scholarly journals Hepatoblastoma: current understanding, recent advances, and controversies

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 53 ◽  
Author(s):  
Piotr Czauderna ◽  
Hanna Garnier
Keyword(s):  
Preoperative Chemotherapy ◽  
Locally Advanced ◽  
Prognostic Significance ◽  
Surgical Techniques ◽  
Liver Neoplasm ◽  
Clinical Approach ◽  
Beta Catenin ◽  
Clinical Series ◽  
Malignant Liver

Introduction: Hepatoblastoma (HB) is the most common primary malignant liver neoplasm in children. Its increasing survival rate is related to the progress in modern imaging, surgical techniques, and new chemotherapy regimens. Clinical approach: One of the past achievements was the development of the pretreatment extension of disease (PRETEXT) system. Gradually, the HB therapeutic approach has become more individualized with better stratification of patients. Controversies: These include the need for preoperative chemotherapy and its optimal duration; intensity of preoperative chemotherapy required for locally advanced cases (PRETEXT 4); optimal surgical treatment for locally advanced tumors: aggressive hepatic resections versus liver transplantation; the role of postoperative chemotherapy in the post-transplant setting; the timing and role of metastasectomy in patients with disseminated disease who undergo partial liver resection; and the prognostic significance of several HB pathology variants. Hepatoblastoma biology: Beta-catenin mutations and the beta-catenin/Wnt pathway play an important role in HB development. There have been at least two molecular signatures in HB published. Unluckily, all of these findings are based on relatively small clinical series and require confirmation. Conclusion: The treatment of HB started from one and the same therapy for all patients and aimed at increased treatment individualization, but the future seems to lie in biology-driven patient-tailored therapies.

scholarly journals Surgical Treatment of Intrahepatic Cholangiocarcinoma: Current and Emerging Principles

2020 ◽  
Vol 10 (1) ◽  
pp. 104
Author(s):  
Eliza W. Beal ◽  
Jordan M. Cloyd ◽  
Timothy M. Pawlik
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Early Stage ◽  
Preoperative Evaluation ◽  
Locally Advanced ◽  
Surgical Techniques ◽  
Future Liver Remnant ◽  
Surgical Morbidity ◽  
Early Stage Disease ◽  
Liver Remnant

Intrahepatic cholangiocarcinoma (ICC) is a rare, aggressive cancer of the biliary tract. It often presents with locally advanced or metastatic disease, but for patients with early-stage disease, surgical resection with negative margins and portahepatis lymphadenectomy is the standard of care. Recent advancements in ICC include refinement of staging, improvement in liver-directed therapies, clarification of the role of adjuvant therapy based on new randomized controlled trials, and advances in minimally invasive liver surgery. In addition, improvements in neoadjuvant strategies and surgical techniques have enabled expanded surgical indications and reduced surgical morbidity and mortality. However, recurrence rates remain high and more effective systemic therapies are still necessary to improve recurrence-free and overall survival. In this review, we focus on current and emerging surgical principals for the management of ICC including preoperative evaluation, current indications for surgery, strategies for future liver remnant augmentation, technical principles, and the role of neoadjuvant and adjuvant therapies.

Combined Chemoradiation Therapy in the Treatment of Squamous Cell Carcinoma of the Head and Neck—An Evolving Paradigm

2013 ◽  
Vol 09 (02) ◽  
pp. 115
Author(s):  
Zachary S Morris ◽  
Pranshu Mohindra ◽  
Tim J Kruser ◽  
◽  
◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Surgical Techniques ◽  
Chemoradiation Therapy ◽  
Definitive Treatment ◽  
The Impact

Combined modality chemoradiation therapy is a standard-of-care treatment for locally advanced squamous cell carcinoma of the head and neck (SCCHN) and is recommended as an adjuvant treatment for certain patients with high-risk features on surgical pathology. In this article, we review the data from clinical trials that have established this role for chemoradiation therapy in the treatment of head and neck cancer, and discuss prior and ongoing studies that have investigated concurrent versus induction chemotherapy in the definitive treatment setting. We briefly review historical and ongoing studies that have explored the impact of radiotherapy fractionation on clinical outcome in patients treated with chemoradiation. Finally, we explore the emerging role of molecular-targeted agents in multimodality treatment approaches for SCCHN. In appropriately selected patients the demonstrable survival benefit of chemoradiation outweighs the risks for additional toxicities. Simultaneous advances in surgical techniques and increasing understanding of the role of viral etiologies pose a number of important questions regarding appropriate combination of multimodality therapy.

scholarly journals The Role of Exenterative Surgery in Advanced Urological Neoplasms

2020 ◽  
Vol 14 (2) ◽  
pp. 57-65
Author(s):  
Colla Cunneen ◽  
Michael Kelly ◽  
Gregory Nason ◽  
Eanna Ryan ◽  
Ben Creavin ◽  
...  
Keyword(s):  
Locally Advanced ◽  
Surgical Techniques ◽  
Life Outcomes ◽  
Extensive Resection ◽  
Pelvic Malignancies ◽  
Centralized Care ◽  
Urological Neoplasms ◽  
Exenterative Surgery

Pelvic exenterative surgery is both complex and challenging, especially in the setting of locally recurrent disease. In recent decades, improved surgical techniques have facilitated more extensive resection of both locally advanced and recurrent pelvic malignancies, but its role in urological cancer surgery is highly selective. However, it remains an important part of the armamentarium for the management of bladder and prostate cancer cases where there is local invasion into adjacent organs or localized recurrence. Better diagnostics, reconstructive options and centralized care have reduced associated morbidity considerably, and it is still used rarely in palliative settings. Despite this, there is sparse prospective evidence reporting on long-term oncological or quality of life outcomes.

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