Treatment allocation in hepatocellular carcinoma: Assessment of the BCLC algorithm.

CONCLUSION: The management of HCC in clinical practice frequently deviates from the BCLC recommendations. Most of the curative therapy options, which have well-defined selection criteria, were allocated according to the recommendations, while the majority of the palliative therapy options were assigned to patients with tumor stages not aligned with the recommendations. The only parameter which is subjective in the algorithm, the performance status, is also the least respected. PMID: 31320173 [PubMed]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research

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Abstract Hepatocellular carcinoma (HCC) accounts for the majority of primary liver cancers. To date, most patients with HCC are diagnosed at an advanced tumor stage, excluding them from potentially curative therapies (i.e., resection, liver transplantation, percutaneous ablation). Treatments with palliative intent include chemoembolization and systemic therapy. Among systemic treatments, the small-molecule multikinase inhibitor sorafenib has been the only systemic treatment available for advanced HCC over 10 years. More recently, other small-molecule multikinase inhibitors (e.g., regorafenib, lenvatinib, cabozanti...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Background: Lymphocytes were reported to play a significant part in host anticancer immune responses and influence tumour prognosis. Few studies have focused on the prognostic values of aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), aspartate aminotransferase to platelet count ratio index (APRI) and systemic immune-inflammation index (SII) in hepatocellular carcinoma (HCC) treated with palliative treatments.Methods: Five hundred and ninety-eight HCC patients treated with palliative therapies were retrospectively analysed. We randomly assigned patients into the training cohort (429 patients) and the validation...
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
Conclusion: 18F-FDG PET/CT has considerable ability to detect and guide treatment management in the setting of CUP and negative conventional imaging. However, it does not appear beneficial in a subgroup of patients with squamous cell carcinoma histology.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Other Solid Tumors Posters Source Type: research
Conclusions The recent, first randomized clinical trial demonstrated overall and progression free survival benefits after SBRT to oligometastatic disease which supports prior retrospective case series (6). The spine is a common site of metastatic bone disease, and as high quality data continue to mature, along with completion of additional randomized clinical trials, it is expected that utility of SBRT to the spine will increase in the future. Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
DiscussionOverall survival rate is the primary endpoint. Secondary endpoints are time to progression according to the modified  response evaluation criteria in solid tumors (mRECIST) criteria, acute and chronic adverse events, and quality of life.Trial registrationChinese Clinical Trial Registry,ChiCTR-IIR-17012916. Registered on 9 October 2017.
Source: Trials - Category: Research Source Type: clinical trials
Introduction: The intermediate stage of the Barcelona Clinic Liver Cancer (BCLC) classification includes a heterogenous population of patients with hepatocellular carcinoma (HCC), and palliative treatment with transarterial chemoembolization is recommended for all of them. In this regard, 2 other classifications could be useful, the subclassification BCLC-B (SUB) and the classification Hong Kong Liver Cancer (HKLC). Objective: To determine the indication of curative or palliative treatment between SUB and HKLC in BCLC-B patients. Patients and Methods: A retrospective study in HCC patients seen between 2011 and 2016...
Source: American Journal of Clinical Oncology - Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research
Saeed Nourmohammadi1†, Thazin Nwe Aung2†, Jian Cui2, Jinxin V. Pei1, Michael Lucio De Ieso1, Yuka Harata-Lee2, Zhipeng Qu2, David L. Adelson2* and Andrea J. Yool1* 1Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia 2Department of Molecular and Biomedical Science, School of Biological Sciences, The University of Adelaide, Adelaide, SA, Australia Traditional Chinese Medicines are promising sources of new agents for controlling cancer metastasis. Compound Kushen Injection (CKI), prepared from medicinal plants Sophora flavescens and Heterosmilax chinensis, disrupts cell cycle...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionIn selected cases, liver resection is possible post SIRT. As this can represent a potentially curative option, it is important to reconsider resection in the follow-up of patients undergoing SIRT. Post-operative complications are noted following major and extended liver resection. Therefore, further studies are needed to improve patient selection.
Source: Journal of Gastrointestinal Cancer - Category: Cancer & Oncology Source Type: research
AbstractHepatocellular carcinoma (HCC) as an indication to liver transplant (LT) started as palliative treatment, then moved to potentially curative anti-cancer therapy and more recently entered the era of competition with non-cancer indications, consequent to the need of the society to target equal distribution of the limited resource of donated organs among different indications. Nowadays HCC is a leading indication to LT, currently representing up to 50% of the indications in most transplant Centers. The risk of post-transplant death and the causes of mortality significantly vary along the post-transplant follow-up. Ove...
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
This article reviews the lights and shadows of AFP as a surveillance test for patients at risk of HCC, and as a diagnostic test for those with chronic liver disease and a suspected hepatic mass. Moreover, the article scrutinizes the large body of evidence supporting the prognostic relevance of AFP in patients undergoing both curative and palliative treatment of HCC and the growing importance attributed to this biomarker (as a static or a dynamic variable) in the selection of potential candidates for liver transplantation. In fact, the inclusion of AFP among transplant criteria would improve the ability of identifying poor ...
Source: Seminars in Liver Disease - Category: Gastroenterology Authors: Tags: Review Article Source Type: research
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