Advanced radiotherapy technique in hepatocellular carcinoma with portal vein thrombosis: Feasibility and clinical outcomes

Background In Thailand, individuals with hepatocellular carcinoma (HCC) who develop portal vein tumor thrombosis (PVTT) have a restricted treatment option because to the extent of the disease, poor underlying liver function, and non-coverage of immuno/targeted therapy. Radiotherapy (RT) plays an increasingly important function in these patients. To investigate the feasibility, efficacy, and adverse event rates, we performed a retrospective analysis of patients with HCC with PVTT who underwent 3-dimensional conformal radiation (3DCRT), intensity-modulated radiation (IMRT), volumetric-modulated radiotherapy (VMAT), and stereotactic body radiotherapy (SBRT) in a single—institution. Objectives To examine clinical results in terms of overall survival (OS), local control (LC), response of primary tumor and PVTT, hepatic and gastrointestinal adverse reaction, and prognosis variables for OS and LC. Materials and methods Between July 2007 and August 2019, non-metastatic HCC with PVTT patients treated with RT were retrospectively reviewed and evaluated. Results The analysis included data from 160 patients. The mean age of the patients was 60.8 years ((95% CI 58.2–62.0). The median diameter of the tumor was 7.7 cm (range: 1–24.5). 85 (54.5%) individuals had PVTT in the main or first branch. At 1.8–10 Gy per fraction, the mean biologically effective dose (BED) as α/β ratio of 10 was 49.6 (95% CI 46.7–52.5) Gy10. The median survival time was 8.3 (95% CI 6.1–10.3) months. Survival rates at one and two years were 39.6% and 17.1%, respectively. Estimated incidence of local failure using competing risk analysis were 24% and 60% at 1 and 2 years, respectively. The overall response rate was 74%, with an 18.5 percent complete response rate. In multivariate analysis, tumor size, overall response, and radiation dose were all significant prognostic variables for OS. Hepatic unfavorable events of grade 3 and 4 were for 14.1% of the total. There was no occurrences of grade 3–4 gastrointestinal toxicity, either acute or late. Additionally, there were no treatment-related mortality. Conclusions Advanced RT is regarded as a safe and effective therapeutic option for HCC with PVTT. Overall survival was clearly related to tumor size, radiation dose, and tumor/PVTT response. Individuals with BED 56 Gy10 had significantly better overall survival than patients with BED 56 Gy10. A prospective randomized trial is required to validate these outcomes in order to corroborate these findings.

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First Analysis of a Phase II Study of Rituximab-Gemcitabine, Cyclophosphamide, Vincristine and Prednisolone (R-GCVP) for Diffuse Large B Cell Lymphoma (DLBCL) Patients Considered Unsuitable for Anthracycline Containing Chemo-Immunotherapy. An NCRI Lymphoma Clinical Studies Group Trial

Blood ◽

10.1182/blood.v118.21.1634.1634 ◽

2011 ◽

Vol 118 (21) ◽

pp. 1634-1634

Author(s):

Paul Fields ◽

Andrew Webb ◽

Christopher FE Pocock ◽

William Townsend ◽

Paul Smith ◽

...

Keyword(s):

Overall Survival ◽

Ejection Fraction ◽

Phase Ii ◽

Overall Response Rate ◽

Response Rate ◽

Progression Free Survival ◽

Free Survival ◽

Overall Response ◽

End Of Treatment ◽

Grade 3

Abstract Abstract 1634FN2 Introduction: The treatment of patients with DLBCL who are unsuitable for anthracycline containing chemotherapy remains a clinical challenge. Gemcitabine is a nucleoside analogue which has proven efficacy in the relapse setting in both non Hodgkin's and Hodgkin's lymphoma. We therefore developed a protocol incorporating Gemcitabine in a first line approach combined with CVP-R chemo-immunotherapy in DLBCL patients considered unfit for anthracycline containing chemotherapy. Methods: We performed a prospective, multicentre phase II trial in patients with DLCBL who were considered unfit for anthracycline containing chemo-immunotherapy. Eligibility criteria included ejection fraction < 50%, or ejection fraction ≥ 50% but with the presence of attendant significant co-morbidities (including: ischaemic heart disease, hypertension, diabetes mellitus), and ECOG PS 0–3. Patients received 6 cycles of Rituximab (375 mg/m2 IV D1), Cyclophosphamide (750mg/m2 IV D1), Vincristine (1.4 mg /m2 IV D1), Prednisolone (100mg, orally D1–5) and Gemcitabine IV D1 and D8. The Gemcitabine dose, if tolerated was sequentially escalated from 750mg/m2 in cycle 1 to 875mg/m2 in cycle 2 to 1000mg/m2 in cycle 3 with the dose maintained at 1000mg/m2 for cycles 4–6. Cycles were repeated every 21 days with growth factor support administered on day 9 of each cycle (pegfilgrastrim 6mg s/c).The primary endpoint was to achieve an overall response rate of > 40% assessed by CT scan at the end of treatment according to the Cheson criteria. Secondary endpoints were progression free survival and overall survival. Results: 62 patients were recruited from 32 UK sites over a 28 month period from April 2008 to July 2010. 66% were male. Median age was 76 years (range 52–90), 48 (77%) were > 70 years. 43 (69%) had stage III/IV disease and 46 (72%) had high – intermediate or high IPI (3–5) disease. ECOG performance status was ≥ 2 in 50% patients. Left ventricular ejection fraction (LVEF) was < 50% in 28 patients (45%). The 34 patients with LVEF ≥ 50% had significant co-morbidities, 22 (65%) had multiple co-morbidities. 44 (70%) received ≥ 3 cycles of treatment, reasons for early termination of treatment in the remaining 18 patients were progression (n=2), toxicity (n=5), death (n=6) patient choice (n=1) and other (n=4). 29 patients (47%) received the full 6 cycles. A total of 250 treatment cycles were delivered. Of the 44 patients who received ≥ 3 cycles of treatment, the dose of Gemcitabine was escalated to the full dose (1000mg/m2) in 67%. Day 8 Gemcitabine was delivered in 215/250 (86%) cycles of treatment. The overall response rate (CR/CRu/PR) at end of treatment for all 62 patients was 60%. For patients who received ≥ 3 cycles of treatment (n =44) the ORR was 79.5% at the end of treatment. There was no significant difference in ORR between those with LVEF <50% and those with LVEF ≥ 50% (71% vs 53%, p=0.155). At a median follow up of 18.2 months the 1 year progression free survival rate for all patients was 52.9% (95% CI 39.4–64.8). The 1 year overall survival (OS) rate is 62.4% (95% CI 48.5–73.6). For the group with LVEF <50% OS was 70.8% (95% CI: 48.4, 84.9) and LVEF group ≥ 50% OS was 55.9% (95% CI 37.1–71).Grade 3/4 haematological toxicity was observed in 54.1% patients. Grade 3/4 infection was observed in 24.6% of patients. The death rate observed related to infection for the whole cohort was 11%. Conclusion: This multicentre trial demonstrates that the R-GCVP regimen delivers excellent overall response rates with durable remissions in a group of patients where anthracycline use was precluded. The efficacy attained in this difficult group of patients provides a platform for testing the regimen in subsequent randomised phase II and phase III studies to confirm its efficacy. Disclosures: No relevant conflicts of interest to declare.

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Benefits of Local Treatment Including External Radiotherapy for Hepatocellular Carcinoma with Portal Invasion

Biology ◽

10.3390/biology10040326 ◽

2021 ◽

Vol 10 (4) ◽

pp. 326

Author(s):

Han Lee ◽

Sunmin Park ◽

Yeon Seo ◽

Won Yoon ◽

Chai Rim ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Portal Vein ◽

Local Treatment ◽

Best Supportive Care ◽

External Radiotherapy ◽

Pugh Class ◽

The Mean ◽

Extrahepatic Metastases ◽

One Year

We aimed to identify the oncologic benefits of local treatment including radiotherapy (LRT) in hepatocellular carcinoma (HCC) invading the portal vein. We used clinical data of patients with HCC invading the portal vein from 2008 to 2014 provided by 50 hospitals nationwide. A total of 1163 patients were included in the analysis. The LRT group was younger than the best supportive care (BSC) group (p < 0.001). The mean Child-Pugh score of the LRT group (6.1) was significantly lower than that of the BSC group (7.7) (p < 0.001). Propensity score-matched analysis generated 222 pairs. The median survival of all patients, LRT, and BSC groups were 5.0, 8.0, and 2.0 months, respectively. The overall survival (OS) rates in the LRT and BSC groups were 34.2% and 16.2% at one year, and 12.6% and 6.8% at two years, respectively (p < 0.001). Multivariate analysis showed that LRT (HR 0.41, 95% CI 0.32–0.52), age >60 years, extrahepatic metastases, tumor size ≥10 cm, and Child-Pugh class (CPC) B or C were independent predictors of higher mortality (all p < 0.05). Statistical differences in survival were maintained in all CPC-albumin-bilirubin classes (all p < 0.05). LRT was significant in patients with HCC with portal invasion, valid for patients with CPC A and B.

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Combination of trastuzumab, pertuzumab and docetaxel in patients with advanced non-small cell lung cancer (NSCLC) harboring HER2 mutation: Final results from the IFCT-1703 R2D2 trial.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.9015 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 9015-9015

Author(s):

Julien Mazieres ◽

Claire Lafitte ◽

Charles Ricordel ◽

Laurent Greillier ◽

Jean-Louis Pujol ◽

...

Keyword(s):

Brain Metastases ◽

Overall Response Rate ◽

Advanced Nsclc ◽

Response Rate ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Loading Dose ◽

Overall Response ◽

Grade 3 ◽

Exon 20

9015 Background: Human epidermal growth factor receptor 2 ( HER2) exon 20 insertions and mutations are oncogenic drivers found in 1-2% of NSCLC. However, there are no approved therapies for these patients. Many studies suggest that the use of HER2 inhibitors developed for breast cancer patients might be of interest in this setting. The aim of this trial was to prospectively evaluate the interest of a combination of two antibodies against HER2 (trastuzumab and pertuzumab) with docetaxel. Methods: IFCT-1703 R2D2 trial is a multicenter, non-randomized phase 2 study with a two-stage design, a power of 90% and an alpha risk at 5% (one-sided). HER2 mutational status was assessed locally in certified molecular genetic centers. Main other inclusion criteria were advanced NSCLC, progression after ≥ 1 platinum-based chemotherapy, asymptomatic brain metastases, left ventricular ejection fraction (LVEF) ≥ 50%, and PS 0-2. Patients were treated every 3 weeks with pertuzumab at a loading dose of 840 mg, and 420 mg thereafter; plus trastuzumab at a loading dose of 8 mg/kg and 6 mg/kg thereafter; and docetaxel at 75 mg/m². Treatment was given until toxicity or disease progression. The primary outcome was overall response rate (ORR). Other endpoints included duration of response, progression-free survival and safety. NCT number: NCT03845270. Results: From May 2019 to October 2020, 45 patients were enrolled in 17 centers and received study treatment. Median age was 64.5 years (range 31–84), 72% females, 35% smokers, 100% non-squamous histology and 15% with ECOG PS 2. 31.1% patients had brain metastases. PD-L1 was expressed ≥ 1% and ≥ 50% in 36% and 7% of the patients, respectively. No other oncogene driver was found associated with HER2 exon 20 mutation. With a median follow-up of 12 months, 44 (98%) patients were evaluable for the primary endpoint. Overall response rate was 29% (n = 13), stable disease 56% (n = 26). Median PFS was 6.8 months (95% CI[4.0-8.5]). Median duration of treatment in patients with confirmed response (n = 13) was 10 months (95% CI[2.7-14.9]). At the time of data cut-off, 15 patients (33%) were still under treatment. Grade 3/4 treatment-related adverse events (AEs) were observed in 64% of patients. No patient experienced treatment discontinuation because of toxicity. One sudden death was possibly related to treatment. Most frequent grade ≥ 3 AEs were neutropenia (33%), diarrhea (13%) and anaemia (9%). Grade 1/2 dyspnea was observed in 3 (6.7%) patients. No ILD were reported. Variation LVEF was -1.72% on average (min: -18 %; max: 10 %). Conclusions: The triplet trastuzumab, pertuzumab and docetaxel is feasible and active in HER2 pretreated advanced NSCLC. These results confirm the activity of HER2 antibodies-based strategy which should be considered in these patients. Clinical trial information: NCT03845270.

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Efficacy of bevacizumab and temozolomide therapy in locally advanced, recurrent, and metastatic malignant solitary fibrous tumour: A population-based analysis

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155218784760 ◽

2018 ◽

Vol 25 (6) ◽

pp. 1301-1304 ◽

Cited By ~ 3

Author(s):

Mário L de Lemos ◽

Isabell Kang ◽

Kimberly Schaff

Keyword(s):

Overall Survival ◽

Overall Response Rate ◽

Response Rate ◽

Locally Advanced ◽

Case Series ◽

Progression Free Survival ◽

Population Based ◽

Solitary Fibrous Tumour ◽

Free Survival ◽

Overall Response

Background Patients with locally advanced, recurrent or metastatic solitary fibrous tumour are often treated with bevacizumab and temozolomide based on the clinical efficacy reported in a case series of 14 patients. Given the rarity of solitary fibrous tumour, large trials are not feasible. We report the efficacy of this regimen based on a population-based analysis. Methods This was a population-based retrospective, multi-centre analysis using patient data from a provincial cancer registry and treatment database. Cases from June 2006 through October 2016 were identified for patients receiving bevacizumab and temozolomide for locally advanced, recurrent or metastatic solitary fibrous tumour or hemangiopericytoma, which is sometimes used to describe tumours arising from the meninges. The primary outcome was overall response rate. Secondary outcomes included time to response, progression free survival and overall survival estimated using the Kaplan–Meier method. Results Fourteen patients were identified: median age 59 (range 44–70), male 78.6%. Diagnoses were solitary fibrous tumour in 10 (71.4%) and hemangiopericytoma in four (28.6%), with metastatic disease in 10 (72.7%) patients. The most common primary sites were meninges in four (28.6%) and pelvis in three (21.4%) patients. The median follow-up was 15.5 months, with median treatment of four months. Overall response rate was 21.4% (no complete response, 3 partial response), with median time to response of four months. Median progression free survival, six-month progression free survival and overall survival were 17 months, 65.0%, and 45 months, respectively. Conclusions Efficacy of bevacizumab and temozolomide in solitary fibrous tumour appeared to be similar to that previously reported. Our findings confirmed that bevacizumab and temozolomide is an effective and tolerated treatment for this patient population.

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Sorafenib for the Treatment of Unresectable Hepatocellular Carcinoma: Preliminary Toxicity and Activity Data in Dogs

Cancers ◽

10.3390/cancers12051272 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1272 ◽

Cited By ~ 1

Author(s):

Laura Marconato ◽

Silvia Sabattini ◽

Giorgia Marisi ◽

Federica Rossi ◽

Vito Ferdinando Leone ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Safety Profile ◽

Median Overall Survival ◽

Response Rate ◽

Treatment Options ◽

Objective Response ◽

Metronomic Chemotherapy ◽

Time To Progression ◽

Activity Data

Unresectable nodular and diffuse hepatocellular carcinoma (HCC) have a poor prognosis with limited treatment options. Systemic traditional chemotherapy has been only rarely reported, with unsatisfactory results. The aim of this prospective, non-randomized, non-blinded, single center clinical trial was to investigate safety profile, objective response rate, time to progression and overall survival of sorafenib in comparison with metronomic chemotherapy (MC) consisting of thalidomide, piroxicam and cyclophosphamide in dogs with advanced, unresectable HCC. Between December 2011 and June 2017, 13 dogs were enrolled: seven received sorafenib, and six were treated with MC. Median time to progression was 363 days (95% CI, 191–535) in dogs treated with sorafenib versus 27 days (95% CI, 0–68) in dogs treated with MC (p = 0.044). Median overall survival was 361 days (95% CI, 0–909) in dogs receiving sorafenib, while 32 days (95% CI, 0–235) in those receiving MC (p = 0.079). Sorafenib seems to be a good candidate for the treatment of dogs with advanced HCC, due to a benefit in disease control and an acceptable safety profile, offering a good basis on which new randomized prospective clinical trials should be undertaken to compare the efficacy and drawback of sorafenib versus MC or traditional chemotherapy.

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Efficacy and Safety of Drug-Eluting Beads Transarterial Chemoembolization by CalliSpheres® in 275 Hepatocellular Carcinoma Patients: Results From the Chinese CalliSpheres® Transarterial Chemoembolization in Liver Cancer (CTILC) Study

Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics ◽

10.3727/096504019x15662966719585 ◽

2020 ◽

Vol 28 (1) ◽

pp. 75-94 ◽

Cited By ~ 2

Author(s):

Junhui Sun ◽

Guanhui Zhou ◽

Xiaoxi Xie ◽

Wenjiang Gu ◽

Jing Huang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cancer ◽

Portal Vein ◽

Treatment Response ◽

Transarterial Chemoembolization ◽

Efficacy And Safety ◽

Portal Vein Invasion ◽

Drug Eluting Beads ◽

Drug Eluting ◽

The Mean

The purpose of this study was to investigate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) treatment in Chinese hepatocellular carcinoma (HCC) patients and the prognostic factors for treatment response as well as survival. A total of 275 HCC patients were included in this prospective study. Treatment response was assessed by modified Response Evaluation Criteria in Solid Tumors (mRECIST), and progression-free survival (PFS) as well as overall survival (OS) were determined. Liver function and adverse events (AEs) were assessed before and after DEB-TACE operation. Complete response (CR), partial response (PR), and objective response rate (ORR) were 22.9%, 60.7%, and 83.6%, respectively. The mean PFS was 362 (95% CI: 34.9‐375) days, the 6-month PFS rate was 89.4 ± 2.1%, while the mean OS was 380 (95% CI: 370‐389) days, and the 6-month OS rate was 94.4 ± 1.7%. Multivariate logistic regression revealed that portal vein invasion (p = 0.011) was an independent predictor of worse clinical response. Portal vein invasion (p = 0.040), previous cTACE treatment (p = 0.030), as well as abnormal serum creatinine level (BCr) (p = 0.017) were independent factors that predicted worse ORR. In terms of survival, higher Barcelona Clinic Liver Cancer (BCLC) stage (p = 0.029) predicted for worse PFS, and abnormal albumin (ALB) (p = 0.011) and total serum bilirubin (TBIL) (p = 0.009) predicted for worse OS. The number of patients with abnormal albumin, total protein (TP), TBIL, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were augmented at 1 week posttreatment and were similar at 1‐3 months compared with baseline. The most common AEs were pain, fever, nausea, and vomiting, and no severe AEs were observed in this study. DEB-TACE was effective and tolerable in treating Chinese HCC patients, and portal vein invasion, previous cTACE treatment, abnormal BCr, ALB, and TBIL appear to be important factors that predict worse clinical outcome.

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Melflufen and Dexamethasone in Heavily Pretreated Relapsed and Refractory Multiple Myeloma

Journal of Clinical Oncology ◽

10.1200/jco.20.02259 ◽

2020 ◽

pp. JCO.20.02259

Author(s):

Paul G. Richardson ◽

Albert Oriol ◽

Alessandra Larocca ◽

Joan Bladé ◽

Michele Cavo ◽

...

Keyword(s):

Multiple Myeloma ◽

Overall Survival ◽

Overall Response Rate ◽

Response Rate ◽

Progression Free Survival ◽

Free Survival ◽

Duration Of Response ◽

Heavily Pretreated ◽

Grade 3

PURPOSE Melphalan flufenamide (melflufen) is a first-in-class peptide-drug conjugate that targets aminopeptidases and rapidly and selectively releases alkylating agents into tumor cells. The phase II HORIZON trial evaluated the efficacy of melflufen plus dexamethasone in relapsed and refractory multiple myeloma (RRMM), a population with an important unmet medical need. PATIENTS AND METHODS Patients with RRMM refractory to pomalidomide and/or an anti-CD38 monoclonal antibody received melflufen 40 mg intravenously on day 1 of each 28-day cycle plus once weekly oral dexamethasone at a dose of 40 mg (20 mg in patients older than 75 years). The primary end point was overall response rate (partial response or better) assessed by the investigator and confirmed by independent review. Secondary end points included duration of response, progression-free survival, overall survival, and safety. The primary analysis is complete with long-term follow-up ongoing. RESULTS Of 157 patients (median age 65 years; median five prior lines of therapy) enrolled and treated, 119 patients (76%) had triple-class–refractory disease, 55 (35%) had extramedullary disease, and 92 (59%) were refractory to previous alkylator therapy. The overall response rate was 29% in the all-treated population, with 26% in the triple-class–refractory population. In the all-treated population, median duration of response was 5.5 months, median progression-free survival was 4.2 months, and median overall survival was 11.6 months at a median follow-up of 14 months. Grade ≥ 3 treatment-emergent adverse events occurred in 96% of patients, most commonly neutropenia (79%), thrombocytopenia (76%), and anemia (43%). Pneumonia (10%) was the most common grade 3/4 nonhematologic event. Thrombocytopenia and bleeding (both grade 3/4 but fully reversible) occurred concomitantly in four patients. GI events, reported in 97 patients (62%), were predominantly grade 1/2 (93%); none were grade 4. CONCLUSION Melflufen plus dexamethasone showed clinically meaningful efficacy and a manageable safety profile in patients with heavily pretreated RRMM, including those with triple-class–refractory and extramedullary disease.

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PS01.135: PROGNOSTIC ANALYSIS OF TLE-CHEST SURGERY IN ESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.135 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 88-88

Author(s):

Renquan Zhang ◽

Yunlong Huang

Keyword(s):

Quality Of Life ◽

Overall Survival ◽

Esophageal Cancer ◽

Tumor Size ◽

Operative Time ◽

Ivor Lewis ◽

Total Operative Time ◽

Ivor Lewis Esophagectomy ◽

The Mean

Abstract Background Esophageal cancer was the ninth most common malignant tumor and ranked sixth for death globally, especially in developing country[1]. Standardized esophagectomy followed by chemotherapy or chemoradiotherapy remains the curative treatment for esophageal cancer[2]. Ivor Lewis esophageal resection, including two-stage approach for carcinoma of the middle third of the esophagus, was proposed in 1946[3]. Meanwhile, to avoid the risk of anastomotic leakage in Ivor Lewis surgery, three-stage approach with cervical anastomosis was introduced by McKeown[4]. However, considering the less complications of minimally invasive Ivor Lewis esophagectomy and the increased incidence of distal esophageal and gastroesophageal junction adenocarcinoma, two-stage approach with intrathoracic anastomosis was gaining more attention. Recent years, thoracoscopic laparoscopic esophagectomy with intrathoracic anastomosis (TLE-chest) has gradually become the mainstream approach of minimally invasive Ivor Lewis esophagectomy for the treatment of middle and lower esophageal cancers. In the previous study, we described the technique strategies of TLE-chest, which was featured with improved anastomosis layer by layer and embedding of the anastomosis with preserved mediastinal pleura[5]. In this study, we presented the perioperative data, complications and long-term survivals of TLE-chest in esophageal cancers. Methods The clinical data of 201 patients, who underwent TLE-chest for primary esophageal cancer in the First Affiliated Hospital of Anhui Medical University (FAHAMU) from November 2011 to December 2015, was analyzed retrospectively. Postoperative patients’ life quality by the European Organization into Research and Treatment of Cancer (EORTC) quality of life questionnaire for esophageal cancer and overall survivals were analyzed using Kaplan–Meier curve. The normal distribution of the measured data is expressed in terms of x ± s. Cox's hazard regression model was used for single factor and multi-factor analysis. Results Overall, 168 (83.6%) patients were males and 33 (16.4%) were females. The mean age of patients was 62.7 years old (range from 40 to 88). 150 (74.6%) patients’ tumors were located in the middle of esophagus, whereas 50 (24.9%) and 1 (0.5%) tumors were in the low and up. 194 (96.5%) esophageal tumors were confirmed as squamous carcinoma expect 7 (3.5%) adenocarcinomas. The mean of tumor size was 3.7 cm and the numbers of postoperative pathological TNM classification I, II, III and IV were 38 (18.9%), 72 (35.8%), 73 (36.3%) and 18 (9%) respectively. The average of total operation time was 293.9 min. Among them, the means of VATS and LS time were 156.9 min and 116.5 min respectively. The mean of intraoperative blood loss was 77.5 ml. The number of resected lymph nodes was 22.9 ± 9.7 (maximum: 58).7 (3.5%) patients suffered from anastomotic fistula, 5 (2.5%) patients occurred RRLN injury in lymph nodes dissection and 5 (2.5%) suffered chylothorax. Pulmonary complications were observed in 21 (10.4%) patients. Meanwhile, the rates of other complications containing anastomotic stenosis, bleeding and delayed gastric empty were 0.5% (1/201), 1.5% (3/201) and 0.5% (1/201) respectively. The score of quality of patients’ life was 85 ± 6.5. And at the 12 months, quality of life was improved by 4.1%. Until up to the 24 months, patients’ quality of life was recovered to 90 ± 7.5. The 1, 2 and 3 years overall survival of 100 patients was 94%, 79% and 74% respectively. Univariate analysis showed that the pT stage (P = 0.040), pN stage (P = 0.001), pTNM stage(P = 0.001) and Total operative time(P = 0.000) were associated with 3-year overall survival (3-OS). Further, multivariate analysis affirmed that the operative time (≥ 311 min), tumor size (≥ 3.5 cm) and pTNM stage were independent prognostic factors for 3-OS (P < 0.05). Conclusion TLE-chest surgery in esophageal cancer was safe and effective. And the total operative time, tumor size and TNM stage could be used as independent prognostic indicators in esophageal cancer patients after the TLE-chest. Disclosure All authors have declared no conflicts of interest.

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A Critical Role for ZDHHC2 in Metastasis and Recurrence in Human Hepatocellular Carcinoma

BioMed Research International ◽

10.1155/2014/832712 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 9

Author(s):

Chuanhui Peng ◽

Zhijun Zhang ◽

Jian Wu ◽

Zhen Lv ◽

Jie Tang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Portal Vein ◽

Tumor Size ◽

Chromosomal Region ◽

Critical Role ◽

Migration And Invasion ◽

Metastatic Recurrence ◽

Tumor Thrombi

It has been demonstrated that loss of heterozygosity (LOH) was frequently observed on chromosomes 8p22-p23 in hepatocellular carcinoma (HCC) and was associated with metastasis and prognosis of HCC. However, putative genes functioning on this chromosomal region remain unknown. In this study, we evaluated LOH status of four genes on 8p22-p23 (MCPH1, TUSC3, KIAA1456, and ZDHHC2). LOH on ZDHHC2 was associated with early metastatic recurrence of HCC following liver transplantation and was correlated with tumor size and portal vein tumor thrombi. Furthermore, our results indicate that ZDHHC2 expression was frequently decreased in HCC. Overexpression of ZDHHC2 could inhibit proliferation, migration, and invasion of HCC cell line Bel-7402in vitro. These results suggest an important role for ZDHHC2 as a tumor suppressor in metastasis and recurrence of HCC.

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Hepatocellular carcinoma with type II–III portal vein tumour thrombosis: treatment using transarterial chemoembolisation and microwave ablation

British Journal of Radiology ◽

10.1259/bjr.20200415 ◽

2021 ◽

Vol 94 (1117) ◽

pp. 20200415

Author(s):

Wen Peng Zhao ◽

Honglu Li ◽

Jiang Guo ◽

Liang Cai ◽

Youjia Duan ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Adverse Events ◽

Portal Vein ◽

Microwave Ablation ◽

Type Ii ◽

Time To Progression ◽

Treatment Alternative ◽

Transarterial Chemoembolisation ◽

Grade 3

Objective: To evaluate the use of transarterial chemoembolisation (TACE) combined with microwave ablation (MWA) to treat patients with hepatocellular carcinoma (HCC) and type Ⅱ–Ⅲ portal vein tumour thrombosis (PVTT) intolerant to targeted drug (TG) therapy. Methods: A total of 18 patients with HCC and type Ⅱ–Ⅲ PVTT intolerant to TG were enrolled between June 2015 and December 2019, who were treated with TACE + MWA (MWA group). 24 patients were treated with TACE + TG (TG group; control cohort). Time to progression and overall survival (OS) were analysed along with the incidence of adverse events. Results: The median follow-up time was 19.0 months (9.0–32.0 months). The median OS was 17.0 months (8.3–29.3 months; MWA group) and 13.5 months (5.5–22.5 months; TG group) and was not significantly different. The 1- and 2 year OS was also comparable (MWA group: 66.7%, 44.4% vs Target group: 41.7%, 29.2%). Time to progression showed no distinct differences (MWA group: 11.5 months; TG group: 9.0 months) between the two groups. Moreover, the incidence of major Grade 3–4 adverse events in the MWA group (5.6%) was similar to those in the TG group (8.3%). Conclusion: TACE + MWA and TACE + TG were comparable in their safety and efficacy in patients with HCC, type Ⅱ–Ⅲ PVTT, and intolerance to TG. Advances in knowledge: TACE + MWA can be used as a palliative treatment alternative for TACE + TG in patients with HCC, type Ⅱ–Ⅲ PVTT, and intolerance to TG.

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