scholarly journals Critical evaluation of the prognostic relevance of complete pathologic response after neoadjuvant therapy in liver transplantation for hepatocellular carcinoma

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S795
Author(s):  
M. Grąt ◽  
M. Krawczyk ◽  
J. Stypułkowski ◽  
M. Morawski ◽  
M. Wasilewicz ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Neoadjuvant Therapy ◽  
Critical Evaluation ◽  
Pathologic Response ◽  
Complete Pathologic Response ◽  
Prognostic Relevance

Complete Pathologic Response to Pretransplant Locoregional Therapy for Hepatocellular Carcinoma Defines Cancer Cure After Liver Transplantation

2015 ◽  
Vol 262 (3) ◽  
pp. 536-545 ◽  
Author(s):  
Vatche G. Agopian ◽  
Maud M. Morshedi ◽  
Justin McWilliams ◽  
Michael P. Harlander-Locke ◽  
Daniela Markovic ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Pathologic Response ◽  
Locoregional Therapy ◽  
Complete Pathologic Response

scholarly journals Prognostic Relevance of a Complete Pathologic Response in Liver Transplantation for Hepatocellular Carcinoma

2019 ◽  
Vol 26 (13) ◽  
pp. 4556-4565 ◽  
Author(s):  
Michał Grąt ◽  
Marek Krawczyk ◽  
Jan Stypułkowski ◽  
Marcin Morawski ◽  
Maciej Krasnodębski ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Propensity Score ◽  
Neoadjuvant Treatment ◽  
Pathologic Response ◽  
Secondary Outcome ◽  
Complete Pathologic Response ◽  
Risk Of Recurrence ◽  
Increased Risk ◽  
Treatment Naïve

Abstract Background A complete pathologic response (CPR) after neoadjuvant treatment is reported to be associated with an exceptionally low risk of recurrence after liver transplantation for hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic role of CPR in liver transplantation for HCC. Methods This retrospective cohort study was based on 222 HCC transplant recipients. Incidence of recurrence and survival at 5 years were the primary and secondary outcome measures, respectively. Competing risk analyses were applied to evaluate recurrence incidence and its predictors. Propensity score matching was performed to compare the outcomes for patients after neoadjuvant treatment with and without CPR. Results Neoadjuvant treatment was performed for 127 patients, 32 of whom achieved CPR (25.2%). Comparison of baseline characteristics showed that the patients with CPR were at lowest baseline recurrence risk, followed by treatment-naïve patients and patients without CPR. Adjusted for potential confounders, CPR did not have any significant effects on tumor recurrence. No significant net reclassification improvement was noted after addition of CPR to existing criteria. Neoadjuvant treatment without CPR was associated with increased risk of recurrence in subgroups within the Milan criteria (p = 0.016), with alpha-fetoprotein concentration (AFP) model not exceeding 2 points (p = 0.021) and within the Warsaw criteria (p = 0.007) compared with treatment-naïve patients who were at risk similar to those with CPR. The 5-year incidences of recurrence in propensity score-matched patients with and without CPR were respectively 14.0% and 15.9% (p = 0.661), with corresponding survival rates of 73.2% and 67.4%, respectively (p = 0.329). Conclusions The findings showed that CPR is not independently associated with long-term outcomes after liver transplantation for HCC.

scholarly journals Pathologic validation of an yttrium-90 trans-arterial radioembolization dosimetry: a case report

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
Jacqueline B Baikovitz ◽  
Lindsay Thornton ◽  
Monica T Garcia-Buitrago ◽  
Alan S Livingstone ◽  
Matthew T Studenski ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Case Report ◽  
Liver Resection ◽  
Pathologic Response ◽  
Clinical Scenario ◽  
Complete Pathologic Response ◽  
Pathological Findings ◽  
Rigorous Approach ◽  
Yttrium 90

Abstract Yttrium-90 (Y-90) trans-arterial radioembolization (TARE) is used in the management of unresectable hepatocellular carcinoma (HCC). During the last 5 years, dosimetry software has been developed to allow for a more rigorous approach of dose prescription in Y-90 TARE. We present here a case study of a 77-year-old woman diagnosed with HCC, who underwent a Y-90 TARE as a bridge procedure to liver resection. This clinical scenario represents a unique opportunity to illustrate the predictive value of dosimetric findings correlating dosimetry with pathological findings. In this case, Y-90 TARE dosimetry was predictive of treatment response in which the tumor received a mean dose of 156 Gy and demonstrated a complete pathologic response.

Neoadjuvant Radiation Lobectomy and Immunotherapy for Angioinvasive Hepatocellular Carcinoma Resulting in Complete Pathologic Response

Hepatology ◽  
2020 ◽  
Author(s):  
Harris Liou ◽  
Kabir Mody ◽  
Ashton W. Boyle ◽  
Andrew P. Keaveny ◽  
Kristopher P. Croome ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Pathologic Response ◽  
Complete Pathologic Response

scholarly journals Neoadjuvant therapy with cisplatin in BRCA1-positive breast cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 502-502 ◽  
Author(s):  
J. Gronwald ◽  
T. Byrski ◽  
T. Huzarski ◽  
R. Dent ◽  
V. Bielicka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Brca1 Mutation ◽  
Complete Response ◽  
Pathologic Response ◽  
Complete Pathologic Response ◽  
Breast Cancer Patients ◽  
Platinum Based Chemotherapy

502 Background: Neoadjuvant chemotherapy is administered to control disease, make surgical resection possible and increase the possibility of breast tissue conservation. A further advantage of neoadjuvant therapy is that it helps to assess chemo-sensitivity to a particular agent. Induction of a pathological complete response (pCR) is one of the primary goals of neoadjuvant therapy in order to achieve a better disease-free and overall survival. Experimental data suggest that BRCA1 related breast cancer may have increased sensitivity to platinum-based chemotherapy, but clinical data are limited. The aim of this study was to evaluate the frequency of complete pathologic response after neo-adjuvant treatment with cisplatin chemotherapy in women with breast cancer and a BRCA1 mutation. Methods: Twenty five women with breast cancer and a BRCA1 mutation with stage I, II, and III breast cancer between December 2006 and December 2008 were entered into this study. Patients were treated with cisplatin 75 mg/m2 intravenously every three weeks for four cycles. After chemotherapy, patients underwent surgery and were assessed for pathologic response in both the breast and axillary lymph nodes. Complete pathologic response was defined as no residual invasive disease in both the breast and axilla, however ductal carcinoma in situ was allowed. Results: Twenty five patients were enrolled in the study. Thirteen patients had tumors of greater than two centimeters (52%) and seven patients had positive lymph nodes at diagnosis (28%). Twenty two patients completed four cycles of cisplatin (88%) and three patients completed two cycles (12%). Clinical complete response was observed in eighteen patients (72%). Pathologic complete response was observed in eighteen patients (72%). Conclusions: Platinum-based chemotherapy is effective in a high proportion of patients with BRCA1-associated breast cancers. Clinical trials are warranted to determine the optimum treatment for this subgroup of breast cancer patients. No significant financial relationships to disclose.

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