scholarly journals Sequential Circulating Tumor Cell Counts in Patients with Locally Advanced or Metastatic Hepatocellular Carcinoma: Monitoring the Treatment Response

2020 ◽  
Vol 9 (1) ◽  
pp. 188 ◽  
Author(s):  
Kun-Ming Rau ◽  
Chien-Ting Liu ◽  
Yu-Chiao Hsiao ◽  
Kai-Yin Hsiao ◽  
Tzu-Min Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Locally Advanced ◽  
Elevated Serum ◽  
Disease Status ◽  
Circulating Tumor Cell ◽  
Interquartile Range ◽  
Patient Treatment ◽  
Blood Samples ◽  
Cell Counts

Hepatocellular carcinoma (HCC) is among the most common causes of cancer death in men. Whether or not a longitudinal follow-up of circulating tumor cells (CTCs) before and at different time points during systemic/targeted therapy is useful for monitoring the treatment response of patients with locally advanced or metastatic HCC has been evaluated in this study. Blood samples (n = 104) were obtained from patients with locally advanced or metastatic HCC (n = 30) for the enrichment of CTCs by a negative selection method. Analysis of the blood samples from patients with defined disease status (n = 81) revealed that those with progressive disease (PD, n = 37) had significantly higher CTC counts compared to those with a partial response (PR) or stable disease (SD; n = 44 for PR + SD, p = 0.0002). The median CTC count for patients with PD and for patients with PR and SD was 50 (interquartile range 21–139) and 15 (interquartile range 4–41) cells/mL of blood, respectively. A longitudinal analysis of patients (n = 17) after a series of blood collections demonstrated that a change in the CTC count correlated with the patient treatment response in most of the cases and was particularly useful for monitoring patients without elevated serum alpha-fetoprotein (AFP) levels. Sequential CTC enumeration during treatment can supplement standard medical tests and benefit the management of patients with locally advanced or metastatic HCC, in particular for the AFP-low cases.

scholarly journals Liver MRI and clinical findings to predict response after drug eluting bead transarterial chemoembolization in hepatocellular carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong Yeop Lee ◽  
Byung Chan Lee ◽  
Hyoung Ook Kim ◽  
Suk Hee Heo ◽  
Sang Soo Shin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Predictive Factors ◽  
Transarterial Chemoembolization ◽  
Signal Intensity ◽  
Elevated Serum ◽  
Disease Free Survival ◽  
Hepatobiliary Phase ◽  
Mri Features ◽  
Drug Eluting

AbstractTo identify the gadoxetic acid (GA)-enhanced magnetic resonance imaging (MRI) and laboratory findings that enable prediction of treatment response and disease-free survival (DFS) after the first session of drug eluting bead transarterial chemoembolization (DEB-TACE) in patients with hepatocellular carcinoma (HCC). A total of 55 patients who underwent GA-enhanced MRI and DEB-TACE from January 2014 to December 2018 were included. All MRI features were reviewed by two radiologists. Treatment response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors. Univariate and multivariate logistic regression analyses were used to determine predictive factors of treatment response and DFS, respectively. A total of 27 patients (49.1%) achieved complete response (CR) after one session of treatment. There were no significant differences between the two groups in terms of clinical and laboratory characteristics. Heterogeneous signal intensity in the hepatobiliary phase (HBP) was the only independent predictor of non-CR (odds ratio, 4.807; p = 0.048). Recurrent HCC was detected in 19 patients (70.4%) after CR. In the multivariate analysis, elevated serum alpha-fetoprotein (AFP) level (≥ 30 ng/mL) was the only significant parameter associated with DFS (hazard ratio, 2.916; p = 0.040). This preliminary study demonstrated that heterogeneous signal intensity in the HBP and high serum AFP were useful predictive factors for poor treatment response and short DFS after DEB-TACE, respectively.

The prechemoradiotherapy/nadir ratio of white blood-cell count to predict tumor response and survival in locally advanced rectal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 783-783
Author(s):  
Joo Hwan Lee ◽  
Sung Hwan Kim ◽  
Jong Hoon Lee ◽  
Soo Yoon Sung ◽  
Hong Seok Jang
Keyword(s):  
Rectal Cancer ◽  
Blood Cell ◽  
Treatment Response ◽  
White Blood Cell ◽  
Tumor Response ◽  
Locally Advanced ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Cell Counts ◽  
Wbc Count

783 Background: Predicting treatment response of preoperative chemoradiotherapy (CRT) in patients with rectal cancer is important for physicians to guide a patient to the relevant treatment. We evaluate the change of white blood cell (WBC) count before and during CRT if it is associated with susceptibility to the CRT and affects tumor response. Methods: Medical records of 641 patients with rectal cancer who received preoperative CRT followed by curative surgery were retrospectively reviewed. Complete blood cell counts were measured weekly before and during the radiation therapy. We assessed the pre-CRT/nadir ratio of WBC count for the treatment response to CRT and recurrence-free survival. Results: The enrolled patients were divided into two groups of high WBC ratio (HWR) and low WBC ratio (LWR) with the cutoff value of 0.49, which was found by receiver operating characteristic curve (Sensitivity, 0.38 and 1-Specificity, 0.22; p=0.007). In 641 patients, 490 (76.4%) were HWR group and 151 (23.6%) were LWR group. Complete pathologic response rates were 12.2% in HWR group and 23.8% in LWR group, respectively (p=0.001). Downstaging rates of each group were 37.8% and 48.3%, respectively (p=0.02). In the logistic regression analysis, CEA level over 5ng/ml (Adjusted OR 0.566, 95% CI 0.351-0.912; p=0.019) and HWR (Adjusted OR 0.412, 95% CI 0.256-0.663; p=0.001) were significant adverse factors of the pathologic complete response. The 5-year recurrence-free survival rate was significantly higher in LWR group than in HWR group (67.6% and 83.3%; p=0.001). Conclusions: Low WBC ratio predicts a good tumor response to the preoperative CRT, and is significantly associated with an improved recurrence-free survival in rectal cancer.

Comparative efficacy of S-1 versus best supportive care in advanced hepatocellular carcinoma.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 466-466
Author(s):  
Pengfei Yu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Supportive Care ◽  
Lymph Nodes ◽  
Randomized Clinical Trials ◽  
Locally Advanced ◽  
Elevated Serum ◽  
Best Supportive Care ◽  
Advanced Hepatocellular Carcinoma ◽  
Supraclavicular Lymph Nodes

466 Background: S-1, an oral fluoropyrimidine derivative, has been shown to be clinically effective against hepatocellular carcinoma (HCC). We carried out a retrospective study to evaluate the efficacy of S-1, compared to best supportive care (BSC) in patients with advanced hepatocellular carcinoma. Methods: From 2009.12 to 2013.12, 32 cases of advanced hepatocellular carcinoma (the presence of extrahepatic metastasis or locally advanced disease not amenable to surgical resection or other locoregional therapies) were retrospectively analysed. 18 patients received S-1 (80 mg/m2/day, administered during days 1~14 and repeated every 21 days) and 14 patients received best supportive care (BSC). The time to progression (TTP), overall survival (OS) and safety were assessed. Results: 17 of 32 (53.1%) patients had metastatic disease, including the retroperitoneal lymph nodes (7 cases), lung (4 cases), supraclavicular lymph nodes (3 cases), abdominal wall (3 cases), brain (2 cases) and adrenal glands (2 cases). 12 patients (37.5%) had portal vein tumor thrombus. The two groups were well matched at baseline. In S-1 group,a total of 63 cycles were administered with median of 3.5 cycles (range, 2~7).The most common grade 3/4 toxicities were thrombocytopenia (28.1%), neutropenia (21.8%), elevated serum aspartate aminotransferase levels (15.6%) and rash (9.4%). A patient (5.6%) had a partial response,11 (61.1%) had stable disease, and 6 (33.3%) had progressive disease. Median TTP was 4.7 months in the S-1 group compared with 2.3 months in the BSC group (P=0.013). Overall survival was 15.1 months in patients treated with S-1, compared with 8.3 months in those who received BSC (P=0.027). Conclusions: S-1 showed an acceptable safety profile and benefit in survival in patients with advanced HCC.The conclusion needs further evaluation in randomized clinical trials.

scholarly journals En bloc transdiaphragmatic lung resection for locally advanced hepatocellular carcinoma: a case report

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Kit-fai Lee ◽  
Randolph H L Wong ◽  
Howard H W Leung ◽  
Eugene Y J Lo ◽  
Charing C N Chong ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Locally Advanced ◽  
Left Lung ◽  
Lower Lobe ◽  
Uneventful Recovery ◽  
Advanced Hepatocellular Carcinoma ◽  
Right Hepatectomy ◽  
En Bloc ◽  
Liver Recurrence ◽  
Lung Base

Abstract A 56-year-old man presented with an 11-cm hepatocellular carcinoma (HCC) at segment 7 of liver. To induce left liver hypertrophy, a sequential transarterial chemoembolization (TACE) and portal vein embolization before right hepatectomy were adopted. However, the tumor further increased in size despite TACE and invaded through the diaphragm to the right lung base. Anterior approach right hepatectomy with en bloc wedge resection of the involved right lower lobe of lung by endovascular staplers via transdiaphragmatic approach was performed. The diaphragmatic defect was closed with Goretex mesh. Patient made an uneventful recovery. Pathology confirmed a 12.5 cm poorly differentiated HCC invading through diaphragm to lung. During follow-up, patient developed a 6 cm recurrence at left lung base 17 months after surgery for which he received sorafenib therapy. However, the lung mass further increased in size with new liver recurrence at segment 3 despite treatment. He succumbed 2 years and 3 months after surgery.

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