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Pinto E, Pelizzaro F, Cardin R, Battistel M, Palano G, Bertellini F, Kitenge MP, Peserico G, Farinati F, Russo FP. HIF-1α and VEGF as prognostic biomarkers in hepatocellular carcinoma patients treated with transarterial chemoembolization. Dig Liver Dis 2024; 56:872-879. [PMID: 37783655 DOI: 10.1016/j.dld.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/22/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Neoangiogenesis plays a crucial role in the progression of hepatocellular carcinoma (HCC), and concerns have been raised about the role of neoangiogenesis on the effectiveness of transarterial chemoembolization (TACE). AIM In this study, we aimed to evaluate Vascular Endothelial Growth Factor (VEGF) and Hypoxia-Inducible Factor-1α (HIF-1α) as circulating prognostic biomarkers in HCC patients treated with TACE. METHODS Blood samples were collected from 163 patients before (t0) and four weeks after TACE (t1). RESULTS Higher levels of VEGF after TACE were demonstrated (264.0 [78.7-450.8] vs. 278.6 [95.0-576.6] pg/mL; p < 0.0001). Responders to TACE had lower levels of VEGF than non-responders both at t0 (200.0 [58.9-415.8] vs. 406.6 [181.4-558.6] pg/mL; p = 0.006) and at t1 (257.3 [68.5-528.6] vs. 425.9 [245.2-808.3] pg/mL; p = 0.003), and in both groups there was an increase in VEGF compared to measurements before treatment (p = 0.001 and p = 0.005, respectively). VEGF was not associated with overall survival (OS), while patients with HIF-1α ≤ 0.49 ng/mL showed better prognosis (median OS 28.0 months [95% CI 19.7-36.3] vs. 17.0 months [95% CI 11.1-22.9]; p = 0.01). Moreover, HIF-1α was identified as an independent prognostic parameter. CONCLUSIONS VEGF and HIF-1α can be considered useful prognostic biomarkers in HCC patients treated with TACE.
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Affiliation(s)
- Elisa Pinto
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Filippo Pelizzaro
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Romilda Cardin
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Michele Battistel
- Radiology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Giorgio Palano
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Federica Bertellini
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Maria Piera Kitenge
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Giulia Peserico
- Gastroenterology Unit, Veneto Institute of Oncology (IOV), Padova, Italy
| | - Fabio Farinati
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy.
| | - Francesco Paolo Russo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
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Yang D, Yang J, Zhu F, Hui J, Li C, Cheng S, Hu D, Wang J, Han L, Wang H. Complications and local recurrence of malignant liver tumor after ablation in risk areas: a retrospective analysis. Eur J Gastroenterol Hepatol 2023; 35:761-768. [PMID: 37272505 PMCID: PMC10234327 DOI: 10.1097/meg.0000000000002560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/24/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Microwave ablation (MWA) is an effective local treatment for malignant liver tumors; however, its efficacy and safety for liver tumors adjacent to important organs are debatable. PATIENTS AND METHODS Forty-three cases with liver tumors adjacent to important organs were the risk group and 66 cases were the control group. The complications between two groups were compared by chi-square test and t-test. Local tumor recurrence (LTR) was analyzed by log-rank test. Factors affecting complications were analyzed by logistic regression and Spearman analyses. Factors affecting LTR were analyzed by Cox regression analysis. A receiver operating characteristic curve predicted pain treated with drugs and LTR. RESULTS We found no significant difference in complications and LTR between two groups. The risk group experienced lower ablation energy and more antennas per tumor than control group. Necrosis volume after MWA was positively correlated with pain; necrosis volume and ablation time were positively correlated with recovery duration. Major diameter of tumor >3 cm increased risk of LTR by 3.319-fold, good lipiodol deposition decreased risk of LTR by 73.4%. The area under the curve (AUC) for necrosis volume in predicting pain was 0.74, with a 69.1 cm3 cutoff. AUC for major diameter of tumor in predicting LTR was 0.68, with a 27.02 mm cutoff. CONCLUSION MWA on liver tumors in at-risk areas is safe and effective, this is largely affected by proper ablation energy, antennas per tumor, and experienced doctors. LTR is primarily determined by major diameter of tumor and lipiodol deposition status.
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Affiliation(s)
- Dong Yang
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining
- Oncology Department, Shandong University of Traditional Chinese Medicine, Jinan City
| | - Jundong Yang
- Radiotherapy Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Fenghua Zhu
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining
| | - Jing Hui
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining
| | - Changlun Li
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining
| | - Shuyuan Cheng
- Radiotherapy Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, PR China
| | - Dongyu Hu
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining
| | - Junye Wang
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining
| | - Lei Han
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining
| | - Huili Wang
- Oncology Department, Affiliated Hospital of Jining Medical University, Jining
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Kim MS, Kang M, Park J, Ryu JM. Nurses' comfort care of transarterial chemoembolization patients based on their perceptions around postembolization syndrome and symptom interference. Nurs Open 2022; 10:2877-2885. [PMID: 36565057 PMCID: PMC10077417 DOI: 10.1002/nop2.1529] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 10/03/2022] [Accepted: 11/20/2022] [Indexed: 12/25/2022] Open
Abstract
AIM Post-embolization syndrome is a common adverse event following trans-arterial chemoembolization, which negatively impacts the daily life of the patients involved. This study examined whether perceptions around post-embolization syndrome and symptom interference among nurses affect their comfort care performance toward patients who have undergone this procedure. DESIGN A descriptive cross-sectional study. METHODS One hundred and fifty registered nurses were surveyed from September to November 2020. Perceived post-embolization syndrome, symptom interference, and comfort care (including physical, psychospiritual, sociocultural, and environmental dimensions) were measured. Data were analyzed using t-tests, analysis of variance, Pearson's correlation, and a multivariate analysis of variance. RESULTS There were no individual effects found of perceived post-embolization syndrome or symptom interference on nurses' comfort care performance. However, statistically significant interaction effects were found in terms of their sociocultural and environmental care. CONCLUSION Nurses who recognized both high post-embolization syndrome and symptom interference among their patients were found to provide greater sociocultural and environmental care. As such, nurses should improve their early symptom and symptom interference detection protocols based on current care guidelines and provide physical, psychospiritual, sociocultural, and environmental comfort care.
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Affiliation(s)
- Myoung Soo Kim
- Department of Nursing, Pukyong National University, Busan, South Korea
| | - Minkyeong Kang
- Department of Nursing, Pukyong National University, Busan, South Korea
| | - Jiwon Park
- Department of Nursing, Pukyong National University, Busan, South Korea
| | - Jung Mi Ryu
- Department of Nursing, Busan Institute of Science and Technology, Busan, South Korea
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Zhang Y, Qu S, Yi W, Zhai J, Zhang X, Wei L, Lau WY, Wu M, Shen F, Fan H, Wu D. A Pretreatment CT Model Predicts Survival Following Chemolipiodolization in Patients With Hepatocellular Carcinoma. Technol Cancer Res Treat 2019; 18:1533033819844488. [PMID: 31204599 PMCID: PMC6582374 DOI: 10.1177/1533033819844488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose: To establish a computed tomography–based prognostic model for patients with hepatocellular carcinoma treated with transarterial chemoembolization. Materials and Methods: Using prospectively collected data from 195 consecutive patients with hepatocellular carcinoma who underwent chemolipiodolization at the Eastern Hepatobiliary Surgery Hospital between 2013 and 2016, we established a prognostic model based on hepatocellular carcinoma enhancement patterns on computed tomography scans to predict the outcome of transarterial chemoembolization. Furthermore, a histopathology analysis was performed on 108 different patients undergoing resection between 2014 and 2016 to identify whether there was a correlation between enhancement pattern and microvessel density. Results: The prognostic model classified hepatocellular carcinoma into 3 types: type I, which reached peak enhancement during the arterial phase and had a high mean microvessel density (101.5 vessels/0.74 mm2); type II, which reached peak enhancement during the portal venous or delayed phase and had an intermediate microvessel density (53.6 vessels/0.74 mm2); and type III, in which the tumor was insignificantly enhanced and had a low microvessel density (21.1 vessels/0.74 mm2). For type I, II, and III hepatocellular carcinoma, the post-transarterial chemoembolization 1-year tumor complete necrosis rates were 13.7%, 36.5%, and 0%, respectively (P < .001), and the 3-year overall survival rates were 14.1%, 38.6%, and 0%, respectively (P < .001). Conclusion: Our results indicate that hepatocellular carcinoma type is an independent predictor of complete necrosis and overall survival
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Affiliation(s)
- Yijun Zhang
- 1 Department of Hepatic Surgery, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.,2 Department of Radiological Intervention treatment, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Shuping Qu
- 1 Department of Hepatic Surgery, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Wanwan Yi
- 3 Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Jian Zhai
- 2 Department of Radiological Intervention treatment, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Xiaobing Zhang
- 2 Department of Radiological Intervention treatment, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Lixin Wei
- 4 Tumor Immunology and Gene Therapy Center, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Wan Yee Lau
- 1 Department of Hepatic Surgery, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.,5 Faculty of Medicine, the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Mengchao Wu
- 1 Department of Hepatic Surgery, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Feng Shen
- 1 Department of Hepatic Surgery, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Hengwei Fan
- 1 Department of Hepatic Surgery, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Dong Wu
- 1 Department of Hepatic Surgery, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
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Cai W, Liu Z, Xiao Y, Zhang W, Tang D, Cheng B, Li Q. Comparison of clinical outcomes of laparoscopic versus open surgery for recurrent hepatocellular carcinoma: a meta-analysis. Surg Endosc 2019; 33:3550-3557. [PMID: 31342257 DOI: 10.1007/s00464-019-06996-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 07/15/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The purpose of this study is to compare the clinical outcomes of laparoscopic liver resection versus open liver resection for recurrent hepatocellular carcinoma (RHCC). METHODS Published studies which investigated laparoscopic versus open liver resection for RHCC were identified, and meta-analysis was used for statistical analysis. RESULTS Six studies were analyzed by meta-analysis method, and cumulative 335 cases were included in this study. Laparoscopic liver resection was performed in 145 cases, and open liver resection was performed in 190 cases. Meta-analysis showed that there was no difference in operative time and 90-day mortality between the laparoscopic group and the open group (p = 0.06 and p = 0.06 respectively); Nevertheless, compared with the open group, the laparoscopic group resulted in significantly lower rate of in-hospital complication (p < 0.0001), much less blood loss (p < 0.0001) and shorter postoperative hospital stay (p = 0.002). CONCLUSION Laparoscopic liver resection for RHCC offers a benefit of lower in-hospital complication rate, less blood loss, shorter postoperative hospital stay, while similar operative time and 90-day mortality as the open liver resection. Laparoscopic liver resection is feasible with satisfactory postoperative outcomes and can be a safe alternative treatment strategy to open procedure for RHCC.
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Affiliation(s)
- Wenwu Cai
- Department of General Surgery, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Zhide Liu
- Department of General Surgery, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Yangyan Xiao
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Weichang Zhang
- Department of General Surgery, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Da Tang
- Department of General Surgery, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Boran Cheng
- Department of Oncology, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, People's Republic of China
| | - Qinglong Li
- Department of General Surgery, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
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Wei Y, Dai F, Zhao T, Tao C, Wang L, Ye W, Zhao W. Transcatheter arterial chemoembolization monotherapy vs combined transcatheter arterial chemoembolization-percutaneous microwave coagulation therapy for massive hepatocellular carcinoma (≥10 cm). Cancer Manag Res 2018; 10:5273-5282. [PMID: 30464624 PMCID: PMC6219403 DOI: 10.2147/cmar.s172395] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background The prognosis of massive hepatocellular carcinomas (MHCCs; ≥10 cm) remains worse. Purpose The aim of this study was to evaluate the clinical benefits of transcatheter arterial chemoembolization (TACE) or TACE combined with percutaneous microwave coagulation therapy (PMCT) and the long-term survival rate of MHCC patients treated with these techniques. Patients and methods A retrospective study was performed using data involving 102 MHCC patients admitted to the Second Hospital of Nanjing from September 2010 to August 2015. The median interval between treatments and overall survival (OS) was hierarchically analyzed using log-rank tests. Multivariate analysis was done using Cox regression model analysis. Results The median survival time of MHCC patients was 3 months (range, 1–10 months) in the palliative group, 3 months (range, 1–39 months) in the TACE group, and 7.5 months (range, 3–30 months) in the TACE–PMCT group (P=0.038). The 6-, 12-, and 18-month OS rates for MHCC patients were 15%, 0%, and 0% in the palliative group, 30%, 25.63%, and 17.97% in the TACE group, and 50%, 41.67%, and 16.67% in the TACE–PMCT group, respectively (P=0.0467). In addition, TACE sessions had positive correlation with the survival time of MHCC patients (rho = 0.462, P<0.001). TACE treatment more than three times (HR =0.145, P<0.001) was an independent predictor of the survival of MHCC patients, which was identified by the Cox regression model analysis. Conclusions These results indicated that TACE–PMCT treatment in MHCC patients had advantages in prolonging OS and improving liver function. Multiple TACE treatments might be a suitable treatment for the MHCC patients.
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Affiliation(s)
- Yanyan Wei
- Liver Disease Department, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing, China, ;
| | - Feng Dai
- Liver Disease Department, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing, China, ;
| | - Tianhui Zhao
- Liver Disease Department, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing, China, ;
| | - Chen Tao
- Liver Disease Department, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing, China, ;
| | - Lili Wang
- Liver Disease Department, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing, China, ;
| | - Wei Ye
- Liver Disease Department, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing, China, ;
| | - Wei Zhao
- Liver Disease Department, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing, China, ;
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Aliberti C, Carandina R, Sarti D, Pizzirani E, Ramondo G, Cillo U, Guadagni S, Fiorentini G. Transarterial chemoembolization with DC Bead LUMI™ radiopaque beads for primary liver cancer treatment: preliminary experience. Future Oncol 2017; 13:2243-2252. [DOI: 10.2217/fon-2017-0364] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Aim: Primary objectives of the study were to assess the safety of transarterial chemoembolization (TACE) using DC Bead LUMI™ for the treatment of hepatocellular carcinoma and beads distribution after TACE. Patients/methods: This was a prospective observational cohort study. The study included 44 hepatocellular carcinoma patients who were treated with TACE using DC Bead LUMI. Beads distribution was monitored 1 h after TACE by CT scan. Results: TACE had no intraprocedural complications. Observed side effects were of mild intensity and included pain in 5 (11%), fever in 4 (9%) and vomiting in 2 (5%) patients. Most patients (89%) reported no adverse event. Non-target distribution was observed in only two cases (5%). Conclusion: DC Bead LUMI allowed assessing in real time their distribution. This could prevent non-target infusion and reduce toxicity.
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Affiliation(s)
- Camillo Aliberti
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy
| | - Riccardo Carandina
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy
| | - Donatella Sarti
- Onco-Ematology Department, Azienda Ospedaliera ‘Ospedali Riuniti Marche Nord’, 61122 Pesaro, Italy
| | - Enrico Pizzirani
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy
| | - Gaetano Ramondo
- Oncology Radiodiagnostics Department, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy
| | - Umberto Cillo
- Surgical and Gastroenterological Sciences Dept, University of Padova, 35128 Padova, Italy
| | - Stefano Guadagni
- Department of Applied Clinical Sciences & Biotechnology, University of L'Aquila, 7100 L'Aquila, AQ, Italy, and Alma Mater Europaea – ECM, Slovenska ulica 17, Maribor, Slovenja
| | - Giammaria Fiorentini
- Onco-Ematology Department, Azienda Ospedaliera ‘Ospedali Riuniti Marche Nord’, 61122 Pesaro, Italy
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