Search

Objective To investigate the effect of postoperative transarterial chemoembolization (TACE) for huge intrahepatic cholangiocarcinoma (ICC). Methods Data of 125 huge ICC (diameter ≥10 cm) patients with surgical treatment treated with or without TACE (TACE group 35 cases, and non-TACE group 90 cases) between January 2009 and December 2013 were analyzed retrospectively. Both recurrence rate and overall survival (OS) rate were analyzed using the Kaplan-Meier method and the difference using Log-Rank test. Cox regression analysis was used to explore the independent risk factors of postoperative recurrence and OS. Propensity score matching was used to reduce the difference between groups. Subgroup analysis was done for benefited patients from TACE based on the 8th TNM staging of ICC. Results TACE group had similar recurrence and OS with non-TACE group. 5-year recurrence rate and OS rate were 85.7% vs. 84.4%, P=0.487; 22.9% vs. 20.0%, P=0.426, respectively. After 1∶1 propensity score matching with 33 cases each group, there was no significant difference between two groups (P=0.114 for recurrence, P=0.197 for OS). According to TNM sta-ging, there were 61 cases in stage Ⅰ and 64 cases in stage Ⅱ. Staging analysis showed that TACE group and non-TACE groups yielded similar recurrence and OS in patients with stage Ⅰ. However, for patients in stage Ⅱ, TACE group had lower recurrence rate (91.7% vs. 97.5%, P=0.022) and higher OS rate (12.5% vs. 2.5%, P=0.002). After adjustment for multiple tumors, vascular invasion, and CEA ≥5 μg/L, TACE was independent risk factor of recurrence (hazard ratio: 0.564, 95%CI: 0.327-0.974) and OS (hazard ratio: 0.449, 95%CI: 0.259-0.777) in patients with stage Ⅱ. Conclusions For patients with huge ICC, postoperative TACE may improve the prognosis of patients with TNM stage Ⅱ.

Objective To investigate the effect of wide surgical margin on the prognosis of patients with single intrahepatic cholangiocarcinoma (ICC) undergoing hepatectomy and the effect of microvascular invasion (MVI) on the treatment of hepatectomy with both wide surgical margin and narrow surgical margin. Methods From December 2011 to December 2017, the clinicopathological data of 302 patients with single ICC who underwent radical resection were retrospectively studied in 13 medical centers. According to the width of surgical margin, there were 126 patients (41.7%) in wide surgical margin group (≥1 cm) and 176 patients (58.3%) in narrow surgical margin group (0.05). Disease-free survival rate in wide surgical margin group before PSM was significantly higher than that in narrow surgical margin group (P=0.005), while overall survival rate showed no statistically significant difference (P=0.053). After PSM, both overall survival rate and disease-free survival rate in wide surgical margin group were significantly higher than those in narrow surgical margin group (P0.05). In MVI negative group, however both overall survival rate and disease-free survival rate were significantly higher in the patients with wide surgical margin hepatectomy than in those with narrow surgical margin (P

Introduction: Hepatic fibrosis is a progressive pathological process involving the exhaustion of hepatocellular regenerative capacity and ultimately leading to the development of cirrhosis and even hepatocellular carcinoma. Brg1, the core subunit of the SWI/SNF chromatin-remodeling complex, was recently identified as important for liver regeneration. This study investigates the role of Brg1 in hepatic fibrosis development. Methods: Hepatocyte-specific Brg1 knockout mice were generated and injected with carbon tetrachloride (CCl4) for 4, 6, 8, and 12 weeks to induce liver fibrosis. Afterwards, liver fibrosis and liver damage were assessed. Results: Brg1 expression was significantly increased in the fibrotic liver tissue of wild-type mice, as compared to that of untreated wild-type mice. The livers of the Brg1 knockout animals showed reduced liver inflammation, extracellular matrix accumulation, and liver fibrosis. TNF-α and NF-κB-mediated inflammatory response was reduced in Brg1 knockout animals. Conclusion: Brg1 promotes the progression of liver fibrosis in mice and may therefore be used as a potential therapeutic target for treating patients with liver fibrosis due to chronic injury. [ABSTRACT FROM AUTHOR]

Background Preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) may optimize individualized treatment decision-making. This study aimed to investigate the prognostic differences between HCC patients undergoing liver resection (LR) and liver transplantation (LT) based on predicted MVI risks. Methods We analysed 905 patients who underwent LR, including 524 who underwent anatomical resection (AR) and 117 who underwent LT for HCC within the Milan criteria using propensity score matching. A nomogram model was used to predict preoperative MVI risk. Results The concordance indices of the nomogram for predicting MVI were 0.809 and 0.838 in patients undergoing LR and LT, respectively. Based on an optimal cut-off value of 200 points, the nomogram defined patients as high- or low-risk MVI groups. LT resulted in a lower 5-year recurrence rate and higher 5-year overall survival (OS) rate than LR among the high-risk patients (23.6% vs 73.2%, P  <   0.001; 87.8% vs 48.1%, P  <   0.001) and low-risk patients (19.0% vs 45.7%, P  <   0.001; 86.5% vs 70.0%, P  =   0.002). The hazard ratios (HRs) of LT vs LR for recurrence and OS were 0.18 (95% confidence interval [CI], 0.09–0.37) and 0.12 (95% CI, 0.04–0.37) among the high-risk patients and 0.37 (95% CI, 0.21–0.66) and 0.36 (95% CI, 0.17–0.78) among the low-risk patients. LT also provided a lower 5-year recurrence rate and higher 5-year OS rate than AR among the high-risk patients (24.8% vs 63.5%, P  =   0.001; 86.7% vs 65.7%, P  =   0.004), with HRs of LT vs AR for recurrence and OS being 0.24 (95% CI, 0.11–0.53) and 0.17 (95% CI, 0.06–0.52), respectively. The 5-year recurrence and OS rates between patients undergoing LT and AR were not significantly different in the low-risk patients (19.4% vs 28.3%, P  =   0.129; 85.7% vs 77.8%, P  =   0.161). Conclusions LT was superior to LR for patients with HCC within the Milan criteria with a predicted high or low risk of MVI. No significant differences in prognosis were found between LT and AR in patients with a low risk of MVI. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) is one of the most common malignancies in China. Most HCC patients are first diagnosed at an advanced stage, and systemic treatments are the mainstay of treatment. Summary: In recent years, immune checkpoint inhibitors have made a breakthrough in the systemic treatment of middle-advanced HCC, breaking the single therapeutic pattern of molecular-targeted agents. To better guide the clinical treatment for effective and safe use of immunotherapeutic drugs, the Chinese Association of Liver Cancer and Chinese Medical Doctor Association has gathered multidisciplinary experts and scholars in relevant fields to formulate the "Chinese Clinical Expert Consensus on Immunotherapy for Hepatocellular Carcinoma (2021)" based on current clinical studies and clinical medication experience for reference in China. Key Messages: The consensus contained 17 recommendations, including the preferred regimen for first- and second-line immunotherapy, evaluation and monitoring before/during/after treatment, management of complications, precautions for special patients, and potential population for immunotherapy. [ABSTRACT FROM AUTHOR]

To explore the biological activity of transmembrane prostateandrogen induced RNA (PMEPA1) in human pancreatic cancer (hPAC) cells and its drug sensitivity to gemcitabine (GEM) and cisplatin (DDP). Gene Expression Profiling Interactive Analysis (GEPIA) and Cancer Cell Line Encyclopedia (CCLE) were consulted to indicate the expression of PMEPA1 in hPAC tissues and cells. Quantitative real‐time PCR (RT‐qPCR) and western blot were performed to verify the indication. RT‐qPCR and western blot also detected the expressions of PTEN/PI3K/AKT before and after transfection of PMEPA1 siRNA plasmids. Cell counting Kit‐8 (CCK‐8) and EdU staining were performed to examine cell proliferation before and after transfection of phosphatase and tensin homologue delet2ed on chromosome ten (PTEN) siRNA plasmids. Transwell and wound healing detected the invasion and migration of hPAC cells. The expressions of MMP‐2 and MMP‐9 were detected by western blot. After GEM or DDP treatment, cell viability was observed by commercial kits and cell apoptosis by flow cytometry. GEPIA and CCLE predicted increased expression of PMEPA1 in hPAC tissues and cells, which was confirmed by quantitative reverse transcription polymerase chain reaction (RT‐qPCR) and western blot. PMEPA1 was also shown to be associated with disease‐free survival. Transfection of PMEPA1 siRNA plasmids affected the expressions of PTEN/PI3K/AKT. PMEPA1 interference inhibited the proliferation, invasion and migration of hPAC cells. Furthermore, PMEPA1 interference also enhanced the sensitivity of hPAC cells to GEM and DDP via PTEN interference. PMEPA1 interference inhibits the proliferation, invasion and migration of pancreatic cancer cells and enhances the sensitivity to GEM and cisplatin by activating PTEN/PI3K/AKT signaling. [ABSTRACT FROM AUTHOR]