Proposal of a New Definition of “Very Early” Intrahepatic Cholangiocarcinoma—A Retrospective Single-Center Analysis

Intrahepatic cholangiocarcinoma (ICC) is a rare disease with poor outcome, despite advances in surgical and non-surgical treatment. Recently, studies have reported a favorable long-term outcome of “very early” ICC (based on tumor size and absence of extrahepatic disease) after hepatic resection and liver transplantation, respectively. However, the prognostic value of tumor size and a reliable definition of early disease remain a matter of debate. Patients undergoing resection of histologically confirmed ICC between February 1996 and January 2021 at our institution were reviewed for postoperative morbidity, mortality, and long-term outcome after being retrospectively assigned to two groups: “very early” (single tumor ≤ 3 cm) and “advanced” ICC (size > 3 cm, multifocality or extrahepatic disease). A total of 297 patients were included, with a median follow-up of 22.8 (0.1–301.7) months. Twenty-one (7.1%) patients underwent resection of “very early” ICC. Despite the small tumor size, major hepatectomies (defined as resection of ≥3 segments) were performed in 14 (66.7%) cases. Histopathological analyses revealed lymph node metastases in 5 (23.8%) patients. Patients displayed excellent postoperative outcome compared to patients with “advanced” disease: intrahospital mortality was not observed, and patients displayed superior long-term survival, with a 5-year survival rate of 58.2% (versus 24.3%) and a median postoperative survival of 62.1 months (versus 25.3 months; p = 0.013). In conclusion, although the concept of a “very early” ICC based solely on tumor size is vague as it does not necessarily reflect an aggressive tumor biology, our proposed definition could serve as a basis for further studies evaluating the efficiency of either surgical resection or liver transplantation for this malignant disease.

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THE LONG-TERM OUTCOME OF LIVER TRANSPLANTATION FOR INTRAHEPATIC CHOLANGIOCARCINOMA: A SINGLE-CENTER EXPERIENCE IN CHINA

Transplantation Journal ◽

10.1097/00007890-201007272-01507 ◽

2010 ◽

Vol 90 ◽

pp. 777

Author(s):

T. Zhang ◽

B. Fu ◽

H. Yi ◽

Y. An ◽

S. Yi ◽

...

Keyword(s):

Liver Transplantation ◽

Intrahepatic Cholangiocarcinoma ◽

Single Center ◽

Term Outcome ◽

Long Term Outcome ◽

Single Center Experience

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Long-Term Outcome of Liver Transplantation in HIV-1-Positive Patients: 15-Year Follow-Up

ISRN Transplantation ◽

10.5402/2013/480582 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8

Author(s):

Shinji Yamamoto ◽

Robert Schwarcz ◽

Ola Weiland ◽

Antti Oksanen ◽

Annika Wernerson ◽

...

Keyword(s):

Liver Transplantation ◽

Highly Active Antiretroviral Therapy ◽

Patient Survival ◽

Biliary Cirrhosis ◽

Term Outcome ◽

Term Survival ◽

Long Term Outcome ◽

Hiv 1

Liver transplantation (LT) for patients with human immunodeficiency virus type-1 (HIV-1) infection has been associated with poor outcome. However, after the introduction of the highly active antiretroviral therapy, short-term patient survival after LT has improved significantly. We examined the long-term outcome of HIV-1-positive patients who underwent LT. Medical records were analysed in nine HIV-1-positive LT patients who underwent LT from August 1998 to May 2012. Eight were known to be HIV-1 positive at the time of listing for LT and had end-stage liver disease (ESLD) due to hepatitis C. One patient had primary biliary cirrhosis, and primary HIV-1 infection was found at the date of LT. Seven of the nine patients remain alive to date. So far, three have survived more than 12 years after LT. The overall patient survival rate for both five and 10 years is 77.8%. Four patients experienced acute rejection and six acquired biopsy-confirmed HCV recurrence. HIV-1 replication was effectively blocked during follow-up in all patients. We conclude that long-term survival of HIV-1-positive patients after LT can be achieved. Our study suggests that LT can offer an effective treatment option in selected HIV-1 infected patients with ESLD.

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Find the Flame: Predictive Biomarkers for Immunotherapy in Melanoma

Cancers ◽

10.3390/cancers13081819 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1819

Author(s):

Mattia Garutti ◽

Serena Bonin ◽

Silvia Buriolla ◽

Elisa Bertoli ◽

Maria Antonietta Pizzichetta ◽

...

Keyword(s):

Meta Analysis ◽

Tumor Biology ◽

Predictive Biomarkers ◽

Decision Making Process ◽

Checkpoint Inhibition ◽

Clinical Context ◽

Term Outcome ◽

Long Term Outcome ◽

Therapeutic Landscape

Immunotherapy has revolutionized the therapeutic landscape of melanoma. In particular, checkpoint inhibition has shown to increase long-term outcome, and, in some cases, it can be virtually curative. However, the absence of clinically validated predictive biomarkers is one of the major causes of unpredictable efficacy of immunotherapy. Indeed, the availability of predictive biomarkers could allow a better stratification of patients, suggesting which type of drugs should be used in a certain clinical context and guiding clinicians in escalating or de-escalating therapy. However, the difficulty in obtaining clinically useful predictive biomarkers reflects the deep complexity of tumor biology. Biomarkers can be classified as tumor-intrinsic biomarkers, microenvironment biomarkers, and systemic biomarkers. Herein we review the available literature to classify and describe predictive biomarkers for checkpoint inhibition in melanoma with the aim of helping clinicians in the decision-making process. We also performed a meta-analysis on the predictive value of PDL-1.

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