Search

Background & Aims Prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma ( ICC) after curative resection were not clear. We aim to analyse prognostic factors after curative resection and evaluate adjuvant therapy and survival based on the new staging system. Methods A retrospective analysis of 283 patients who underwent surgical exploration for ICC was performed. Staging was performed according to the 7th edition AJCC staging manual. Univariate and multivariate analyses were used to evaluate independent prognostic factors. Results The difference for OS at different TNM stages after R0 resection was significant ( P < 0.001). Despite regional lymph node metastasis, tumour number and vascular invasion, serum GGT level was also an independent prognostic factor for OS of patients after R0 resection. The incidence of biliary and vascular invasion was significantly higher in high GGT group than in normal GGT group. Factors predictive of recurrence were multiple tumours and regional lymph node metastasis. After R0 resection, adjuvant TACE not only did not improve the OS of patients at TNM stage I ( P = 0.508), but significantly promoted recurrence of these patients ( P = 0.006). Only patients at TNM stage II, III and IV benefited from adjuvant TACE for longer survival, while the recurrence rates were not affected. Conclusions The new staging system can predict the survival of ICC patients after R0 resection. High GGT level may be suggestive of biliary and vascular invasion and was an independent risk factor for OS after R0 resection. Adjuvant TACE may be indicated only for patients at advanced stages for better survival. [ABSTRACT FROM AUTHOR]

BACKGROUND: Dickkopf-related protein 1 (DKK1) has been reported involved in metastasis and invasion in several tumors. This study sought to investigate the prognostic value of DKK1 in intrahepatic cholangiocarcinoma (ICC) and its role in promoting ICC metastasis. METHODS: Tissue microarrays of 138 ICC patient samples were employed to detect DKK1, vascular endothelial growth factor C (VEGF-C), and matrix metalloproteinase 9 (MMP9) expression using immunohistochemistry. The prognostic significances were assessed by Kaplan-Meier survival estimates. DKK1 expression was measured in an ICC cell line (HCCC-9810) and ICC tissues by immunofluorescence assay, quantitative real-time polymerase chain reaction, and western blot. Serum levels of DKK1 from 37 ICC patients were tested by enzyme-linked immunosorbent assay. The role of DKK1 in proliferation, migration, invasion, and gene expression regulation was assessed by DKK1 depletion using small interfering RNA. RESULTS: Multivariate analyses revealed that DKK1 was an unfavorable predictor for overall survival and time to recurrence. The prognostic significance was retained in ICC patients with low recurrence risk ( P < .05). DKK1 expression was elevated in an ICC cell line, tumor samples, and patient sera. High levels of DKK1 in ICC tissues correlated with elevated MMP9, VEGF-C, and metastasis of hepatic hilar lymph nodes. DKK1 depletion caused a decrease in cell migration and invasiveness, and down-regulation of MMP9 and VEGF-C expression. CONCLUSIONS: DKK1 is a novel prognostic biomarker for ICC, and it enhances tumor cell invasion and promotes lymph node metastasis of ICC through the induction of MMP9 and VEGF-C. DKK1 may be a potential therapeutic target for ICC. Cancer 2013. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND: PIWI protein family was found to play an important role in stem cell self-renewal. Overexpression of HIWI, the human homolog of PIWI family proteins, was found in several solid tumors, although the role of HIWI in hepatocellular carcinoma (HCC) and its prognostic value remain unclear. METHODS: HIWI expression was measured in stepwise metastatic HCC cell lines (HCCLM3, MHCC97H, MHCC97L, SMMC7721, and HepG2), the normal liver cell line (L02), and HCC tissue samples (n = 20). Proliferation and invasion were investigated in HCC cell lines undergoing HIWI target small interfering RNA transfection. Also explored was HIWI expression in HCC tissue microarrays (n = 168) for survival analysis. RESULTS: Levels of HIWI protein and mRNA were up-regulated in highly metastatic HCC cell lines (HCCLM3, MHCC97H, and MHCC97L), whereas their proliferation and invasion significantly decreased after depletion of HIWI. Intratumoral HIWI expression was higher than that of peritumoral tissue ( P < .001) and positively associated with proliferating cell nuclear antigen expression ( P < .001). Positive expression of intratumoral HIWI was associated with larger tumor size ( P = .047) and intrahepatic metastasis ( P = .027) and was an independent risk factor for overall survival ( P = .007) and recurrence-free survival ( P = .036), particularly in patients with low serum α-fetoprotein and low Edmondson-Steiner grade. CONCLUSIONS: HIWI may play a key role in HCC proliferation and metastasis and can be a potential prognostic factor for HCC after curative resection, particularly with well-differentiated HCC. Cancer 2011. © 2011 American Cancer Society. [ABSTRACT FROM AUTHOR]

The article reports on a study investigating placental growth factor (PlGF) expression in tumor and peritumoral liver tissues from 105 patients with hepatocellular carcinoma (HCC). It was found in the study that peritumoral PlGF expression was significantly higher than intratumoral PlGF expression which was not associated with patients time to recurrence (TTR). Also, peritumoral PlGF expression was an independent risk factor for patients' overall survival and TTR.

The article presents a study regarding the clinical features and independent survival predictors in patients having bone metastases from hepatocellular carcinoma (HCC). The study administered to 205 patients aims to determine these factors to those who receive external beam radiotherapy (ERT). The result shows that survival outcomes, clinical features and prognostic factors can help these patients in determining proper use of dose and fraction.

To emphasize the role of clinical innovation and basic research on the advances of hepatocellular carcinoma (HCC) surgery, related papers published by the author's institution in the last three decades and recent data were analysed. In the 1970s-1980s, diagnosis using alpha fetoprotein assay and innovation of limited resection instead of lobectomy have resulted in early diagnosis and resection of small HCC. These have led to a marked increase of long-term survivors of HCC. In the 1980s-1990s, research works including establishment of human HCC nude mice model, experimental multimodality therapy and studies on targeting therapy have been conducted. These have made resection possible in some patients after downstaging of initially unresectable HCC. The 5-year survival of unresectable HCC was improved. Since the early 1990s, research works have been carried out on metastatic recurrence of HCC, including the establishment of metastatic human HCC model, the molecular basis of HCC metastasis, angiogenesis and experimental intervention. These provide clues for prediction and prevention of metastatic recurrence of HCC. Translation from bench to bedside has resulted in improved disease free survival after curative HCC resection in a randomized control trial using interferon alpha. It is concluded, clinical innovation and basic research are essential for progress of HCC surgery. &figfua; &figfub;. [ABSTRACT FROM AUTHOR]