Prognosis of hepatocellular carcinoma.

Barcelona-Clinic Liver Cancer (BCLC) Group, Liver Unit, Institut de Malalties Digestives, Hospital Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Catalonia, Spain.
Hepato-gastroenterology (Impact Factor: 0.91). 49(43):7-11.
Source: PubMed

ABSTRACT The prognosis of patients with hepatocellular carcinoma is related to the stage of the tumor at diagnosis and to the degree of liver function impairment induced either by the tumor itself or by the underlying cirrhosis. Any prognostic prediction should also take into account the potential impact of therapeutic interventions. Only surgical resection, liver transplantation and percutaneous ablation achieve a relatively high rate of complete responses in patients with tumors diagnosed at an early stage and may improve survival. By contrast, patients diagnosed at an advanced stage will receive palliative treatment with unproven survival benefits. Each stage and each treatment have their specific prognostic predictors. Thus, the most accurate prognostic system will have to use a specific model for each strata at which patients may be diagnosed: early, intermediate-advanced and terminal. Patients at an early stage may achieve a 5-year survival rate above 50%, those at intermediate-advanced present a 20-50% survival at 3 years and those at terminal stage die within six months. In addition to predicting prognosis, the staging system should also guide the selection of treatment and this is the major advantage of the classification applied in the Barcelona-Clinic Liver Cancer Group.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Recently, a genome-wide association study conducted in Chinese reported a single nucleotide polymorphism at KIF1B, rs17401966, associated with the susceptibility of hepatitis B virus-related hepatocellular carcinoma. In this study, we aim to investigate the effect of rs17401966 on the prognosis of hepatitis B virus-related hepatocellular carcinoma patients at intermediate or advanced stages.
    Cancer Epidemiology 08/2014; · 2.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Attenuated Listeria monocytogenes (LM) is a promising candidate vector for the delivery of cancer vaccines. After phagocytosis by antigen-presenting cells, this bacterium stimulates the major histocompatibility complex (MHC)-I and MHC-II pathways and induces the proliferation of antigen-specific T lymphocytes. A new strategy involving genetic modification of the replication-deficient LM strain ΔdalΔdat (Lmdd) to express and secrete human CD24 protein has been developed. CD24 is a hepatic cancer stem cell biomarker that is closely associated with apoptosis, metastasis and recurrence of hepatocellular carcinoma (HCC). After intravenous administration in mice, Lmdd-CD24 was distributed primarily in the spleen and liver and did not cause severe organ injury. Lmdd-CD24 effectively increased the number of interferon (IFN)-γ-producing CD8(+) T cells and IFN-γ secretion. Lmdd-CD24 also enhanced the number of IL-4- and IL-10-producing T helper 2 cells. The efficacy of the Lmdd-CD24 vaccine was further investigated against Hepa1-6-CD24 tumors, which were inguinally inoculated into mice. Lmdd-CD24 significantly reduced the tumor size in mice and increased their survival. Notably, a reduction of T regulatory cell (Treg) numbers and an enhancement of specific CD8(+) T-cell activity were observed in the tumor-infiltrating lymphocytes (TILs). These results suggest a potential application of the Lmdd-CD24 vaccine against HCC.Cellular & Molecular Immunology advance online publication, 3 February 2014; doi:10.1038/cmi.2013.64.
    Cellular & molecular immunology 02/2014; · 4.19 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Classical external-beam radiation in the treatment of hepatocellular carcinoma produced unsatisfactory results. Research on the development of irradiation is in an evaluation stage to reach an optimal strategy or even a curative goal. Three-dimensional conformal radiation therapy has a possibility of increasing the radiation dose to eliminate tumors and to avoid toxicity in non-tumor tissues. New improvements are currently available with the advent of respiratory gating and stereotactic irradiation, to again increase the radiation dose while sparing the surrounding normal tissues. In addition, surgery, radiofrequency ablation, percutaneous injection of alcohol, and the advantages of the external-beam radiation have been clearly demonstrated such as its availability, accessibility to target multiple localizations anywhere within the liver parenchyma, non-invasive treatment for profound lesions, and potential association with anti-tumor approaches. Current clinical trials on these newtechniques contribute to the integration of external radiotherapy as one of the optimal therapeutic strategies for the treatment of hepatocellular carcinoma. On the other hand, due to the late and mediocre diagnosis of cholangiocarcinoma, radiotherapy plays its role mainly in palliative care, rather than curative one. Two types of irradiation, by associating with other therapeutic modalities, are disposables: external-beam radiation and brachytherapy. Results are encouraging, but definitive randomized trials for this setting are difficult to design.
    Oncologie 03/2012; 14(3). · 0.08 Impact Factor