scholarly journals Role of Multidisciplinary Care in the Management of Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Kia Byrd ◽  
Saleh Alqahtani ◽  
Adam C. Yopp ◽  
Amit G. Singal
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Multidisciplinary Care ◽  
Multimodal Approach ◽  
Poor Survival ◽  
The Past ◽  
Different Types ◽  
Potential Structure

AbstractDespite advances in treatment options for hepatocellular carcinoma (HCC), 5-year survival for HCC remains below 20%. This poor survival is multifactorial but is partly related to underuse of curative treatment in clinical practice. In light of growing treatment options, delivered by different types of providers, optimal management requires input from multiple specialties. A multidisciplinary approach has been evolving over the past couple of decades, bringing different specialists together to develop a therapeutic plan to treat and manage HCC, which significantly increases timely guideline-concordant treatment and improves overall survival. The present review attempts to highlight the need for such a multimodal approach by providing insights on its potential structure and impact on the various aspects of HCC management.

scholarly journals JAK/STAT signaling in hepatocellular carcinoma

2020 ◽  
Vol 7 (1) ◽  
pp. HEP18 ◽  
Author(s):  
Justin Jit Hin Tang ◽  
Dexter Kai Hao Thng ◽  
Jhin Jieh Lim ◽  
Tan Boon Toh
Keyword(s):  
Hepatocellular Carcinoma ◽  
Target Genes ◽  
Treatment Options ◽  
Clinical Status ◽  
Immune Surveillance ◽  
Downstream Target ◽  
The Past ◽  
Liver Cancers ◽  
Stat Signaling

Liver cancer is the second most lethal cancer in the world with limited treatment options. Hepatocellular carcinoma (HCC), which accounts for more than 80% of all liver cancers, has had increasing global incidence over the past few years. There is an urgent need for novel and better therapeutic intervention for HCC patients. The JAK/STAT signaling pathway plays a multitude of important biological functions in both normal and malignant cells. In a subset of HCC, JAK/STAT signaling is aberrantly activated, leading to dysregulation of downstream target genes that controls survival, angiogenesis, stemness, immune surveillance, invasion and metastasis. In this review, we will focus on the role of JAK/STAT signaling in HCC and discuss the current clinical status of several JAK/STAT inhibitors.

scholarly journals Biological and Clinical Significance of the CCR5/CCL5 Axis in Hepatocellular Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 883 ◽  
Author(s):  
Santosh K. Singh ◽  
Manoj K. Mishra ◽  
Brian M. Rivers ◽  
Jennifer B. Gordetsky ◽  
Sejong Bae ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cell Proliferation ◽  
Clinical Significance ◽  
Treatment Options ◽  
Biological Significance ◽  
Improve Patient Survival ◽  
Cell Proliferation And Migration ◽  
And Migration ◽  
Proliferation And Migration

Despite the improvement in survival for patients with liver cancer (LCa) in recent decades, only one in five patients survive for 5 years after diagnosis. Thus, there is an urgent need to find new treatment options to improve patient survival. For various cancers, including LCa, the chemokine CCL5 (RANTES) facilitates tumor progression and metastasis. Since the function of the CCR5/CCL5 interaction in LCa cell proliferation and migration is poorly understood, the present study was undertaken to investigate the role of the CCR5/CCL5 axis in these processes. Flow cytometry, RT-PCR, Western blot, and immunofluorescence techniques were used to quantify the expression of CCR5 and CCL5 in LCa cells. To determine the biological significance of CCR5 expressed by LCa cell lines, a tissue microarray of LCas stained for CCR5 and CCL5 was analyzed. The results showed higher expression (p < 0.001) of CCR5 and CCL5 in hepatocellular carcinoma (HCC) tissues compared to non-neoplastic liver tissues. Furthermore, to delineate the role of the CCR5/CCL5 interaction in LCa cell proliferation and migration, various LCa cells were treated with maraviroc, a CCR5 antagonist, in the presence of CCL5. These data demonstrated the biological and clinical significance of the CCR5/CCL5 axis in LCa progression. The targeting of this axis is a promising avenue for the treatment of LCa.

Role of hepatologists in management of hepatocellular carcinoma in the new era of transplant oncology.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 501-501
Author(s):  
Divya Ashat ◽  
Mark Karwal ◽  
Shiliang Sun ◽  
Sandeep Laroia ◽  
Tomohiro Tanaka
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Complete Response ◽  
Meld Score ◽  
Locoregional Therapy ◽  
Direct Role ◽  
New Era ◽  
Tumor Boards ◽  
Median Diameter

501 Background: There have been global efforts to manage hepatobiliary malignancies such as hepatocellular carcinoma (HCC) in a multidisciplinary setting under the concept of transplant oncology. We published preliminary data of hepatology-directed treatment of HCC (Ann Hepatol 2019). However, the actual role of hepatologists in this setting is not well defined. Methods: We evaluated 107 patients with newly diagnosed HCC, undergoing locoregional therapy (LRT) as a first therapy (microwave ablation, TACE, TARE or SBRT) in our institution between 1/2017 to 2/2019 and being followed until 8/2019. Patients were divided into three groups based on referral pathways: outside referral directly to oncologists (O-group, n=24), internal referral from hepatologists to oncologists (H/O-group, n=62) and hepatologist directed HCC treatment (H-group, n=21). The hepatologist performed all microwave ablations in H-group; rest of the LRTs were performed by either interventional radiology or radiation oncology. Results: The baseline gender, etiology of liver disease, MELD score, Child-Pugh score, BCLC stage, CLIP score, AFP and proportion of patients within Milan criteria were similar between 3 groups ( p=n.s.). However, O-group included older patients (median 70 vs 63/62 y.o., p<0.01), and had larger HCC size (median diameter 41 vs 26/28mm, p<0.01). In H-group, there were more cases discussed in multidisciplinary tumor boards (77% vs 46%, p=0.012) and referrals for liver transplantation (71% versus 50%, p=0.046). Time between the diagnosis and the first procedure was shorter in H-group than others (median 53 vs 69 days, p=0.048). The rate of complete response/partial response per mRECIST criteria was highest in H-group (91 vs 66%, p=0.024). The 2-year cumulative survival was comparable among three groups (70, 74 and 76% in O-group, H/O-group and H-group, respectively, p=0.4). Conclusions: Hepatologists are often the first point of contact and can play a key (and even more direct) role in subsequent management of HCC. To further accomplish the concept of multidisciplinary approach and transplant oncology, primary/secondary care institutions might be a potential target for intervention for outreach.

On the Role of Characterization in the Design of Interfaces in Nanoscale Materials Technology

2004 ◽  
Vol 10 (3) ◽  
pp. 324-335 ◽  
Author(s):  
S.P. Ringer ◽  
K.R. Ratinac
Keyword(s):  
Three Dimensional ◽  
Atom Probe ◽  
Turbine Rotor ◽  
Clay Nanocomposites ◽  
Multimodal Approach ◽  
Transmission Electron ◽  
Different Types ◽  
And Control

This work reviews recent research on the design and control of interfaces in engineering nanomaterials. Four case studies are presented that demonstrate the power of a multimodal approach to the characterization of different types of interfaces. We have used a combination of conventional, high resolution, and analytical transmission electron microscopy, microbeam electron diffraction, and three-dimensional atom probe to study polymer–clay nanocomposites, turbine rotor steels used for power generation, multicomponent aluminum alloys, and nanocrystalline magnetic materials.

scholarly journals Role of antioxidants in the treatment of hepatocellular carcinoma: Integrative review

2021 ◽  
Vol 10 (1) ◽  
pp. e46310112028
Author(s):  
Claudriana Locatelli ◽  
Joyce Kelly Busolin Jardim ◽  
Vilmair Zancanaro
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radical Scavenging Activity ◽  
Treatment Options ◽  
Radical Scavenging ◽  
Integrative Review ◽  
Advanced Hepatocellular Carcinoma ◽  
Rate Dependent

Theorical framework: Hepatocellular carcinoma is a unique cancer that typically arises in the setting of chronic liver disease at a rate dependent upon the complex interplay between the host, disease, and environmental factors. Unfortunately, with contemporary management, patients with advanced hepatocellular carcinoma have few treatment options, and the prognosis is poor. Objective: Evaluate the role of antioxidants in the treatment of hepatocellular carcinoma. Methodology: It is an integrative review, with a qualitative approach. Based on research on ScienceDirect and PubMed databases, 12 articles were selected that were consistent with the theme and the inclusion and exclusion criteria, through the association of descriptors and keywords. Results: Studies in vivo demonstrated a positive correlation of antioxidants in the treatment of hepatocellular carcinoma. The antioxidants were able to promote inhibition of development tumor through promotes decrease of proinflammatory cytokines IL-1 and IL-6 and changes the ratios of Bax/Bcl2 that supports apoptosis. In oxidative stress, may be able to direct free radical scavenging activity. Among the main antioxidants with advanced preclinical evidence in the treatment of hepatocellular carcinoma is curcumin with tests in humans, and gallic acid, quercetin and resveratrol with several tests in vitro and in vivo. Conclusion: This study highlights that antioxidants can be a promising therapy in the treatment of hepatocellular carcinoma.

scholarly journals The journey of Claire in the works of Gaito Gazdanov: the analysis of the female image of Claire in the novels “An Evening with Claire”, “Hannah”, and “The Fate of Salome”

Litera ◽  
2021 ◽  
pp. 162-170
Author(s):  
Ziwei Zhu
Keyword(s):  
Real World ◽  
The Novel ◽  
The Past ◽  
Character Type ◽  
Female Image ◽  
Different Types ◽  
Inner World ◽  
New Perspective ◽  
Gradual Transformation

&nbsp; This article is dedicated to the analysis of the female image of Claire and its variant in the works of Gaito Gazdanov. This character type in the works of G. Gazdanov often resembles the past in the present, i.e. an important part of the &ldquo;lost world&rdquo; for the protagonist. However, deliberate examination allows following the gradual transformation of the authors attitude towards the character of Claire throughout his creative path. In the novel &ldquo;Ab Evening with Clair&rdquo;, the author adheres to priority of that past world over the present, while in the novel of his later period &ldquo;The Fate of Salome&rdquo;, the narrator tends to release from the shadow of the past. The underlying cause for such change lies in the transition of the writer from the romantic theurgical worldview towards phenomenal. In the later period, Gazdanov reconsidered the real world and justified the earthly existence due to the fact that submerging into the own inner world can entail loneliness and dissolution &ldquo;Self&rdquo; in one&rsquo;s mind. The goal of this research consists in tracing the transformation of the role of Claire in the works of Gaito Gazdanov, as well as in description of different types of relations between the protatonist and the heroine in order to prove the evolution of the writer's reasoning on the problem of &ldquo;two-worldness&rdquo;. The relevance of this article consists in explication of the type of Claire in Gazdanov&rsquo;s artistic system of &ldquo;two-worldness&rdquo; as a literary technique, as well as from the new perspective of studying the evolution the writer&rsquo;s worldview. &nbsp;

scholarly journals The Role of Public-Private Partnerships in Higher Education How Tertiary Institutions in emerging Economies benefit from Public-Private Partnerships

2017 ◽  
Vol 2 (1) ◽  
pp. 1-7
Author(s):  
Ronak Warasthe
Keyword(s):  
Higher Education ◽  
Emerging Economies ◽  
Tertiary Education ◽  
Added Value ◽  
Public Private Partnerships ◽  
Tertiary Institutions ◽  
The Past ◽  
Different Types ◽  
Insight Into

Abstract The number of Public-Private Partnerships in the education sector is growing in developing and emerging economies. Traditionally governments are the main financial contributor to education however, the involvement of the private sector is an increasing one. While more established in primary and secondary education, PPPs in tertiary education are a phenomenon rather slowly growing in the past decades (Patrinos, Barrera-Osorio, & Guaqueta, 2009). There are various concepts of PPPs in higher education each targeting different goals. In order to give an insight into different types of PPPs, the typology according to Mabizela has been briefly displayed and the case of a PPP in Namibia is given. The framework of the partnership was compiled to give an outlook on the practicability of partnerships. The paper exemplifies that both partners within a PPP can benefit from the added value they may generate for their target group. Thus, the benefit depends on quality, relevance and execution of the partnership.

Plasma Osteopontin Level as a Diagnostic Marker of Hepatocellular Carcinoma in Patients with Radiological Evidence of Focal Hepatic Lesions

2013 ◽  
Vol 99 (1) ◽  
pp. 100-107 ◽  
Author(s):  
Ashraf Khalil ◽  
Jamalat Elgedawy ◽  
Mohammed F Faramawi ◽  
Ashraf Elfert ◽  
Ibrahim Salama ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Malignant Tumors ◽  
Treatment Options ◽  
Alpha Fetoprotein ◽  
Egyptian Patients ◽  
Diagnostic Role ◽  
Focal Hepatic Lesions ◽  
Serum Alpha Fetoprotein ◽  
Hepatic Lesions

Aims Hepatocellular carcinoma is one of the most aggressive malignant tumors and has limited treatment options. Needle-guided biopsies have been utilized as a tool to diagnose malignant focal hepatic lesions. These techniques are discouraged because of their complications. Nowadays, alpha fetoprotein is the most widely used tumor marker for screening and diagnosis of hepatocellular carcinoma. Nevertheless, this marker has limitations. The diagnostic role of plasma osteopontin as an adjuvant or alternative marker to alpha fetoprotein to detect hepatocellular carcinoma in Egyptian patients with focal hepatic lesions was evaluated in this study. Subject and methods Eighty participants were recruited from the Egyptian National Liver Institute and were self-assigned to three groups, namely, focal hepatic lesions (n = 40), liver cirrhosis (n = 20), and controls (n = 20). Participants' plasma osteopontin and serum alpha fetoprotein levels were determined and were compared across the three groups. Results The discriminatory ability of plasma osteopontin for hepatocellular carcinoma was lower than that of alpha fetoprotein. Osteopontin and alpha fetoprotein were not correlated with each other. Neither the gender nor the age of the patients showed a significant association with plasma osteopontin level. Conclusion Measuring plasma osteopontin level alone has no advantage over serum alpha fetoprotein in patients with focal hepatic lesions due to chronic liver disease.

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