scholarly journals Screening for Hepatocellular Carcinoma to Improve Cancer-Related Mortality: Looking Behind When We Should Be Looking Ahead

2019 ◽  
Vol 156 (4) ◽  
pp. 1215-1217 ◽  
Author(s):  
Neil Mehta ◽  
Alexander Monto ◽  
Francis Y. Yao
Keyword(s):  
Hepatocellular Carcinoma ◽  
Related Mortality

One- year mortality in patients with advanced hepatocellular carcinoma on immunotherapy: Prediction using machine learning models (Preprint)

2021 ◽  
Author(s):  
Thomas Ka-Luen Lui ◽  
Ka Shing, Michael Cheung ◽  
Wai Keung Leung
Keyword(s):  
Machine Learning ◽  
Hepatocellular Carcinoma ◽  
Characteristic Curve ◽  
False Negative ◽  
False Negative Rate ◽  
Absolute Error ◽  
Advanced Hepatocellular Carcinoma ◽  
Data Set ◽  
One Year ◽  
Related Mortality

BACKGROUND Immunotherapy is a new promising treatment for patients with advanced hepatocellular carcinoma (HCC), but is costly and potentially associated with considerable side effects. OBJECTIVE This study aimed to evaluate the role of machine learning (ML) models in predicting the one-year cancer-related mortality in advanced HCC patients treated with immunotherapy METHODS 395 HCC patients who had received immunotherapy (including nivolumab, pembrolizumab or ipilimumab) in 2014 - 2019 in Hong Kong were included. The whole data set were randomly divided into training (n=316) and validation (n=79) set. The data set, including 45 clinical variables, was used to construct six different ML models in predicting the risk of one-year mortality. The performances of ML models were measured by the area under receiver operating characteristic curve (AUC) and the mean absolute error (MAE) using calibration analysis. RESULTS The overall one-year cancer-related mortality was 51.1%. Of the six ML models, the random forest (RF) has the highest AUC of 0.93 (95%CI: 0.86-0.98), which was better than logistic regression (0.82, p=0.01) and XGBoost (0.86, p=0.04). RF also had the lowest false positive (6.7%) and false negative rate (2.8%). High baseline AFP, bilirubin and alkaline phosphatase were three common risk factors identified by all ML models. CONCLUSIONS ML models could predict one-year cancer-related mortality of HCC patients treated with immunotherapy, which may help to select patients who would most benefit from this new treatment option.

scholarly journals From bench to bed: the tumor immune microenvironment and current immunotherapeutic strategies for hepatocellular carcinoma

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Yaojie Fu ◽  
Shanshan Liu ◽  
Shan Zeng ◽  
Hong Shen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Small Cell Lung ◽  
Immune Microenvironment ◽  
Liver Malignancy ◽  
The Third ◽  
Clinical Investigations ◽  
Tumor Immune Microenvironment ◽  
Novel Strategy ◽  
Immunosuppressive Microenvironment ◽  
Related Mortality

Abstract Hepatocellular carcinoma (HCC) ranks the most common primary liver malignancy and the third leading cause of tumor-related mortality worldwide. Unfortunately, despite advances in HCC treatment, less than 40% of HCC patients are eligible for potentially curative therapies. Recently, cancer immunotherapy has emerged as one of the most promising approaches for cancer treatment. It has been proven therapeutically effective in many types of solid tumors, such as non-small cell lung cancer and melanoma. As an inflammation-associated tumor, it’s well-evidenced that the immunosuppressive microenvironment of HCC can promote immune tolerance and evasion by various mechanisms. Triggering more vigorous HCC-specific immune response represents a novel strategy for its management. Pre-clinical and clinical investigations have revealed that various immunotherapies might extend current options for needed HCC treatment. In this review, we provide the recent progress on HCC immunology from both basic and clinical perspectives, and discuss potential advances and challenges of immunotherapy in HCC.

scholarly journals Nucleos(t)ide analogues and Hepatitis B virus-related hepatocellular carcinoma: A literature review

2020 ◽  
Vol 28 ◽  
pp. 204020662092133 ◽  
Author(s):  
Mohamed A Abd El Aziz ◽  
Rodolfo Sacco ◽  
Antonio Facciorusso
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Literature Review ◽  
Nucleoside Analogues ◽  
B Virus ◽  
Effect Of Treatment ◽  
Related Mortality

Hepatitis B virus is mainly considered to cause hepatocellular carcinoma which is the fourth leading cause of cancer-related mortality worldwide. Treatment of Hepatitis B virus with nucleos(t)ide analogues can decrease the progression of the disease and subsequently decreases the incidence of hepatocellular carcinoma. In this review, we have discussed the different classes of nucleos(t)ide analogues used in the treatment of Hepatitis B virus and their relationship with the development of hepatocellular carcinoma. Furthermore, we discussed the effect of treatment of Hepatitis B virus with Nucleoside analogues (NAs) before, during and after surgery, chemoembolization, radiofrequency ablation, and chemotherapy for the treatment of hepatocellular carcinoma.

scholarly journals Hepatocellular carcinoma: epidemiology, screening, and assessment of hepatic reserve

2020 ◽  
Vol 27 (S3) ◽  
Author(s):  
J.M. Schwartz ◽  
S.Z. Frager
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumour Detection ◽  
Hepatic Reserve ◽  
Screening And Surveillance ◽  
Related Mortality

Hepatocellular carcinoma is a leading cause of cancer-related mortality worldwide. This review summarizes the epi­demiology, causes, and roles of screening and surveillance for early tumour detection. It also highlights the important role of assessment of hepatic reserve in consideration of appropriate staging and treatment.

scholarly journals Clinical Outcomes After Treatment With Direct Antiviral Agents: Beyond The Virological Response in Patients With Previous HCV-Related Decompensated Cirrhosis

2021 ◽  
Author(s):  
Georges-Philippe PAGEAUX ◽  
Clovis LUSIVIKA NZINGA ◽  
Nathalie GANNE ◽  
Didier SAMUEL ◽  
Céline DORIVAL ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Virological Response ◽  
Antiviral Agents ◽  
Multivariable Analysis ◽  
Decompensated Cirrhosis ◽  
All Cause Mortality ◽  
Clinical Benefits ◽  
Direct Antiviral Agents ◽  
Related Mortality

Abstract Background In HCV-infected patients with advanced liver disease, the direct antiviral agents (DAAS)-associated clinical benefits remain debated. We compared the clinical outcome of patients with a previous history of decompensated cirrhosis following treatment or not with DAAs from the French ANRS CO22 HEPATHER cohort. Methods We identified HCV patients who had experienced an episode of decompensated cirrhosis. Study outcomes were all-cause mortality, liver-related or non-liver-related deaths, hepatocellular carcinoma, liver transplantation. Secondary study outcomes were sustained virological response (SVR) and its clinical benefits Results 559 patients met the identification criteria, of which 483 received DAA and 76 remained untreated after inclusion in the cohort. The median follow-up time was 39·7 (IQR: 22·7–51) months. After adjustment for multivariate analysis, exposure to DAAs was associated with a decrease in all-cause mortality (HR 0·45, 95% CI 0·24–0·84, p = 0·01) and non-liver-related death (HR 0·26, 95% CI 0·08–0·82, p = 0·02), and was not associated with liver-related death, decrease in hepatocellular carcinoma and need for liver transplantation. The SVR was 88%. According to adjusted multivariable analysis, SVR achievement was associated with a decrease in all-cause mortality (HR 0·29, 95% CI 0·15–0·54, p < 0·0001), liver-related mortality (HR 0·40, 95% CI 0·17–0·96, p = 0·04), non-liver-related mortality (HR 0·17, 95% CI 0·06–0·49, p = 0.001), liver transplantation (HR 0·17, 95% CI 0·05–0·54, p = 0.003), and hepatocellular carcinoma (HR 0·52, 95% CI 0·29–0·93, p = 0·03). Conclusion Treatment with DAAS is associated with reduced risk for mortality. Thus, DAA treatment should be considered for any patient with HCV-related decompensated cirrhosis.

scholarly journals Spontaneous Regression of Advanced Hepatocellular Carcinoma

2020 ◽  
Vol 14 (3) ◽  
pp. 491-496
Author(s):  
Dhiraj J. Sonbare ◽  
Rupal Bandi ◽  
Vivek Sharma ◽  
Thomas Cacciarelli ◽  
Obaid S. Shaikh
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Invasion ◽  
Spontaneous Regression ◽  
Tumor Regression ◽  
Complete Regression ◽  
Advanced Hepatocellular Carcinoma ◽  
Specific Therapy ◽  
Therapeutic Implications ◽  
Spontaneous Tumor Regression ◽  
Related Mortality

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. The tumor carries poor prognosis with curative therapeutic options limited to surgical resection, tumor ablation, and liver transplantation. Rarely, there is spontaneous regression of the tumor. We describe the case of a 74-year-old male with cirrhosis from non-alcoholic steatohepatitis who developed advanced HCC that was associated with tumor invasion of the portal vein and marked elevation of serum alfa-fetoprotein level. The patient received no cancer-specific therapy. However, 1 year after the initial diagnosis, he was noted to have complete regression of the tumor. In this report, we discuss possible mechanisms of spontaneous tumor regression and its therapeutic implications.

scholarly journals Hepatocellular Carcinoma: Consensus, Controversies and Future Directions: A Report from the Canadian Association for the Study of the Liver Hepatocellular Carcinoma Meeting

2015 ◽  
Vol 29 (4) ◽  
pp. 178-184 ◽  
Author(s):  
Kelly Warren Burak ◽  
Morris Sherman
Keyword(s):  
Hepatocellular Carcinoma ◽  
North America ◽  
Consensus Conference ◽  
Future Directions ◽  
Diagnosis And Management ◽  
Canadian Association ◽  
Consensus Statements ◽  
Liver Hepatocellular Carcinoma ◽  
Related Mortality

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide and its incidence has rapidly increased in North America in recent years. Although there are many published guidelines to assist the clinician, there remain gaps in knowledge and areas of controversy surrounding the diagnosis and management of HCC. In February 2014, the Canadian Association for the Study of the Liver organized a one-day single-topic consensus conference on HCC. Herein, the authors present a summary of the topics covered and the result of voting on consensus statements presented at this meeting.

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