Review
Biochemistry & Molecular Biology
Joon Hyuk Choi, Jae Y. Ro
Summary: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer with aggressive behavior and poor prognosis compared to classic hepatocellular carcinoma (HCC). The morphologic and phenotypic diversity of cHCC-CCA poses diagnostic challenges for pathologists. Accurate diagnosis is crucial for patient management and prognostication.
Review
Oncology
Johannes Eschrich, Zuzanna Kobus, Dominik Geisel, Sebastian Halskov, Florian Rossner, Christoph Roderburg, Raphael Mohr, Frank Tacke
Summary: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer that shares clinicopathologic features of hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCA). The diagnostic workup is challenging due to the similarities with HCC and CCA. Blood tumor markers such as alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA 19-9) can be used for diagnosis, but with low sensitivity.
Article
Gastroenterology & Hepatology
Julien Calderaro, Luca Di Tommaso, Pascale Maille, Aurelie Beaufrere, Cong Trung Nguyen, Lara Heij, Viviane Gnemmi, Rondell P. Graham, Frederic Charlotte, Suzanne Chartier, Dominique Wendum, Mukul Vij, Daniela Allende, Alba Diaz, Carla Fuster, Benjamin Riviere, Astrid Herrero, Jeremy Augustin, Katja Evert, Diego Francesco Calvisi, Wei Qiang Leow, Howard Ho Wai Leung, Jan Bednarsch, Emmanuel Boleslawski, Mohamed Rela, Anthony Wing-Hung Chan, Alejandro Forner, Maria Reig, Anais Pujals, Loetitia Favre, Manon Allaire, Olivier Scatton, Arnaud Uguen, Eric Trepo, Lukas Otero Sanchez, Denis Chatelain, Myriam Remmelink, Camille Boulagnon-Rombi, Celine Bazille, Nathalie Sturm, Benjamin Menahem, Eric Frouin, David Tougeron, Christophe Tournigand, Emmanuelle Kempf, Haeryoung Kim, Massih Ningarhari, Sophie Michalak-Provost, Jakob Nikolas Kather, Annette S. H. Gouw, Purva Gopal, Raffaele Brustia, Eric Vibert, Kornelius Schulze, Darius F. Ruther, Soren A. Weidemann, Rami Rhaiem, Jean-Charles Nault, Alexis Laurent, Giuliana Amaddeo, Helene Regnault, Eleonora de Martin, Christine Sempoux, Pooja Navale, Jayendra Shinde, Ketan Bacchuwar, Maria Westerhoff, Regina Cheuk-Lam Lo, Mylene Sebbagh, Catherine Guettier, Marie Lequoy, Mina Komuta, Marianne Ziol, Valerie Paradis, Jeanne Shen, Stefano Caruso
Summary: Nestin protein is a valuable biomarker for diagnosis and prognosis assessment in cHCC-CCA. It can distinguish cHCC-CCA from HCC and has high prognostic value. Nestin immunohistochemistry may be used to refine risk stratification and improve treatment allocation for patients with this highly aggressive malignancy.
JOURNAL OF HEPATOLOGY
(2022)
Article
Cell Biology
M. Sasaki, Y. Sato, Y. Nakanuma
Summary: Nestin may serve as a diagnostic marker for combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and small duct-type intrahepatic cholangiocarcinoma (iCCA). Its expression is associated with NCAM and vimentin, and correlates with tumor size, CLC components, p53 overexpression, and multiple genetic alterations.
Article
Gastroenterology & Hepatology
Maria Reig, Giuseppe Cabibbo
Summary: The potential impact of DAAs in BCLC-B/C stage patients with HCC is understudied, as HCC patients have been excluded from DAA trials. The decision on using DAAs should be made based on individual patient profiles.
JOURNAL OF HEPATOLOGY
(2021)
Review
Gastroenterology & Hepatology
Aurelie Beaufrere, Julien Calderaro, Valerie Paradis
Summary: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a tumor with both hepatocytic and biliary differentiation, whose diagnosis is primarily based on morphology and immunostaining, with a prognosis worse than hepatocellular carcinoma and treatment limited to surgery.
JOURNAL OF HEPATOLOGY
(2021)
Review
Oncology
Matteo Renzulli, Daryl Ramai, Jameel Singh, Samridhi Sinha, Nicolo Brandi, Anna Maria Ierardi, Elisa Albertini, Rodolfo Sacco, Antonio Facciorusso, Rita Golfieri
Summary: Cholangiocarcinoma and combined hepatocellular cholangiocarcinoma are aggressive primary malignancies with liver resection as the main treatment modality. Locoregional therapies can provide local tumor control and increase chances of survival.
Article
Oncology
Zhen Yang, Guangjun Shi
Summary: Patients with combined hepatocellular-cholangiocarcinoma (CHC) who underwent surgical intervention showed better long-term survival outcomes compared to non-surgical treatments. The overall survival rate of CHC patients was different from that of intrahepatic cholangiocarcinoma (ICC) patients before and after a 3-year follow-up.
Article
Gastroenterology & Hepatology
Laura Izquierdo-Sanchez, Angela Lamarca, Adelaida La Casta, Stefan Buettner, Kirsten Utpatel, Heinz-Josef Klumpen, Jorge Adeva, Arndt Vogel, Ana Lleo, Luca Fabris, Mariano Ponz-Sarvise, Raffaele Brustia, Vincenzo Cardinale, Chiara Braconi, Gianpaolo Vidili, Nigel B. Jamieson, Rocio Ir Macias, Jan Philipp Jonas, Marco Marzioni, Waclaw Holowko, Trine Folseraas, Juozas Kupcinskas, Zeno Sparchez, Marcin Krawczyk, Lukasz Krupa, Viorel Scripcariu, Gian Luca Grazi, Ana Landa-Magdalena, Jan Nm Ijzermans, Katja Evert, Joris Erdmann, Flora Lopez-Lopez, Anna Saborowski, Alexander Scheiter, Alvaro Santos-Laso, Guido Carpino, Jesper B. Andersen, Jose Jg Marin, Domenico Alvaro, Luis Bujanda, Alejandro Forner, Juan W. Valle, Bas Groot Koerkamp, Jesus M. Banales
Summary: This study investigates the clinical course of cholangiocarcinoma in a pan-European cohort and finds that the disease is frequently diagnosed at an advanced stage and a proportion of patients fail to receive cancer-specific therapies, resulting in a poor prognosis.
JOURNAL OF HEPATOLOGY
(2022)
Article
Oncology
Liangtao Ye, Julia S. S. Schneider, Najib Ben Khaled, Peter Schirmacher, Carolin Seifert, Lea Frey, Yulong He, Andreas Geier, Enrico N. N. De Toni, Changhua Zhang, Florian P. P. Reiter
Summary: Combined hepatocellular-cholangiocarcinoma (cHCC-iCCA) is a rare primary liver cancer with characteristics of both hepatocytic and cholangiocytic differentiation. Patients with cHCC-iCCA have a worse prognosis compared to those with HCC. Surgical resection and liver transplantation can be curative, but eligibility is limited and recurrence rates are high. For ineligible cases, treatment is often based on protocols for HCC or iCCA, with personalized therapy choices guided by the suspected component and affected by genomic and molecular heterogeneity.
Article
Radiology, Nuclear Medicine & Medical Imaging
Rong Wen, Peng Lin, Yuquan Wu, Haihui Yin, Weiche Huang, Danxia Guo, Yuye Peng, Dun Liu, Yun He, Hong Yang
Summary: This study analyzed the CEUS manifestations of combined hepatocellular cholangiocarcinoma (CHC) and investigated the diagnostic value of CEUS LI-RADS and serum tumor markers in CHC. The results showed that CEUS LI-RADS and serum tumor markers can be useful tools for reducing the misdiagnosis of CHC, although CHC lacks specific CEUS features. Beginners in radiology need to learn more about the CEUS features involved in CHC due to their relative complexity.
EUROPEAN JOURNAL OF RADIOLOGY
(2022)
Review
Oncology
Timo Alexander Auer, Federico Collettini, Laura Segger, Uwe Pelzer, Raphael Mohr, Felix Krenzien, Bernhard Gebauer, Dominik Geisel, Clarissa Hosse, Wenzel Schoening, Uli Fehrenbach
Summary: cHCC-CCA is a rare form of liver cancer that combines features of both hepatocellular and biliary tract cancer. There is currently no established interventional therapy for cHCC-CCA due to its rarity. This review aims to provide an overview of current radiologic interventions for CCA, review the existing literature, and explore the potential role of these interventions in the treatment of cHCC-CCA in the future.
Review
Oncology
Florian Rossner, Bruno Valentin Sinn, David Horst
Summary: This review discusses the histomorphological classification and diagnosis methods of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA), as well as the molecular foundation for potential therapeutic approaches. cHCC-CCA is a rare primary liver cancer composed of hepatocellular and cholangiocellular differentiated cells. The classification of this cancer has evolved over time, with the latest WHO classification emphasizing morphological diagnosis and introducing new subtypes. Immunohistochemical markers have limited value for diagnosis, but recent discoveries in molecular pathway regulation may lead to new therapeutic approaches for this challenging disease.
Review
Oncology
Marcus Bahra, Ali Yahyazadeh
Summary: Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare liver tumor with both hepatocellular and cholangiocellular differentiation. Accurate diagnosis is challenging, and radical oncological surgery is the only curative option. Factors such as clinicopathological characteristics and biological behavior are crucial in understanding this tumor.
Review
Oncology
Jemmy Zhao, Susann Stephan-Falkenau, Markus Schuler, Boerge Arndt
Summary: This review discusses the recent advances in genetic and molecular characterization of combined hepatocellular-cholangiocarcinoma (cHCC-CC), a rare and aggressive liver tumor with features of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). The optimal treatment for cHCC-CC has not been defined due to its rarity, but liver resection is the mainstay treatment for resectable disease. For advanced disease, there is a lack of guideline recommendations or prospective trial reports to evaluate treatment options. This review explores locoregional and medical treatment approaches for advanced cHCC-CC and discusses the potential of predictive biomarker-guided therapies.
Review
Surgery
Aikaterini Mastoraki, Dimitrios Schizas, Vasiliki Ntella, Anastasia Roka, Michail Vailas, Ioannis S. Papanikolaou, Pantelis Vassiliu, Ioannis Papaconstantinou
Summary: Primary anorectal malignant melanoma (ARMM) is a rare and aggressive tumor, often asymptomatic or mimicking other diseases. Diagnosis requires colonoscopy and histological characteristics, with surgical resection as the standard treatment but controversy over the choice of procedure. Newer treatments like immune-checkpoint inhibitors and targeted therapies need further validation through multicenter studies.
ANZ JOURNAL OF SURGERY
(2021)
Review
Gastroenterology & Hepatology
Aikaterini Mastoraki, Dimitrios Schizas, Athina Tousia, George Chatzopoulos, Anastasia Gkiala, Athanasios Syllaios, Maximos Frountzas, Pantelis Vassiliu, Georgios E. Theodoropoulos, Evangelos Felekouras
Summary: The review summarizes the role of molecular and genetic factors in the development of diverticular disease, and their possible contribution towards new prognostic indicators, diagnostic algorithms, and therapeutic approaches. In addition to common predisposing factors, genetic mutations, immune factors, neurotransmitters, hormones, and protein dysfunctions have been associated with early onset of symptoms, pathogenesis and prognosis of the disease. Specific structural changes in the colonic wall, altered matrix composition, and compromised motility have been identified as possible pathogenic factors for the development of diverticular disease.
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
(2021)
Review
Surgery
Dimitrios Schizas, Aikaterini Mastoraki, Ilias Giannakodimos, Alexios Giannakodimos, Afroditi Ziogou, Ioannis Katsaros, Maximos Frountzas, Ioannis Koutelidakis, Pantelis Vassiliu, Emmanouil Pikoulis
Summary: Primary Gastrointestinal Angiosarcoma (PGAS) is an extremely rare malignant tumor arising from vascular or lymphatic endothelial cells. It has atypical clinical presentation, challenging diagnosis, and aggressive behavior. High clinical suspicion is crucial for its prompt management. Further studies and the development of novel therapeutic agents are required in order to improve survival.
JOURNAL OF INVESTIGATIVE SURGERY
(2022)
Review
Environmental Sciences
Michail Papapanou, Maria Papaioannou, Aikaterini Petta, Eleni Routsi, Maria Farmaki, Nikolaos Vlahos, Charalampos Siristatidis
Summary: The study analyzed 39 systematic reviews on the obstetric-perinatal and neonatal outcomes of infected pregnant women and their newborns during the COVID-19 pandemic. Findings showed increased rates of cesarean sections and preterm births, with potential iatrogenic reasons involved. The possibility of vertical transmission cannot be completely ruled out, highlighting the need for further original research on women from all trimesters.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2021)
Article
Medicine, General & Internal
Michail Papapanou, Eleni Routsi, Konstantinos Tsamakis, Lampros Fotis, Georgios Marinos, Irene Lidoriki, Marianna Karamanou, Theodore G. Papaioannou, Dimitrios Tsiptsios, Nikolaos Smyrnis, Emmanouil Rizos, Dimitrios Schizas
Summary: The COVID-19 pandemic has disrupted the traditional structure of medical education, leading to the rapid development of online learning environments and affecting the lives and academic trajectories of medical students. Some medical students acting as frontline healthcare staff have found this experience to be positive, sparking remarkable innovations in medical education.
POSTGRADUATE MEDICAL JOURNAL
(2022)
Article
Surgery
Panteleimon Vassiliu, Stavros Parasyris, Theodoros A. Sidiropoulos, Ioannis Margaris, Nikolaos Oikonomopoulos, Kostas Kostopanagiotou, Vasileios Smyrniotis, Nikolaos Arkadopoulos
Summary: The case illustrates that trauma and abdominal surgery involving the diaphragm and pericardium can rarely result in post-operative visceral herniation into the pericardial cavity, emphasizing the importance of urgent intervention to restore cardiac output and prevent bowel strangulation.
ANNALS OF VASCULAR SURGERY
(2021)
Article
Emergency Medicine
Lorenzo Cobianchi, Francesca Dal Mas, Maurizio Massaro, Paola Fugazzola, Federico Coccolini, Yoram Kluger, Ari Leppaniemi, Ernest E. Moore, Massimo Sartelli, Peter Angelos, Luca Ansaloni
Summary: Emergency surgery teams operate under extreme stress, and understanding team dynamics is crucial for optimal outcomes. Research found uncertainties among surgeons regarding knowledge translation, while tools like training and non-technical skills are widely recognized and used. Teamwork difficulties include lack of time, communication, training, trust, and ego.
WORLD JOURNAL OF EMERGENCY SURGERY
(2021)
Article
Surgery
Dimitrios Schizas, Michail Papapanou, Eleni Routsi, Aikaterini Mastoraki, Irene Lidoriki, Nikolaos Zavras, Dimitrios V. Avgerinos, Andreas M. Lazaris, Alexandra Tsaroucha
Summary: Despite increasing numbers of female medical students, surgery remains male-dominated. Female surgeons face various obstacles in their career development, including biases, lack of mentorship, work-life balance issues, infertility, and unequal compensation. Changing mindset and modifying relevant policies are crucial to attenuate gender imbalance.
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND
(2022)
Editorial Material
Medicine, General & Internal
Charalampos Siristatidis, Kalliopi Syristatidi, Michail Papapanou
Summary: The updates in assisted reproduction topic will be the center of scientific attention in the next decades, both in clinical and laboratory aspects.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Acoustics
C. Siristatidis, M. Papapanou, V. Karageorgiou, W. P. Martins, I. Bellos, D. M. Teixeira, N. Vlahos
Summary: A meta-analysis comparing blastocyst-stage and cleavage-stage embryo transfers found no significant difference in the risk of congenital anomalies, but blastocyst transfer was associated with a slightly increased probability of a male neonate. A network meta-analysis showed that frozen-blastocyst transfer had a lower risk of low birth weight compared to fresh-blastocyst or fresh-cleavage transfer, but had an increased risk of perinatal death compared to fresh-cleavage transfer.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Medicine, General & Internal
Michail Papapanou, Kalliopi Syristatidi, Maria Gazouli, Makarios Eleftheriades, Nikolaos Vlahos, Charalampos Siristatidis
Summary: Controlled ovarian hyperstimulation (COH) is crucial for successful in vitro fertilization (IVF). Personalized approaches to study patients' responses to different COH protocols are necessary. The mTOR and Hippo signaling pathways play important roles in follicular homeostasis and oocyte quality.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Biochemistry & Molecular Biology
Spyridon Christodoulou, Christina D. Sotiropoulou, Panteleimon Vassiliu, Nikolaos Danias, Nikolaos Arkadopoulos, Diamantis C. Sideris
Summary: This study aimed to investigate the prognostic potential of miR-675-5p as a molecular biomarker in colorectal cancer (CRC). The results showed that miR-675-5p was downregulated in CRC tissue samples and its high expression was associated with shorter disease-free and overall survival in CRC patients. Additionally, high miR-675-5p expression was correlated with TNM staging. In conclusion, miR-675-5p overexpression may serve as an independent molecular biomarker for unfavorable prognosis in CRC.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Health Policy & Services
Aikaterini Dedeilia, Michail Papapanou, Andreas N. Papadopoulos, Nina-Rafailia Karela, Anastasia Androutsou, Dimitra Mitsopoulou, Melina Nikolakea, Christos Konstantinidis, Manthia Papageorgakopoulou, Michail Sideris, Elizabeth O. Johnson, Siobhan Fitzpatrick, Giorgio Cometto, Jim Campbell, Marinos G. Sotiropoulos
Summary: This systematic review and meta-analysis provide early evidence on the disruption to health worker education caused by the COVID-19 pandemic and the policy responses that followed. Out of the 171,489 publications screened, 2,249 were eligible, showing that the perceived training disruption rate was 71.1%. Asian medical schools and medical students were the main focus of the included studies. Policy responses included shifting to online learning, innovations in assessment, COVID-19-specific courses, volunteerism, and measures for learner safety. Overall, learners were satisfied with online learning, while faculty satisfaction was slightly lower.
HUMAN RESOURCES FOR HEALTH
(2023)
Review
Oncology
Michail Papapanou, Anastasios E. Athanasopoulos, Eleni Georgiadi, Stefanos A. Maragkos, Michalis Liontos, Dimitrios C. Ziogas, Dimitrios Damaskos, Dimitrios Schizas
Summary: A systematic review was conducted to recognize specific characteristics and parameters related to a worse prognosis in adult patients with solid tumors experiencing spontaneous tumor lysis syndrome (STLS). Metastatic disease, especially in the liver or lungs, was significantly associated with STLS-related death. The use of urate-lowering agents, specifically rasburicase monotherapy, was linked to a higher probability of death. Careful surveillance of high-risk cases is crucial for predicting morbidity and mortality.
Article
Surgery
Dimitrios Schizas, Michail Papapanou, Eleni Routsi, Aikaterini Mastoraki, Irene Lidoriki, Nikolaos Zavras, Dimitrios V. Avgerinos, Andreas M. Lazaris, Alexandra Tsaroucha
Summary: Despite the increasing numbers of female medical students, surgery remains male-dominated. Female surgeons face implicit and explicit biases, lack effective mentorship, experience limited career advancement, struggle with work-life imbalance and infertility, and are financially undercompensated compared to their male counterparts. Specialty-specific challenges should not be overlooked.
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND
(2022)