Review
Medicine, General & Internal
Pierluigi Toniutto, Elisa Fumolo, Ezio Fornasiere, Davide Bitetto
Summary: This review discusses the current data on pretransplant criteria for liver transplantation in HCC patients exceeding the Milan Criteria, based on tumor morphological and histological characteristics validated in clinical practice. It also evaluates the role of HCC biological markers and tumor response to downstaging procedures as new tools for selecting patients with a tumor burden outside of the Milan Criteria for liver transplantation.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Oncology
Bleuenn Brusset, Jerome Dumortier, Daniel Cherqui, Georges-Philippe Pageaux, Emmanuel Boleslawski, Ludivine Chapron, Jean-Louis Quesada, Sylvie Radenne, Didier Samuel, Francis Navarro, Sebastien Dharancy, Thomas Decaens
Summary: The study compared the agreement for the criteria and outcomes of liver transplantation before and after the adoption of the AFP model, finding a longer waiting time and higher rate of bridging therapies after the AFP model was implemented, leading to poorer patient outcomes.
Article
Oncology
Jan-Paul Gundlach, Michael Linecker, Henrike Dobbermann, Felix Wadle, Thomas Becker, Felix Braun
Summary: Liver transplantation is the only definitive treatment for hepatocellular carcinoma in cirrhosis. The use of Milan-criteria and labMELD in selecting patients for transplantation has limitations. This study found that liver transplantation for patients with hepatocellular carcinoma, regardless of Milan-criteria, had comparable outcomes and cost-effectiveness. Extended criteria donor grafts were favored for patients outside the Milan-criteria with low labMELD.
Article
Gastroenterology & Hepatology
Alexander Clevewood Ng
Summary: This article discusses the feasibility of adhering to the Brazil-Milan Criteria in determining liver transplantation for HCC patients, highlighting the potential risks of disregarding the number of tumor nodules in patients and its impact on disease recurrence potential.
ANNALS OF HEPATOLOGY
(2021)
Article
Biochemical Research Methods
Mamatha Bhat, Sergi Clotet-Freixas, Cristina Baciu, Elisa Pasini, Ahmed Hammad, Tommy Ivanics, Shelby Reid, Amirhossein Azhie, Marc Angeli, Anand Ghanekar, Sandra Fischer, Gonzalo Sapisochin, Ana Konvalinka
Summary: The study identified that increased levels of LGALS3 and LGALS3BP gene and protein expression in HCC explants were associated with post-transplant recurrence, while increased ALDH1A1 levels were associated with absence of recurrence in patients who underwent liver transplantation for HCC beyond Milan criteria.
CLINICAL PROTEOMICS
(2021)
Article
Surgery
Hsin-Rou Liang, Chia-En Hsieh, Kuo-Hua Lin, Chih-Jan Ko, Yu-Ju Hung, Ya-Lan Hsu, Yao-Li Chen
Summary: The study suggests that patients with HCC undergoing LDLT in Taiwan can achieve good treatment outcomes even beyond the Milan criteria by using new expanded criteria, reaching a similar level of treatment effectiveness as those meeting the Milan criteria, and allowing more patients to benefit from liver transplantation.
Article
Geriatrics & Gerontology
Berend R. Beumer, Jeroen L. A. van Vugt, Gonzalo Sapisochin, Peter Yoon, Marco Bongini, Di Lu, Xiao Xu, Paolo De Simone, Lorenzo Pintore, Nicolas Golse, Malgosia Nowosad, William Bennet, Emmanouil Tsochatzis, Evangelia Koutli, Fariba Abbassi, Marco P. A. W. Claasen, Manuela Merli, Joanne O'Rourke, Martina Gambato, Alberto Benito, Avik Majumdar, Ek Khoon Tan, Maryam Ebadi, Aldo J. Montano-Loza, Marina Berenguer, Herold J. Metselaar, Wojciech G. Polak, Vincenzo Mazzaferro, Jan N. M. IJzermans
Summary: This study aimed to determine the value of muscle mass in patients with hepatocellular carcinoma (HCC). The results showed that higher muscle mass is associated with better long-term survival. However, low muscle mass should not be considered an absolute contra-indication for liver transplantation in individual patients.
JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE
(2022)
Article
Oncology
Shuanggang Chen, Weimei Ma, Lujun Shen, Ying Wu, Han Qi, Fei Cao, Tao Huang, Weijun Fan
Summary: The study found that compared to ablation, resection should be considered a more appropriate first-line option for patients with single-nodule HBV-associated HCC of 2-3 cm, offering a more promising bridge for liver transplantation.
FRONTIERS IN ONCOLOGY
(2021)
Article
Surgery
Masateru Yamamoto, Tsuyoshi Kobayashi, Naruhiko Honmyo, Akihiko Oshita, Tomoyuki Abe, Toshihiko Kohashi, Takashi Onoe, Saburo Fukuda, Ichiro Omori, Yasuhiro Imaoka, Hideki Ohdan
Summary: Patients with hepatocellular carcinoma beyond the Barcelona Clinic Liver Cancer criteria can benefit from liver resection based on a predictive formula that considers a high a-fetoprotein level, macrovascular invasion, and high total tumor burden. Risk stratification using these factors can predict the prognosis and guide treatment decisions.
Article
Gastroenterology & Hepatology
Chengxiang Guo, Xiuwen Zou, Zhengtao Hong, Junhui Sun, Wenbo Xiao, Ke Sun, Xuejie Li, Yinan Shen, Tingbo Liang, Xueli Bai
Summary: Preoperative TACE for HCC beyond the Milan criteria can improve prognosis without significant perioperative complications. Factors such as larger preoperative tumor diameter and hepatitis B infection may be associated with favorable recurrence-free survival after HCC resection.
Article
Surgery
Zi-Han Feng, Ming-Da Wang, Zhong Chen, Li-Yang Sun, Xiao Xu, Qing-Yu Kong, Zi-Xiang Chen, Yong-Yi Zeng, Ying-Jian Liang, Zhi-Yu Chen, Hong Wang, Ya-Hao Zhou, Ting-Hao Chen, Lan-Qing Yao, Chao Li, Timothy M. Pawlik, Wan Yee Lau, Feng Shen, Tian Yang
Summary: This study aimed to identify risk factors and assess the prognosis of patients who experienced beyond-Milan recurrence after hepatectomy for early-stage hepatocellular carcinoma. Out of 753 patients, 18.3% developed beyond-Milan recurrence. Factors such as high preoperative alpha-fetoprotein level, large tumor size, multifocal disease, microvascular invasion, and no/irregular recurrence surveillance were independently associated with increased risk of beyond-Milan recurrence. The median post-recurrence survival among patients with beyond-Milan recurrence was 8.4 months. Child-Pugh grade B/C, early recurrence, macrovascular invasion/distant metastasis, and noncurative treatment of recurrence were independent risk factors associated with worse post-recurrence survival.
Review
Radiology, Nuclear Medicine & Medical Imaging
Giuseppe Mamone, Settimo Caruso, Mariapina Milazzo, Giorgia Porrello, Ambra Di Piazza, Giovanni Gentile, Vincenzo Carollo, Francesca Crino, Gianluca Marrone, Gianvincenzo Sparacia, Luigi Maruzzelli, Roberto Miraglia, Salvatore Gruttadauria
Summary: Liver transplantation provides the best survival benefit for hepatocellular carcinoma (HCC) patients who cannot undergo resection. The Milan criteria have been developed to select suitable candidates for transplantation, aiming to improve survival and reduce the risk of HCC recurrence. However, up to 20% of cases experience HCC recurrence after transplantation, posing a significant challenge due to poor prognosis. Various extended criteria have been proposed to accommodate the increasing demand for organs and the associated higher risk of recurrence. Radiologists need to be aware of the possibility of HCC recurrence involving multiple organs after transplantation. Understanding the location and radiologic appearance of recurrent HCC is crucial for choosing the most appropriate therapy.
INSIGHTS INTO IMAGING
(2023)
Article
Oncology
De-Zhen Guo, Jian-Wen Cheng, Jia-Yan Yan, Ao Huang, Yu-Peng Wang, Shi-Yu Zhang, Ya Cao, Xiao-Wu Huang, Jia Fan, Jian Zhou, Xin-Rong Yang
Summary: This study found that postoperative administration of Lenvatinib in HCC patients beyond the Milan criteria can prolong the time to recurrence and decrease the rate of early recurrence. However, it does not significantly affect overall survival. Patients receiving Lenvatinib experienced treatment-related adverse events, but there were no treatment-related deaths.
ANNALS OF TRANSLATIONAL MEDICINE
(2022)
Article
Oncology
Altan Alim, Yalcin Erdogan, Murat Dayangac, Yildiray Yuzer, Yaman Tokat, Arzu Oezcelik
Summary: Liver transplantation is the preferred treatment for hepatocellular carcinoma, even in patients beyond Milan criteria. This study shows that the Milan criteria alone are not sufficient to predict survival after transplantation. Independent prognostic factors for survival include Alpha-fetoprotein level and vascular invasion status.
Article
Oncology
Ao Huang, De-Zhen Guo, Yu-Peng Wang, Guo-Huan Yang, Qi-Man Sun, Xin Zhang, Yi-Feng He, Kang Song, Xiao-Wu Huang, Xin-Rong Yang, Jia Fan, Jian Zhou, Jie Hu
Summary: The study demonstrated the significance of plasma microRNA panel for predicting and monitoring early tumor recurrence in hepatocellular carcinoma patients following liver transplantation. The positive status of microRNA panel was associated with a higher recurrence rate, and it changed from negative to positive earlier than AFP and DCP upon recurrence.
Article
Gastroenterology & Hepatology
Carol Rouphael, Rocio Lopez, John McMichael, Carol A. Burke
Summary: The study compared baseline adenoma characteristics between patients undergoing colonoscopy in a historic versus contemporary cohort and found an increase in the proportion of patients with >= 3 nonadvanced adenomas in the contemporary cohort. However, follow-up colonoscopies showed that these patients did not have a significantly higher risk of metachronous advanced neoplasia compared to low-risk adenoma patients.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2021)
Article
Nutrition & Dietetics
Christan Bury, Robert DeChicco, Diane Nowak, Rocio Lopez, Lulu He, Sandhya Jacob, Donald F. Kirby, Nadeem Rahman, Gail Cresci
Summary: This study found that critically ill patients in the surgical intensive care unit experienced significant loss of quadriceps muscle layer thickness over 10 days, with greater losses occurring after 5 days. The results suggest that performing ultrasounds to detect muscle mass changes could be valuable in evaluating lean body mass changes in critically ill patients.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2021)
Letter
Gastroenterology & Hepatology
Amandeep Singh, Rajat Garg, Rocio Lopez, Naim Alkhouri
Summary: This study aims to develop a simple noninvasive fibrosis score to detect advanced fibrosis in patients with diabetes and compare its performance with other fibrosis scores.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Article
Allergy
M. Macmurdo, R. Lopez, B. L. Udeh, J. Zein
Summary: This study aimed to determine the indirect impact of substance misuse on disease severity, healthcare utilization, and healthcare costs in patients with chronic obstructive lung disease. Using data from the National Readmissions Database, the study found that substance misuse was associated with an increase in hospital readmission rate and higher healthcare costs. Targeting substance misuse in this patient population has the potential for significant cost savings to the healthcare system.
Article
Substance Abuse
Maeve MacMurdo, Rocio Lopez, Belinda L. Udeh, Joe G. Zein
Summary: The study revealed that patients with alcohol use disorder (AUD) are more likely to experience respiratory failure and require mechanical ventilation in the emergency room when admitted with asthma or COPD. Patients with AUD also have increased hospitalization costs, longer stays, and a higher likelihood of readmission within 30 days.
Article
Emergency Medicine
Philip R. Wang, Rocio Lopez, Spencer S. Seballos, Matthew J. Campbell, Belinda L. Udeh, Michael P. Phelan
Summary: Analysis of NHAMCS data from 2010 to 2017 showed a positive trend in the medical management of migraine in US emergency departments, with a yearly decline in opioid prescriptions. During this period, ketorolac and metoclopramide were more frequently prescribed. Factors associated with increased opioid administration included female sex, older age, white race, higher pain scores, and Medicare or private insurance as primary payment source.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Multidisciplinary Sciences
Chihyun Park, Jean R. Clemenceau, Anna Seballos, Sara Crawford, Rocio Lopez, Tyler Coy, Gowtham Atluri, Tae Hyun Hwang
Summary: The study analyzed opioid-related mortality in Ohio from 2010 to 2016, finding higher death rates among white males aged 25-54 and a tendency for deaths to cluster in urban areas. Additionally, comorbidity analysis showed a relatively high co-occurrence of cardiovascular disease, anxiety, or drug abuse history with opioid-related deaths.
SCIENTIFIC REPORTS
(2021)
Article
Pathology
Ryan Demkowicz, Prashanthi N. Thota, Tanmayee Benjamin, Rocio Lopez, Haiyan Lu, Deepa T. Patil, Erinn Downs-Kelly, Jennifer A. Jeung, Keith K. Lai, James Lapinski, Erica C. Savage, John R. Goldblum, Ilyssa O. Gordon
Summary: This study confirms the importance of assessing specimen adequacy and evaluating the prevalence of SSIM. It is also the first to assess interobserver agreement for SSIM and dysplasia within SSIM. Overall agreement for SSIM by slide was 92% to 94%, and by patient was 82% to 94%, showing moderate to strong agreement.
ANNALS OF DIAGNOSTIC PATHOLOGY
(2021)
Article
Allergy
Peng Zhang, Rocio Lopez, Amy H. Attaway, Steve N. Georas, Sumita B. Khatri, Simon Abi-Saleh, Joe G. Zein
Summary: Asthmatic patients with diabetes mellitus (DM) had increased hospital length of stay, cost, and risk for readmission during asthma-related hospitalizations. They were also more likely to develop nonrespiratory complications during their hospital stay compared to patients without diabetes. However, the risk of mortality was similar between the two groups.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2021)
Article
Gastroenterology & Hepatology
Matheus Cavalcante Franco, Sunguk Jang, Bruno da Costa Martins, Tyler Stevens, Vipul Jairath, Rocio Lopez, John J. Vargo, Alan Barkun, Fauze Maluf-Filho
Summary: This study validates the accuracy of prognostic scores in predicting outcomes for cancer patients with upper gastrointestinal bleeding (UGIB), and develops a new score to predict the need for hemostatic therapy.
CLINICAL ENDOSCOPY
(2022)
Article
Pediatrics
Nawras Habash, Yamen Ezaizi, Ibrahim Kak, Praveen Kumar Conjeevaram Selvakumar, Rocio Lopez, Naim Alkhouri, Mohammad Nasser Kabbany
Summary: This study evaluated the performance of three fibrosis scores in assessing advanced fibrosis in children after liver transplantation. The FIB-4 score showed satisfactory accuracy in detecting advanced fibrosis, but there is still a need to develop a reliable pediatric fibrosis score.
PEDIATRIC TRANSPLANTATION
(2022)
Article
Surgery
Jesse D. Schold, Anne M. Huml, S. Ali Husain, Emilio D. Poggio, R. Blake Buchalter, Rocio Lopez, Bruce Kaplan, Sumit Mohan
Summary: In the United States, over 20% of procured kidneys for transplantation are not utilized. This study examined the factors associated with nonutilization and found that deceased donors from higher distressed communities were more likely to have their kidneys not utilized. The study also found regional variations in kidney nonutilization rates and minimal impact on recipient outcomes.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Anesthesiology
Josie Znidarsic, Kellie N. Kirksey, Stephen M. Dombrowski, Anne Tang, Rocio Lopez, Heather Blonsky, Irina Todorov, Dana Schneeberger, Jonathan Doyle, Linda Libertini, Starkey Jamie, Tracy Segall, Andrew Bang, Kathy Barringer, Bar Judi, Jane Pernotto Ehrman, Michael F. Roizen, Mladen Golubic
Summary: The study evaluated the effectiveness of a multidisciplinary, nonpharmacological approach using shared medical appointments to improve health-related quality of life and reduce opioid medication use in patients with chronic pain. Results showed that patients experienced reduced pain and improved physical, mental, and social health without increased use of opioid medications over an 8-week intervention.
Article
Gastroenterology & Hepatology
Marc Monachese, Peter J. Lee, Kevin Harris, Sunguk Jang, Amit Bhatt, Prabhleen Chahal, Rocio Lopez, Tyler Stevens
Summary: This study aimed to assess the ability of EUS and ePFT to predict disease progression in patients with suspected MCCP who had nondiagnostic baseline imaging. The results showed that abnormal ePFT and EUS Rosemont classification were significant predictors of disease progression.
ENDOSCOPIC ULTRASOUND
(2021)
Article
Food Science & Technology
Roy J. Kim, Rocio Lopez, Megan Snair, Anne Tang
Summary: The study revealed that adherence to the Mediterranean diet was very low among US adolescents, with Mexican American youths showing slightly higher adherence. Higher income was associated with greater adherence, but adherence to the Mediterranean diet did not seem to be related to metabolic syndrome.
INTERNATIONAL JOURNAL OF FOOD SCIENCES AND NUTRITION
(2021)