Regression of fibrosis stage after treatment in patients with HFE haemochromatosis and severe fibrosis at diagnosis: relevance to hepatocellular carcinoma

2018 ◽  
Vol 68 ◽  
pp. S419
Author(s):  
E. Bardou-Jacquet ◽  
M. Emilie ◽  
A. Gregory ◽  
G. Ramm ◽  
L. Ramm ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Fibrosis Stage ◽  
Severe Fibrosis

scholarly journals Predictors of Developing Hepatocellular Carcinoma in Treated HCV-Carriers in Morocco according to University Hospital Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Younès Cherradi ◽  
Rajaa Afifi ◽  
Hanaa Benbrahim ◽  
Wafaa Essamri ◽  
Imane Benelbarhdadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Predictive Factors ◽  
Antiviral Treatment ◽  
Significant Risk ◽  
University Hospital ◽  
Advanced Age ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Severe Fibrosis

Introduction. Hepatitis C is the first major cause for HCC in Morocco. Antiviral treatment reduces the risk of developing HCC but few cases of HCC in HCV-treated patients were reported. We aimed to define this population’s features and to identify predictive factors of developing HCC. Patients and Methods. We included all HCV carriers who developed HCC after antiviral treatment from January 2002 to April 2010. We compare HCV-treated patients with no developed HCC to HCC population using khi-2 and Fisher Exact analysis. Results. 369 HVC-treated patients were considered, and 20 HCC were reported. The risk of HCC was not significant according to gender and genotypes (resp., P=0.63 and P=0.87). Advanced age and severe fibrosis were significant risk factors (resp., P=0.003 and P=0.0001). HCC was reported in 2.6% of sustained virological responders versus 12.5% of nonresponders (P=0.004). Conclusion. In our series, 5% of previously treated patients developed an HCC. Advanced age and severe fibrosis at HCV diagnosis are predictive factors of HCC occurrence. Sustained virological response reduces considerably the risk of HCC occurrence but screening is indicated even after SVR.

scholarly journals A novel, non-invasive model for diagnosing liver fibrosis stage in patients with hepatocellular carcinoma

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Gao-Xiong Ouyang ◽  
Yu-mei Zhang ◽  
Shao-Liang Zhu ◽  
Peng Wang ◽  
Yuan Ren ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Fibrosis ◽  
Fibrosis Stage ◽  
Non Invasive

scholarly journals Fibrosis Stage as a Predictor of Outcome after Resection for Hepatocellular Carcinoma

2019 ◽  
Vol 87 (12) ◽  
pp. 5201-5206
Author(s):  
MAHMOUD H. ALLAM, M.D.; MOHAMED A.S. KOHLA, M.D. ◽  
ALIAA SABRY, M.D.; OSAMA HIGAZY, M.D. ◽  
WALEED ABOGHARBIA, M.Sc.; ASHRAF ABOGABAL, M.D.
Keyword(s):  
Hepatocellular Carcinoma ◽  
Fibrosis Stage

scholarly journals Risk of hepatocellular carcinoma and fibrosis evolution in hepatitis C patients with severe fibrosis or cirrhosis treated with direct acting antiviral agents

2021 ◽  
Vol 84 (1) ◽  
pp. 25-32
Author(s):  
C Hamoir ◽  
Y Horsmans ◽  
P Stärkel ◽  
G Dahlqvist ◽  
S Negrin Dastis ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Incidence Rate ◽  
Cox Regression ◽  
Annual Incidence ◽  
Annual Incidence Rate ◽  
Factors Associated ◽  
Genotype 2 ◽  
Direct Acting ◽  
Severe Fibrosis

Background and study aims : Cirrhosis associated to chronic hepatitis C virus (HCV) is one of the leading cause of hepatocellular carcinoma (HCC). The goal of our study was to evaluate first the risk and determinants of HCC and second the evolution of fibrosis in patients treated for HCV with advanced fibrosis stages who achieved sustained virological response (SVR) after direct-acting antivirals (DAA) treatment. Patients and methods : We conducted a prospective study on HCV patients with F3 or F4 Metavir fibrosis scores treated with DAA between October 2014 and February 2017. The annual incidence rate for HCC was calculated. We used Cox regression model in order to identify factors associated with HCC. Transient elastography (TE) was performed 12 and 24 months after the end of DAA treatment and non-invasive liver fibrosis biomarkers were performed twice a year during follow-up. Results : 143 patients with severe fibrosis or cirrhosis were enrolled in the study. 6 patients developed HCC. The annual incidence rate of HCC in our cohort was 2.7 per 100 patients. Risk factors associated with HCC after DAA were genotype 2 and steatosis. Overall TE values significantly decreased after DAA treatment with a median value prior to treatment of 16.9 kPa to a median of 10.8 kPa 24 months after the end of the treatment. Biological fibrosis scores also significantly decreased following viral eradication. Conclusions : DAA treatment does not seem to be associated with HCC promotion after HCV eradication in patients with severe fibrosis stages. DAA-induced SVR is associated with a reduced estimation of fibrosis.

Radiofrequency Ablation Versus Stereotactic Body Radiotherapy for Localized Hepatocellular Carcinoma in Nonsurgically Managed Patients: Analysis of the National Cancer Database

2018 ◽  
Vol 36 (6) ◽  
pp. 600-608 ◽  
Author(s):  
Devalkumar J. Rajyaguru ◽  
Andrew J. Borgert ◽  
Angela L. Smith ◽  
Reggie M. Thomes ◽  
Patrick D. Conway ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Radiofrequency Ablation ◽  
Propensity Score ◽  
Stereotactic Body Radiotherapy ◽  
Stage I ◽  
National Cancer Database ◽  
Ablative Therapy ◽  
Local Ablative Therapy ◽  
Severe Fibrosis

Purpose Data that guide selection of optimal local ablative therapy for the management localized hepatocellular carcinoma (HCC) are lacking. Because there are limited prospective comparative data for these treatment modalities, we aimed to compare the effectiveness of radiofrequency ablation (RFA) versus stereotactic body radiotherapy (SBRT) by using the National Cancer Database. Methods We conducted an observational study to compare the effectiveness of RFA versus SBRT in nonsurgically managed patients with stage I or II HCC. Overall survival was compared by using propensity score–weighted and propensity score–matched analyses based on patient-, facility-, and tumor-level characteristics. A sensitivity analysis was performed to evaluate the effect of severe fibrosis/cirrhosis. In addition, we performed exploratory analyses to determine the effectiveness of RFA and SBRT in clinically relevant patient subsets. Results Overall, 3,684 (92.6%) and 296 (7.4%) nonsurgically managed patients with stage I or II HCC received RFA or SBRT, respectively. After propensity matching, 5-year overall survival was 29.8% (95% CI, 24.5% to 35.3%) in the RFA group versus 19.3% (95% CI, 13.5% to 25.9%) in the SBRT group ( P < .001). Inverse probability–weighted analysis yielded similar results. The benefit of RFA was consistent across all subgroups examined and was robust to the effects of severe fibrosis/cirrhosis. Conclusion Our study suggests that treatment with RFA yields superior survival compared with SBRT for nonsurgically managed patients with stage I or II HCC. Even though our results are limited by the biases related to the retrospective study design, we believe that, in the absence of a randomized clinical trial, our findings should be considered when recommending local ablative therapy for localized unresectable HCC.

scholarly journals Smad Phospho-Isoforms for Hepatocellular Carcinoma Risk Assessment in Patients with Nonalcoholic Steatohepatitis

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 286
Author(s):  
Kanehiko Suwa ◽  
Takashi Yamaguchi ◽  
Katsunori Yoshida ◽  
Miki Murata ◽  
Mayuko Ichimura ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Nonalcoholic Steatohepatitis ◽  
Transforming Growth Factor ◽  
Oncogenic Signaling ◽  
Domain Specific ◽  
Smad3 Phosphorylation ◽  
Carcinoma Risk ◽  
Severe Fibrosis

Nonalcoholic steatohepatitis (NASH)-related hepatocellular carcinoma (HCC) sometimes occurs in mildly fibrotic livers, while HCC incidence in NASH-related cirrhosis is lower than and less predictable than in hepatitis C virus (HCV)-related cirrhosis. Transforming growth factor (TGF)-β signaling in hepatocytic nuclei is implicated in fibrosis and carcinogenesis. TGF-βtype I receptor (TβRI) and c-Jun N-terminal kinase (JNK) differentially phosphorylate the mediator Smad3, resulting in 2 distinct phospho-isoforms: C-terminally phosphorylated Smad3 (pSmad3C) and linker-phosphorylated Smad3 (pSmad3L). In mature hepatocytes, oncogenic signaling via the JNK/pSmad3L pathway antagonizes signaling via the tumor-suppressive TβRI/pSmad3C pathway. We immunohistochemically examined domain-specific Smad3 phosphorylation in liver biopsy specimens from 30 NASH patients representing different fibrotic stages and 20 chronically infected hepatitis C patients as controls, correlating Smad3 phosphorylation with clinical course. HCC occurred during follow-up in 11 of 12 NASH patients with abundant pSmad3L and limited pSmad3C but in only 2 of 18 with limited pSmad3L. In contrast, HCC developed in 12 of 15 NASH patients with limited pSmad3C but only 1 of 15 with abundant pSmad3C. Two of fourteen NASH patients with mild fibrosis developed HCC, their hepatocytic nuclei showed abundant pSmad3L and limited pSmad3C. Five of sixteen patients with severe fibrosis did not develop HCC, their hepatocytic nuclei showed limited pSmad3L and abundant pSmad3C. Smad phospho-isoforms may represent important biomarkers predicting HCC in NASH and potential therapeutic targets for preventing NASH-related HCC.

scholarly journals 670Lifestyle risk factors for hepatocellular carcinoma in treated chronic hepatitis C patients

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Tomoka Matsuura ◽  
Satoko Ohfuji ◽  
Masaru Enomoto ◽  
Akihiro Tamori ◽  
Shoji Kubo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Duodenal Ulcer ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Medical Information ◽  
Antiviral Treatment ◽  
Chronic Hepatitis C Patients ◽  
Severe Fibrosis

Abstract Background The purpose of this study was to identify lifestyle risk factors, such as cigarette smoking and alcohol consumption, associated with the development of hepatocellular carcinoma (HCC) among chronic hepatitis C patients who have achieved a sustained virological response (SVR). Methods This cross-sectional study was conducted between 2014 and 2017 using self-administered questionnaires and medical information at two tertiary hospitals in Osaka, Japan. Study subjects were chronic hepatitis C patients who had achieved SVR following antiviral treatment that was completed more than 1 year earlier. A logistic regression model was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for post-SVR HCC. Results Of 202 participants, 18 had been diagnosed with post-SVR HCC. After considering potential confounders, former drinkers at the time of SVR (OR, 9.51; 95%CI, 1.08 to 83.90), and patients with a history of gastric or duodenal ulcer (OR, 4.14; 95%CI, 1.37 to 12.46) were significantly associated with HCC. Among patients with severe fibrosis, current smokers at the time of SVR had an increased OR for HCC compared with non-smokers, with marginal significance (OR, 5.61; 95%CI, 0.97 to 32.63). Conclusions In chronic hepatitis C patients with severe fibrosis, continued smoking could be a risk factor for post-SVR HCC. The relationship between gastric or duodenal ulcer history and post-SVR HCC should be investigated further. Key messages Smoking cessation may be preferred for chronic hepatitis C patients with severe fibrosis to prevent post-SVR HCC.

Simplified Staging for Hepatocellular Carcinoma

2002 ◽  
Vol 20 (6) ◽  
pp. 1527-1536 ◽  
Author(s):  
Jean-Nicolas Vauthey ◽  
Gregory Y. Lauwers ◽  
Nestor F. Esnaola ◽  
Kim-Anh Do ◽  
Jacques Belghiti ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Staging System ◽  
Microvascular Invasion ◽  
Multiple Tumors ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
Single Tumor ◽  
Severe Fibrosis

PURPOSE: The current American Joint Committee on Cancer (AJCC) staging system for hepatocellular carcinoma (HCC) fails to stratify patients adequately with respect to prognosis. PATIENTS AND METHODS: The ability of the currently proposed tumor (T) categories to effectively stratify the survival of 557 patients who underwent complete resection for HCC at four centers was examined. Independent predictors of survival were combined into a new staging system. RESULTS: Using the current AJCC T classification, patients with T1 and T2 tumors had similar 5-year survivals (P = .6). In addition, the survival of patients with multiple bilobar tumors (T4) matched that of T3 patients (P = .5). Independent predictors of death were major vascular invasion (P < .001), microvascular invasion (P = .001), severe fibrosis/cirrhosis of the host liver (P = .001), multiple tumors (P = .007), and tumor size greater than 5 cm (P = .01). Based on our results, a simplified stratification is proposed: (a) patients with a single tumor and no microvascular invasion, (b) patients with a single tumor and microvascular invasion or multiple tumors, none more than 5 cm, and (c) patients with either multiple tumors, any more than 5 cm, or tumor with major vascular invasion (P < .001). Severe fibrosis/cirrhosis had a negative impact on survival within all categories. The survival of patients with lymph node involvement matched that of patients with major vascular invasion (P = .3). CONCLUSION: The current AJCC staging system for HCC is unnecessarily complex. We propose a simplified model of stratification that is based on vascular invasion, tumor number, and tumor size and incorporates the effect of fibrosis on survival.

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