scholarly journals The role of a multidisciplinary approach in the treatment of hepatocellular carcinoma

2020 ◽  
Vol 21 (4) ◽  
pp. 10-14
Author(s):  
Oleg I. Kit ◽  
Liubov Iu. Vladimirova ◽  
Anna E. Storozhakova ◽  
Tatiana A. Snezhko ◽  
Elena A. Kalabanova ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Practice ◽  
Targeted Therapy ◽  
Surgical Treatment ◽  
Viral Hepatitis ◽  
Multidisciplinary Approach ◽  
Local Treatment ◽  
Treatment Methods ◽  
Viral Hepatitis C ◽  
Advanced Stages

Aim. Evaluation of treatment options and efficacy in patients with hepatocellular carcinoma based on data from the FSBI Rostov Cancer Research Institute using a multidisciplinary approach to the problem. Materials and methods. 124 cases of hepatocellular carcinoma were analyzed. In 79.8% of patients (average age of 61.4 years) the disease was diagnosed at advanced stages (IIIIV). Antibodies to viral hepatitis B were detected in 18 (14.5%) patients, and antibodies to viral hepatitis C in 35 (28.2%) patients. Liver cirrhosis occurred in 38 (30.6%) cases, and ChildPugh class A in 20 (16.1%) cases. In the FSBI RCRI, a multidisciplinary approach has been introduced into clinical practice; decision on treatment tactics is made with a close cooperation of several specialists. The use of special treatment methods was available in 67 (54%) patients. 32 patients with Barcelona Clinic Liver Cancer (BCLC) stage A (early) or stage B (intermediate), had surgical treatment or hepatic arterial chemoembolization (HACE) with lipiodol or microspheres using various cytostatics (18 and 14 patients, respectively). 35 patients with advanced stage C were given a systemic therapy with various cytostatics (gemcitabine, oxaliplatin, doxorubicin) or targeted therapy with sorafenib. The treatment efficacy was assessed according to mRECIST. Results. The best median overall survival (OS) up to 21 months was in the group of patients (n=18) who underwent volume resection surgery. In this group, sorafenib was prescribed to 2 patients after surgery. When performing HACE, the median OS was 14.2 months. In 6 patients, HACE was performed 2 or more times. Among the 14 patients who had HACE, sorafenib was prescribed in 8 cases, and the median OS in this group was 16.3 months. 20 patients were given targeted therapy with sorafenib. Following 3 months of taking the drug, 16 patients achieved stabilization of the disease according to the mRECIST, in 1 patient a partial response, in 3 patients disease progression. Median OS was 9.1 months; progression-free survival among patients treated with sorafenib was 5.4 months. Conclusions. The use of a multidisciplinary approach in clinical practice makes it possible to choose the optimal treatment option for hepatocellular carcinoma and contributes to the improvement in OS. The combination of local treatment methods (surgical treatment, HACE) with effective drug therapy is the most optimal approach to treating patients with advanced stages of hepatocellular carcinoma.

scholarly journals EPIDEMIOLOGIC MANIFESTATIONS OF VIRAL HEPATITIS C IN REPRESENTATIVES OF CAUCASIAN AND MONGOLOID RACES

2016 ◽  
pp. 9-17 ◽  
Author(s):  
E. D. Savilov ◽  
S. I. Malov ◽  
I. V. Malov ◽  
D. .. Gantulga ◽  
I. A. Miroshnichenko ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Viral Hepatitis ◽  
Genotype 1 ◽  
Genotype 3 ◽  
Racial Origin ◽  
Virus Rna ◽  
Irkutsk Region ◽  
Viral Hepatitis C ◽  
Virus Genotypes

Aim. Present comparative epidemiologic characteristics of viral hepatitis C in Mongolia and Irkutsk Region taking into account racial origin of the studied populations. Materials and methods. The studies were carried out in 2009 - 2014 on the territory of Irkutsk Region and Mongolia. Prevalence of viral hepatitis C based on serological monitoring, virus RNA detection, risk factors, change in structure of circulating genotypes, hepatocellular carcinoma morbidity were studied. Results. Epidemiologic manifestations of viral hepatitis C in Mongolia, in contrast to Irkutsk Region, are characterized by a wider prevalence of the disease, predominance of the fraction of seropositive individuals in age category of above 50 years and predominance of genotype 1 virus in circulation. In recent years an evolution of diversity of circulating virus genotypes took place towards a reduction of the fraction of genotype 1 in Mongolia and Russia due to an increase of the fraction of genotype 3. Expressed differences in average-annual values of hepatocellular carcinoma morbidity were detected, that were more than 10 times higher among Mongoloids compared with Caucasians. Conclusion. Pronounced differences were detected in manifestations of epidemic process of viral hepatitis C in Mongolia and Asian part of Russia, represented by Eastern Siberia, that are associated with ethnic, social and cultural living conditions of the indigenous population.

EXPRESS: Serum GP88 as a predictive biomarker for hepatocellular carcinoma in patients with viral hepatitis C after direct-acting antiviral agents

2021 ◽  
pp. 000456322110367
Author(s):  
Ishida Hidekazu ◽  
Masao Takemura ◽  
Atsushi Suetsugu ◽  
Takafumi Naiki ◽  
Takuji Tanaka ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Viral Hepatitis ◽  
Antiviral Treatment ◽  
Predictive Biomarker ◽  
Direct Acting Antiviral ◽  
Control Subjects ◽  
Viral Hepatitis C ◽  
Healthy Control ◽  
Direct Acting

Background: Progranulin (GP88) is an 88-kDa glycoprotein growth factor with important biological effects in tumorigenesis and tumor survival. We investigated the usefulness of measuring serum GP88 (sGP88) levels as a predictive biomarker for hepatocellular carcinoma (HCC) in patients with viral hepatitis C after treatment with direct-acting antiviral (DAA) agents. Methods: We measured the sGP88 levels by using a sandwich enzyme-linked immunoassay from 67 healthy control subjects and 29 patients (20 patients who did not develop HCC and 9 patients who developed HCC after treatment) with viral hepatitis C after treatment with asunaprevir and daclatasvir. Results: The sGP88 levels of patients with chronic hepatitis C prior to antiviral treatment were significantly higher than those of healthy control subjects. After antiviral treatment, the sGP88 levels of patients who eventually developed HCC were significantly higher than those who did not develop HCC. The changes in the sGP88 levels before and after treatment in patients who developed HCC were significantly lower than those in patients who did not develop HCC. The cumulative incidence of HCC was significantly higher in either patients with high sGP88 levels after treatment or those with small changes of sGP88 levels pre- and post-treatment. Conclusions: Sustained high levels of sGP88 in patients treated with DAA agents are correlated with the risk of developing HCC.

scholarly journals Multidisciplinary treatment of advanced hepatocellular carcinoma with severe arterioportal shunt: a case report

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110248
Author(s):  
Yao-chang Luo ◽  
Hai-lin Lu ◽  
Wen-ling Song ◽  
Fei-fei Xuan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Multidisciplinary Treatment ◽  
Advanced Hepatocellular Carcinoma ◽  
Term Survival ◽  
Arterioportal Shunt ◽  
Advanced Stages ◽  
Interventional Radiology Procedures

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer mortality globally. In addition, most patients present in advanced stages with limited curative treatment options. Therefore, multidisciplinary treatment is often warranted. Here, we report a patient with HCC and severe arterioportal shunt (APS) who was treated with a multidisciplinary approach comprising interventional radiology procedures, apatinib and camrelizumab. After treatment, the intrahepatic mass was stable, and a notable decrease in the number and size of lung lesions was observed. The patient achieved a long-term survival of more than 2 years. These data suggest that multidisciplinary treatments may be effective in the treatment of advanced HCC with severe APS.

scholarly journals Skull base meningiomas: development of treatment methods

2021 ◽  
Vol 23 (3) ◽  
pp. 93-103
Author(s):  
S. E. Zuev ◽  
A. S. Tokarev
Keyword(s):  
Targeted Therapy ◽  
Surgical Treatment ◽  
Skull Base ◽  
Proton Therapy ◽  
Robotic Systems ◽  
Treatment Methods ◽  
Significant Events ◽  
Skull Base Meningiomas

The review describes the treatment methods for skull base meningiomas and promising modern trends in this area. The most significant events in the development of meningiomas’ surgical treatment are described. The current research and scientific approaches to the skull base meningiomas’ treatment are presented: medical robotic systems, targeted therapy, radiosurgery, and proton therapy.

scholarly journals Patterns of Comorbidity in Hepatocellular Carcinoma: A Network Perspective

2020 ◽  
Vol 17 (9) ◽  
pp. 3108 ◽  
Author(s):  
Xiao-Min Mu ◽  
Wei Wang ◽  
Yu-Ying Jiang ◽  
Jia Feng
Keyword(s):  
Hepatocellular Carcinoma ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Viral Hepatitis ◽  
Renal Cysts ◽  
Chronic Viral Hepatitis ◽  
Electrolyte Disorders ◽  
Comprehensive Information ◽  
Viral Hepatitis C ◽  
Complications Of Cirrhosis

Hepatocellular carcinoma (HCC) is a common and fatal cancer. People with HCC report higher odds of comorbidity compared with people without HCC. To explore the association between HCC and medical comorbidity, we used routinely collected clinical data and applied a network perspective. In the network perspective, we used correlation analysis and community detection tests that described direct relationships among comorbidities. We collected 14,891 patients with HCC living in Jilin Province, China, between 2016 and 2018. Cirrhosis was the most common comorbidity of HCC. Hypertension and renal cysts were more common in male patients, while chronic viral hepatitis C, hypersplenism, hypoproteinemia, anemia and coronary heart disease were more common in female patients. The proportion of chronic diseases in comorbidities increased with age. The main comorbidity patterns of HCC were: HCC, cirrhosis, chronic viral hepatitis B, portal hypertension, ascites and other common complications of cirrhosis; HCC, hypertension, diabetes mellitus, coronary heart disease and cerebral infarction; and HCC, hypoproteinemia, electrolyte disorders, gastrointestinal hemorrhage and hemorrhagic anemia. Our findings provide comprehensive information on comorbidity patterns of HCC, which may be used for the prevention and management of liver cancer.

scholarly journals Dynamics of serum α‑fetoprotein in viral hepatitis C without hepatocellular carcinoma

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Teodora Isac ◽  
Sebastian Isac ◽  
Simona Ioanitescu ◽  
Enyedi Mihaly ◽  
Maria-Daniela Tanasescu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Viral Hepatitis ◽  
Viral Hepatitis C
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