Article
Gastroenterology & Hepatology
Annsa C. Huang, Jennifer L. Dodge, Francis Y. Yao, Neil Mehta
Summary: This study evaluated the national experience of down-staging in liver transplant for hepatocellular carcinoma. The risk for waitlist dropout was significantly higher in the all-comers group compared to the UNOS-DS and Milan groups after successful down-staging to Milan criteria.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Surgery
Karim J. Halazun, Russell E. Rosenblatt, Neil Mehta, Quirino Lai, Kaveh Hajifathalian, Andre Gorgen, Gagan Brar, Kazunari Sasaki, Maria B. Majella Doyle, Parissa Tabrizian, Vatche G. Agopian, Marc Najjar, Tommy Ivanics, Benjamin Samstein, Robert S. Brown, Jean C. Emond, Francis Yao, Jan Lerut, Massimo Rossi, Gianluca Mennini, Samuele Iesari, Armin Finkenstedt, Benedikt Schaefer, Jans Mittler, Maria Hoppe-Lotichius, Cristiano Quintini, Federico Aucejo, William Chapman, Gonzalo Sapisochin
Summary: This study validates the importance of AFP-R in selecting patients with HCC for liver transplant, showing its accurate prediction of recurrence and overall survival. AFP-R is a truly objective pre-transplant biological characteristic, and its incorporation into selection criteria allows for safe expansion of existing models and offers transplant opportunities to patients with acceptable tumor characteristics who might otherwise be denied potential cure.
Article
Medicine, General & Internal
Behnam Saberi, Ahmet Gurakar, Hani Tamim, Carolin V. Schneider, Omar T. Sims, Alan Bonder, Zachary Fricker, Saleh A. Alqahtani
Summary: This study examined the racial disparities in liver transplant and post-transplant outcomes for hepatocellular carcinoma patients in the United States. The study found that there were unequal proportions of liver transplant and differences in survival rates among different racial groups. Black or African American patients had the worst outcomes after liver transplant.
Article
Oncology
Yi-Hao Yen, Yueh-Wei Liu, Wei-Feng Li, Chih-Chi Wang, Chee-Chien Yong, Chih-Che Lin, Chih-Yun Lin
Summary: This study evaluated whether combining radiographic tumor burden score (TBS) and alpha-fetoprotein (AFP) level could stratify overall survival (OS) among hepatocellular carcinoma (HCC) patients after liver resection (LR). The results showed that the combination of TBS and AFP levels could effectively predict the overall survival of HCC patients.
Article
Oncology
Jin-Chiao Lee, Hao-Chien Hung, Yu-Chao Wang, Chih-Hsien Cheng, Tsung-Han Wu, Chen-Fang Lee, Ting-Jung Wu, Hong-Shiue Chou, Kun-Ming Chan, Wei-Chen Lee
Summary: MVI is a crucial risk factor for HCC recurrence, and predicting MVI preoperatively can optimize treatment plans. The study developed a user-friendly risk score model, which can assist in future research design.
Article
Gastroenterology & Hepatology
Henrique A. Lima, Yutaka Endo, Laura Alaimo, Zorays Moazzam, Muhammad Musaab Munir, Chanza Shaikh, Vivian Resende, Alfredo Guglielmi, Hugo P. Marques, Francois Cauchy, Vincent Lam, George A. Poultsides, Irinel Popescu, Sorin Alexandrescu, Guillaume Martel, Tom Hugh, Itaru Endo, Minoru Kitago, Feng Shen, Timothy M. Pawlik
Summary: The resection of intermediate-stage hepatocellular carcinoma (HCC) remains controversial. This study developed a risk score and identified low AFP and low TBS as the subset of patients most likely to benefit from resection.
JOURNAL OF GASTROINTESTINAL SURGERY
(2022)
Article
Gastroenterology & Hepatology
Neil Mehta, Jennifer L. Dodge, John P. Roberts, Francis Y. Yao
Summary: The study analyzed the risk of wait-list dropout among patients with hepatocellular carcinoma in different regions and found that patients with higher dropout risk scores may have poorer post-transplant survival.
JOURNAL OF HEPATOLOGY
(2021)
Article
Gastroenterology & Hepatology
Helena Degroote, Federico Pinero, Charlotte Costentin, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Aline Lopes Chagas, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrio Di Benedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Adrian Gadano, Claire Vanlemmens, Stefano Fagiuoli, Fernando Rubinstein, Patrizia Burra, Daniel Cherqui, Marcelo Silva, Hans Van Vlierberghe, Christophe Duvoux
Summary: Successful downstaging of more advanced hepatocellular carcinoma (HCC) within the UCSF-DS protocol to the conventional Milan criteria does not result in a higher recurrence rate after liver transplantation (LT) compared to patients remaining within Milan criteria. Additionally, in the UCSF-DS group, an ALP value equal to or below 20 ng/ml at listing might be a novel tool to further optimize selection of candidates for LT.
Article
Gastroenterology & Hepatology
Neil Mehta, Catherine Frenette, Parissa Tabrizian, Maarouf Hoteit, Jennifer Guy, Neehar Parikh, T. Tara Ghaziani, Renu Dhanasekaran, Jennifer L. Dodge, Brahma Natarajan, Matthew L. Holzner, Leana Frankul, Wesley Chan, Austin Fobar, Sander Florman, Francis Y. Yao
Summary: This study is the first multiregional study based on UNOS-DS criteria, showing a successful downstaging rate of >80% and similar efficacy of chemoembolization and yttrium-90 radioembolization as the initial downstaging treatment. Despite a 2-year post-LT survival rate of 95%, a high rate of tumor understaging was observed.
Article
Surgery
Brahma Natarajan, Parissa Tabrizian, Maarouf Hoteit, Catherine Frenette, Neehar Parikh, Tara Ghaziani, Renu Dhanasekaran, Jennifer Guy, Amy Shui, Sander Florman, Francis Y. Yao, Neil Mehta
Summary: Patients with hepatocellular carcinoma meeting UNOS-DS criteria have excellent LT outcomes, but outcomes for AC patients with tumors initially exceeding the criteria are poorly understood. AC patients had a lower probability of successful DS and lower 3-year survival. Understaging on explant was associated with tumor size and AFP level. Post-LT outcomes were similar between cohorts.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Gastroenterology & Hepatology
Simone Famularo, Umberto Cillo, Andrea Lauterio, Matteo Donadon, Alessandro Vitale, Matteo Serenari, Federica Cipriani, Federico Fazio, Mario Giuffrida, Francesco Ardito, Tommaso Dominioni, Mattia Garancini, Quirino Lai, Daniele Nicolini, Sarah Molfino, Pasquale Perri, Enrico Pinotti, Simone Conci, Cecilia Ferrari, Matteo Zanello, Stefan Patauner, Giuseppe Zimmitti, Paola Germani, Marco Chiarelli, Maurizio Romano, Michela De Angelis, Giuliano La Barba, Albert Troci, Valentina Ferraro, Francesco Izzo, Adelmo Antonucci, Andrea Belli, Riccardo Memeo, Michele Crespi, Giorgio Ercolani, Luigi Boccia, Giacomo Zanus, Paola Tarchi, Moh'd Abu Hilal, Antonio Frena, Elio Jovine, Guido Griseri, Andrea Ruzzenente, Mauro Zago, Gianluca Grazi, Gian L. Baiocchi, Marco Vivarelli, Massimo Rossi, Fabrizio Romano, Marcello Maestri, Felice Giuliante, Raffaele D. Valle, Alessandro Ferrero, Luca Aldrighetti, Luciano De Carlis, Guido Torzilli, HERCOLES Grp Contributors
Summary: This study compared the survival after recurrence (SAR) of second-line transplant (SLT) with repeated hepatectomy and thermoablation for recurrent hepatocellular carcinoma. The results showed that SLT patients had a longer SAR compared to patients who underwent repeated hepatectomy and thermoablation. In patients who met the Milan Criteria, SLT and MELD score were the only predictors of mortality. Among patients who did not meet the Milan Criteria, the number of nodules at recurrence was the only predictor of mortality. This suggests the important advantage of SLT in the treatment of recurrent hepatocellular carcinoma.
Review
Gastroenterology & Hepatology
Dana A. Dominguez, Paul Wong, Laleh G. Melstrom
Summary: This review discusses the lack of sensitive and specific biomarkers for predicting prognosis, monitoring minimal residual disease, and predicting treatment response in hepatocellular carcinoma (HCC). Although alpha-fetoprotein (AFP) is the most widely used biomarker, its applicability is limited. Liquid biopsy provides potential biomarkers, but validation in large clinical trials is lacking. Clinical trials are critical for the development of optimal therapeutic regimens and improvement of patient outcomes.
HEPATOBILIARY SURGERY AND NUTRITION
(2023)
Review
Gastroenterology & Hepatology
Francis Y. Yao, Nicholas Fidelman, Neil Mehta
Summary: The success of liver transplant for hepatocellular carcinoma relies on accurate tumor staging, candidate selection based on factors like AFP and response to therapy. Tumor downstaging, achieved through local regional therapy, is crucial for a subgroup of HCC with favorable biology, requiring a structured approach and incorporation of AFP into staging and treatment response assessments.
SEMINARS IN LIVER DISEASE
(2021)
Article
Gastroenterology & Hepatology
Roma Raj, Nihal Aykun, Chase J. Wehrle, Marianna Maspero, Smitha Krishnamurthi, Bassam Estfan, Suneel Kamath, Federico Aucejo
Summary: The combination of immune-checkpoint inhibitor and vascular endothelial growth factor antagonist has become the first line treatment for advanced hepatocellular carcinoma. However, a significant number of patients do not respond to this treatment, and the biomarkers for response remain unknown.
JOURNAL OF GASTROINTESTINAL SURGERY
(2023)
Article
Gastroenterology & Hepatology
Ting-Shi Su, Shi-Xiong Liang, Li-Qing Li, Qiu-Hua Liu, Xue-Zhang Duan, Jing Sun, Hai Zeng, Hai-Sheng Zhu, Jian-Xu Li, Xiao-Fei Zhu, Hong-Qing Zhuang, Ping Liang, Yong Huang
Summary: The study aims to create a new staging model for prognostic hepatocellular carcinoma (HCC) classification based on radiotherapy. The modified staging model shows excellent ability to differentiate patients based on different stages, providing an alternative for clinical radiation oncologists.
JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY
(2023)