine Silvain,René Gerolami,Olivier Mundler,Jean-François Seitz,Vincent Vidal,Christophe Aubé,Frédéric Oberti,Olivier Couturier,Isabelle Brenot-Rossi,Jean-Luc Raoul,Anthony Sarran,Charlotte Costentin,Emmanuel Itti,Alain Luciani,Alain Luciani,René Adam,Maïté Lewin,Didier Samuel,Maxime Ronot,Maxime Ronot,Aurelia Dinut,Laurent Castera,Laurent Castera,Gilles Chatellier,Gilles Chatellier,Elisabeth Delhom Christol,Alina D. Ilonca,Julie Lonjon,Mohamed Abdel-Rehim,Arnaud Dieudonné,Christophe Bazin,Carine Chagneau-Derrode,Patrick Borentain,Antoine Bouvier,Laurent Vervueren,Julia Chalaye,Hicham Kobeiter,Julien Edeline,Etienne Garin,Yan Rolland,Isabelle Archambeaud,T. Eugène,Eric Frampas,Christophe Cassinotto,Martine Guyot,Jean-Baptiste Hiriart,Bruno Lapuyade,Julien Vergniol,Philippe Bachellier,Julien Detour,Bernard Duclos,Michel Greget,Francois Habersetzer,Alessio Imperiale,Philippe Merle,Agnès Rode,Julie Morvan,Eric Nguyen-Khac,Thierry Yzet,G. Baudin,Patrick Chevallier,Abakar Mahamat,Thierry Piche,Micheline Razzouk,Patrick Hillon,Romaric Loffroy,Michel Toubeau,Julie Vincent,Gabriele Barabino,Nadia Bouarioua,Muriel Cuilleron,Marie Ecochard,Nathalie Prevot-Bitot,Vincent Leroy,J. Roux,Christian Sengel,Valérie Bourcier,Nathalie Ganne-Carrié,Olivier Seror,Sylvie Costo,Thong Dao,Jean-Pierre Pelage,Jérôme Dumortier,Francesco Giammarile,Pierre-Jean Valette,Nadia Ghazzar,Olivier Pellerin,Julien Taieb,Pierre Weinmann,Alexandra Heurgue-Berlot,Claude Marcus,Daniele Sommacale,Maria-Angéla Castilla-Lièvre,Sophie Maitre,Lysiane Marthey +111 more
TL;DR: SarAH was a multicentre, open-label, randomised, controlled, investigator-initiated, phase 3 trial done at 25 centres specialising in liver diseases in France to compare the efficacy and safety of sorafenib to that of selective internal radiotherapy in patients with hepatocellular carcinoma.
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CD90+ liver cancer cells modulate endothelial cell phenotype through the release of exosomes containing H19 lncRNA
Alice Conigliaro,Viviana Costa,Alessia Lo Dico,Laura Saieva,Simona Buccheri,Francesco Dieli,Mauro Manno,Samuele Raccosta,Carmine Mancone,Marco Tripodi,Giacomo De Leo,Riccardo Alessandro,Riccardo Alessandro +12 more
TL;DR: A new exosome-mediated mechanism by which CSC-like CD90+ cells could influence their tumor microenvironment by promoting angiogenic phenotype and cell-to-cell adhesion is indicated.
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2018 Korean Liver Cancer Association-National Cancer Center Korea practice guidelines for the management of hepatocellular carcinoma
Joong-Won Park,June Sung Lee,Kyung-Suk Suh,Jin Wook Chung,Jinsil Seong,Do Young Kim,Ji-Hoon Kim,Hyeong Jun Kim,Hwi Young Kim,Soo-Young Park,Joo Hyeon Shim,Jeong Hoon Lee,Young-Suk Lim,Ho Yeong Lim,Jeong Won Jang,Jae Young Jang,Dae Won Jeon,Yang Seok Ko,Kyung Sik Kim,Dong-Sik Kim,Seong Hoon Kim,Jong Man Kim,Yeong Cheol Yun,Dong Hwan Jeong,Jai Young Cho,Young Hwan Koh,Kyeong Min Kim,So Yeon Kim,Young Hwan Kim,In Joon Lee,Jeong Min Lee,Hyeon Cheol Lim,Sung Ki Cho,Ho Jong Cheon,Jun Il Choi,Chul Seung Kay,Mi Sook Kim,Tae Hyun Kim,Hee Chul Park,Sun Hyeon Bae,Sang Min Yoon,Won Sup Yoon,Won Il Jang +42 more
TL;DR: New recommendations that integrate the most up-to-date research findings and expert opinions are developed that will provide useful and constructive advice for the clinical management of patients with HCC.
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Outcomes following definitive stereotactic body radiotherapy for patients with Child-Pugh B or C hepatocellular carcinoma.
Shaelyn Culleton,Shaelyn Culleton,Haiyan Jiang,Carol Haddad,Carol Haddad,John Kim,John Kim,J.D. Brierley,J.D. Brierley,Anthony Brade,Anthony Brade,Jolie Ringash,Jolie Ringash,Laura A. Dawson,Laura A. Dawson +14 more
TL;DR: SBRT is a treatment option for selected HCC patients with small HCCs and modestly impaired (CP B7) liver function and survival was significantly better in patients with CP=B7 and AFP≤4491 ng/mL.
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The Significance of Classifying Microvascular Invasion in Patients with Hepatocellular Carcinoma
Shuji Sumie,Osamu Nakashima,Koji Okuda,Ryoko Kuromatsu,Atsushi Kawaguchi,Masahito Nakano,Manabu Satani,Shingo Yamada,Shusuke Okamura,Maisa Hori,Tatsuyuki Kakuma,Takuji Torimura,Michio Sata +12 more
TL;DR: It is demonstrated that MVI classification can stratify HCC patients by different patterns of recurrence and risk of survival after curative resection, as well as as independent predictors of disease-specific survival.
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