Primary Liver Tumors: Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

Abstract Introduction. Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital. Methods. A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation. Results. The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases. Conclusions. The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.

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A Retrospective Study of Lenvatinib Monotherapy or Combined With Programmed Cell Death Protein 1 Antibody in the Treatment of Patients With Hepatocellular Carcinoma or Intrahepatic Cholangiocarcinoma in China

Frontiers in Oncology ◽

10.3389/fonc.2021.788635 ◽

2021 ◽

Vol 11 ◽

Author(s):

Sihui Zhu ◽

Chenxi Liu ◽

Yanbing Dong ◽

Jie Shao ◽

Baorui Liu ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Cell Death ◽

Liver Cancer ◽

Programmed Cell Death ◽

Intrahepatic Cholangiocarcinoma ◽

Real World ◽

Liver Tumors ◽

Chinese Patients ◽

First Line ◽

Cell Death Protein

Lenvatinib has been ratified as a first-line medication for advanced liver tumors by the American Food and Drug Administration. To assess the effectiveness and security of Lenvatinib in the Chinese population in a real-world setting, we enrolled 48 patients with unresectable liver cancer, managed from December 2018 to March 2021. Among them, 9 and 39 (83.30% men) patients had intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC), respectively. Twenty-one (43.75%) patients had progressive disease after first-line treatment, and others (56.25%) had not receiving systemic treatment. Lenvatinib was administered alone or in combination with a programmed cell death protein 1 antibody (anti-PD-1). Treatment duration, median progression-free survival (mPFS), and median overall survival (mOS) were examined. The mOS and mPFS were 22.43 and 8.93 months, respectively. Of HCC patients treated with Lenvatinib only, the mOS and mPFS were 22.43 and 11.60 months, respectively. The corresponding values for HCC cases managed with anti-PD-1 combined with Lenvatinib were 21.77 and 7.10 months, respectively. ICC patients did not reach the mOS and their mPFS was 8.63 months. The present findings support the efficacy and security of Lenvatinib in the real-world therapy of Chinese patients with unresectable liver cancer.

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Microwave ablation in the treatment of liver tumors. A better tool or simply more power?

Medical Ultrasonography ◽

10.11152/mu-2556 ◽

2020 ◽

Vol 22 (4) ◽

pp. 451

Author(s):

Zeno Sparchez ◽

Tudor Mocan ◽

Pompilia Radu ◽

Iuliana Nenu ◽

Mihai Comsa ◽

...

Keyword(s):

Colorectal Cancer ◽

Hepatocellular Carcinoma ◽

Liver Cancer ◽

Liver Metastases ◽

Intrahepatic Cholangiocarcinoma ◽

Thermal Ablation ◽

Microwave Ablation ◽

Liver Tumors ◽

Colorectal Cancer Liver Metastases ◽

Clinical Scenarios

It has been a long time since tumor ablation was first tested in patients with liver cancer, especially hepatocellular carcinoma. Since than it has become a first line treatment modality for hepatocellular carcinoma. Over the years, the indications of thermal ablation have expanded to colorectal cancer liver metastases and intrahepatic cholangiocarcinoma as well. Together with the new indication for ablation, new ablation devices have been developed as well. Among them microwave ablation shows potential in replacing radiofrequency ablation as the preferred method of thermal ablation in liver cancer. The debate whether radiofrequency or microwave ablation should be the preferred method of treatment in patients with liver cancer remains open. The main purpose of this review is to offer some answers to the question: Microwave ablation in liver tumors: a better tool or simply more power? Various clinical scenarios will be analyzed including small, medium, and intermediate size hepatocellular carcinoma, colorectal cancer liver metastases and intrahepatic cholangiocarcinoma. Furthermore, the advantages, limitations, and technical considerations of MWA treatment will be provided also.

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Labeling of Hinokitiol with 90Y for Potential Radionuclide Therapy of Hepatocellular Carcinoma

Processes ◽

10.3390/pr9060940 ◽

2021 ◽

Vol 9 (6) ◽

pp. 940

Author(s):

Christelle Bouvry ◽

Valérie Ardisson ◽

Nicolas Noiret ◽

Etienne Garin ◽

Nicolas Lepareur

Keyword(s):

Hepatocellular Carcinoma ◽

Radionuclide Therapy ◽

Liver Tumors ◽

Potential Treatment ◽

Primary Liver Tumors ◽

Transarterial Radioembolization ◽

The World ◽

Yttrium 90

Hepatocellular carcinoma (HCC), the most common form of primary liver tumors, is the fifth cancer in the world in terms of incidence, and third in terms of mortality. Despite significant advances in the treatment of HCC, its prognosis remains bleak. Transarterial radioembolization with radiolabeled microspheres and Lipiodol has demonstrated significant effectiveness. Here we present a new, simple radiolabeling of Lipiodol with Yttrium-90, for the potential treatment of HCC.

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HuR Protein in Hepatocellular Carcinoma: Implications in Development, Prognosis and Treatment

Biomedicines ◽

10.3390/biomedicines9020119 ◽

2021 ◽

Vol 9 (2) ◽

pp. 119

Author(s):

Vasiliki Papatheofani ◽

Georgia Levidou ◽

Panagiotis Sarantis ◽

Evangelos Koustas ◽

Michalis V. Karamouzis ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Tumors ◽

Normal Liver ◽

Primary Liver Tumors ◽

The Stability ◽

Hu Antigen R ◽

Post Transcriptional Regulation

Hu-antigen R (HuR) is a post-transcriptional regulator that belongs to the embryonic lethal abnormal vision Drosophila-like family (ELAV). HuR regulates the stability, translation, subcellular localization, and degradation of several target mRNAs, which are implicated in carcinogenesis and could affect therapeutic options. HuR protein is consistently highly expressed in hepatocellular carcinoma (HCC) compared to the adjacent normal liver tissue and is involved in the post-transcriptional regulation of various genes implicated in liver malignant transformation. Additionally, HuR protein seems to be a putative prognosticator in HCC, predicting worse survival. This review summarizes the recent evidence regarding the role of HuR in primary liver tumors, as presented in clinical studies, in vitro experiments and in vivo animal models. In conclusion, our review supports the consistent role of HuR protein in the development, prognosis, and treatment of HCC. Additional studies are expected to expand current information and exploit its putative employment as a future candidate for more personalized treatment in these tumors.

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Gene and protein expression of mTOR and LC3 in hepatocellular carcinoma, colorectal liver metastasis and “normal” liver tissues

PLoS ONE ◽

10.1371/journal.pone.0244356 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244356

Author(s):

Marina Bortolami ◽

Alessandra Comparato ◽

Clara Benna ◽

Andrea Errico ◽

Isacco Maretto ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Protein Expression ◽

Liver Tumors ◽

Statistical Tests ◽

Physiological Role ◽

Control Group ◽

Transcriptional Level ◽

Specific Marker ◽

Primary Liver Tumors ◽

Gene And Protein Expression

The physiological role of autophagy in the progression of liver diseases is still debated. To understand the clinical relevance of autophagy in primary e secondary hepatic tumors, we analyzed the expression of mTOR (mammalian target of rapamycin), a key regulator of autophagy; Raptor (regulatory-associated protein of mTOR); ULK1 (Unc-51 like kinase 1) determinant in the autophagy initiation; LC3 (microtubule-associated protein 1A/1B-light chain 3), a specific marker of autophagosomes; and p62, a selective autophagy receptor. Samples from subjects with chronic hepatitis (n.58), cirrhosis (n.12), hepatocellular carcinoma (HCC, n.56), metastases (n.48) from colorectal cancer and hyperplasia or gallbladder stones (n.7), the latter considered as controls, were examined. Gene expression analysis was carried out in n.213 tissues by absolute q-PCR, while protein expression by Western Blot in n.191 lysates, including tumoral, surrounding tumoral and normal tissues. Nonparametric statistical tests were used for comparing expression levels in the above-mentioned groups. Subgroup analysis was performed considering viral infection and chemotherapy treatment. The mTOR transcriptional level was significantly lower in metastases compared to HCC (P = 0.0001). p-mTOR(Ser2448) and LC3II/LC3I protein levels were significantly higher in metastases compared to HCC (P = 0.008 and P<0.0001, respectively). ULK(Ser757) levels were significantly higher in HCC compared to metastases (P = 0.0002) while the HCV- and HBV- related HCC showed the highest p62 levels. Chemotherapy induced a down-regulation of the p-mTOR(Ser2448) in metastases and in non-tumor surrounding tissues in treated patients compared to untreated (P = 0.001 and P = 0.005, respectively). Conclusions: the different expression of proteins considered, owning their interaction and diverse tissue microenvironment, indicate an impairment of the autophagy flux in primary liver tumors that is critical for the promotion of tumorigenesis process and a coexistence of autophagy inhibition and activation mechanisms in secondary liver tumors. Differences in mTOR and LC3 transcripts emerged in tumor-free tissues, therefore particular attention should be considered in selecting the control group.

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Metronomic chemotherapy for advanced diffuse hepatocellular carcinoma in a dog

Brazilian Journal of Veterinary Pathology ◽

10.24070/bjvp.1983-0246.v14i3p199-205 ◽

2021 ◽

Vol 14 (3) ◽

pp. 199-205

Author(s):

Paloma Silva ◽

◽

Mayara de Souza ◽

Ellen Cavalcanti ◽

Victoria Fonseca ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Palliative Care ◽

Liver Tumor ◽

Low Dose ◽

Standard Treatment ◽

Liver Tumors ◽

Metronomic Chemotherapy ◽

Presumptive Diagnosis ◽

Primary Liver Tumors ◽

Low Dose Naltrexone

Primary liver tumors represent 0.6% to 1.3% of neoplasms in dogs. Hepatocellular carcinoma (HCC) is the most common liver tumor. It is divided into three morphological groups: massive, nodular and diffuse. The presumptive diagnosis is made through imaging tests, such as ultrasound, although confirmation is made by histopathology. Surgery remains the treatment of choice for massive tumors, but there is no standard treatment for nodular and diffuse forms. This study aimed to report a case of prolonged survival in a dog with diffuse HCC, treated with metronomic chemotherapy and palliative care including non-steroidal anti-inflammatory and low-dose naltrexone.

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Prognostic factors of survival and comparison of surgically resected combined hepatocellular-cholangiocellular carcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma

10.32592/ircmj.2021.23.4.225 ◽

2021 ◽

Keyword(s):

Hepatocellular Carcinoma ◽

Vascular Invasion ◽

Perineural Invasion ◽

Liver Tumors ◽

Study Groups ◽

Histopathological Analysis ◽

Rare Type ◽

Primary Liver Tumors ◽

Tertiary Center ◽

Macroscopic Vascular Invasion

Background: Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) are the most common primary malignancies of the liver. The combined form of these two tumors (i.e., cHC-CC) is a considerably rare type of liver cancer displaying both malignant components. Methods: In this research, 53 patients were evaluated retrospectively, who had undergone an operation for primary liver tumors in a single tertiary center, in terms of demographics, operation, tumor features, histopathological analysis, and their relationship with survival. Results: The study groups consisted of 20 ( 37.7%) and 33 (62.3%) females and males, respectively, with a mean age of 62.3 years. It was revealed that the survival rate was significantly higher in HCC, compared to other groups (P<0.05). Moreover, alpha-fetoprotein (AFP) was significantly higher in the HCC group than in the ICC group, and carbohydrate antigen 19-9 levels and the presence of jaundice and perineural invasion were significantly higher in the ICC group, compared to HCC patients. In the HCC group, macroscopic vascular invasion, perineural invasion, and T staging were statistically significant. It was also found that in the ICC group, the macroscopic vascular invasion was statistically significant, and in the cHC-ICC group, the increased levels of AFP showed a statistically significant effect on survival (P<0.05). Conclusions: To the best of our knowledge, the current research was one of the very few studies performed focusing on each group of liver tumors in a single study. Based on the findings of this research, there were statistically significant results in all three groups and their comparison with each other.

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A rare case of adult hepatoblastoma mimicking hepatocellular carcinoma- case report and review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20171165 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1478

Author(s):

Digvijoy Sharma ◽

Nagari Bheerappa ◽

Venu Madhav Thumma ◽

Suryaramchandra Varma ◽

Kunduru Navakishore ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Tumors ◽

Primary Tumour ◽

Primary Liver Tumors ◽

Adult Age ◽

Right Lobe ◽

Triphasic Ct ◽

Malignant Liver ◽

The Right ◽

Operative Recovery

Hepatoblastoma (HB) is a rare malignant primary tumour of the liver and occurs mostly in the pediatric group within the first 3 years of life. It is extremely unusual to find hepatoblastoma in adults and is a very rare cause of primary malignant liver tumour in adults and due to this patient may be diagnosed at late stages of the disease at leading to poor prognosis in this group. Reported here a case of a 20-year-old boy with a large liver mass with abdominal pain. Triphasic CT revealed the presence of a large heterogenous tumor in the right lobe of liver suggestive of hepatocellular carcinoma. Patient underwent a right hepatectomy. Final histopathology was reported as Epithelial type hepatoblastoma. The patient had an uneventful post-operative recovery. We present this case for its rarity and ability to masquerade other primary liver tumors in the adult age as seen in our patient.

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