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Hepatoprotective Marine Phytochemicals
Published in Se-Kwon Kim, Marine Biochemistry, 2023
BR Annapoorna, S Vasudevan, K Sindhu, V Vani, V Nivya, VP Venkateish, P Madan Kumar
Liver cancer is an inflammation-driven liver disease preceded chiefly by hepatitis viral infection and nonalcoholic steatohepatitis (NASH). Based on the types of cells that become cancerous, liver cancer is categorized into primary liver tumors, which include hepatocellular carcinoma (HCC), fibrolamellar carcinoma, cholangiocarcinoma, hepatoblastoma, and mesenchymal cancers of the liver. Liver cancer is the sixth-most common cancer and the third-largest cause of cancer mortality worldwide in 2020, with approximately 906,000 new cases and 830,000 deaths. It is two to three times higher among men than in women and liver cancer ranks fifth in terms of global incidence and second in terms of mortality for men. Liver cancer is the leading cause of cancer death in Mongolia, Thailand, Cambodia, Egypt, and Guatemala among both men and women and in an additional 18 countries among men. Primary liver cancer includes HCC and intrahepatic cholangiocarcinoma. Globally, HCC is the dominant type of liver cancer, accounting for approximately 75% of all liver cancers (Sung et al. 2021). Most HCC cases (>80%) occur in either sub-Saharan Africa or in Eastern Asia (El-Serag and Rudolph 2007). The highest incidence rates in the world are found in Asia and Africa (Petrick et al. 2020). Most Asian countries are in the intermediate- to high-incidence zones of HCC. However, India falls in the low incidence zone. About 42,230 U.S. adults are expected to be diagnosed with liver cancer in 2021, according to the American Society of Clinical Oncology.
Alternative Tumor-Targeting Strategies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
This therapy was a useful addition to available treatments for liver cancer because, although surgical removal of a liver tumor offers the best intervention, only 15% or less of cancer patients are suitable for surgery, usually because their tumors are too far advanced at the time of diagnosis or because of other medical considerations. Also, although systemic chemotherapy is still a first-line treatment for most liver cancer patients, it is not very effective. Therefore, this radioactive microsphere procedure, which can be carried out in an outpatient setting, offers the possibility of effective treatment without the usual side effects of nausea, fatigue, hair loss, etc.
Liver resection
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Rebecka L. Meyers, Zachary Kastenberg, Max Langham
Non-neoplastic masses such as vascular malformations, congenital and acquired cysts, abscess, hematoma, and fatty infiltration of the liver may occasionally be confused with liver tumors. Hepatic hematoma or infarction should be suspected in any child with a history of hepatic trauma or in newborns with sepsis and coagulopathy, especially if there is a history of perinatal birth trauma, thrombocytopenia, or hemodynamic collapse requiring cardiopulmonary resuscitation. Congenital liver cysts are rare and represent a spectrum ranging from large simple cysts to intrahepatic choledochal cysts and ciliated hepatic foregut cysts. Acquired cysts might be bacterial, hydatid, amoebic, or fungal abscesses.
Synchronous Hepatoblastoma and Neuroblastoma in Two Chinese Infants
Published in Fetal and Pediatric Pathology, 2023
Bo Shao, Yi-zhen Wang, Yuan Fang, Jing Chu, Lian Chen, Le-Jian He
Case 1: Grossly, a partial hepatectomy specimen with the size of 12.5 cm × 12.0 cm × 9.0 cm revealed a completely removed 10.0 cm × 9.5 cm × 9.0 cm mass. The cut surface was solid, gray-red, nodular, tough in quality. Histologic sections of the liver tumor showed two distinct patterns: (1) medium-sized cells with a moderate amount of eosinophilic cytoplasm arranged in trabeculae and separated by sinusoids and (2) sheets of cells with high nuclear-to-cytoplasmic ratios, coarse chromatin, and minimal cytoplasm (Fig. 2A). Extensive extramedullary hematopoiesis was present (Fig. 2B), with prominent hemorrhage and vascular ectasia noted in the background. The histologic diagnosis of the liver tumor was a HBL, epithelial subtype. Grossly, the mediastinal tumor specimen was 2.5 cm × 2.0 cm × 0.6 cm in size, and the cut surface was solid, gray-red, and tough in quality. Histologic sections of the mediastinal tumor showed a proliferation of small, high-nuclear-to-cytoplasmic-ratio neoplastic cells with minimal cytoplasm, and stippled nuclear chromatin set within a neurofibrillary background (Fig. 2C). The Homer–Wright rosettes were highlighted (Fig. 2D). The mediastinal tumor was categorized as a poorly differentiated NBL with a low mitosis/karyorrhexis index (MKI) (<2%).
Evaluation of the health economic impact of initial diagnostic modality selection in patients suspected of having HCC in China and the USA
Published in Journal of Medical Economics, 2022
Michael Blankenburg, Mostafa Elhamamy, Diana Zhang, Alice Corbin, Guanyi Jin, James Harris, Gesine Knobloch
The 2019 Guidelines for diagnosis and treatment of HCC in China recommend the use of MDCT, ECCM-MRI, EOB-MRI, and CEUS for the diagnosis of HCC7. The guidelines state that the capability of CT to detect and diagnose small liver tumors is inferior to that of MRI and that the detection, diagnostic accuracy, and differential diagnoses of liver cancers are improved when MRI is used with a hepatocyte-specific contrast agent (e.g. EOB-MRI). Our results show that patients initially imaged with EOB-MRI have lower false-positive and lower false-negative rates compared with other modalities, suggesting that better adherence to the clinical guidelines will have both cost and clinical benefits. In the US, the 2018 AASLD Guidelines for the Diagnosis, Staging, and Management of Hepatocellular Carcinoma recommend MDCT or MRI for the diagnosis of HCC as well as CEUS6. Unlike in the Chinese guidelines, there is no recommendation of one modality over another; however, a study showing superior sensitivity of MRI (with an extracellular or hepatobiliary agent) over CT is referenced9.
Effect of Body Composition on Outcomes in Patients with Hepatocellular Carcinoma Undergoing Radiotherapy: A Retrospective Study
Published in Nutrition and Cancer, 2022
Li-Qing Li, Wei-Dong Zhao, Ting-Shi Su, Yu-Dan Wang, Wan-Wan Meng, Shi-Xiong Liang
The protective role of subcutaneous adiposity in cancer has been recognized in several studies (19–22). Our finding on the role of subcutaneous fat in HCC patients is consistent with that of a large retrospective study by Ebadi et al. (21) on 1,473 cancer patients, which identified low SATI as a risk factor. The cutoff in that study was 50.0 cm2/m2 for male and 42.0 cm2/m2 for female, which were comparable to the cutoffs in our study. Kobayashi et al. (23) also reported that a high SAT volume was associated with better survival outcomes in HCC patients treated with transcatheter intra-arterial therapies. Imai et al (24) found that patients with rapid depletion of SATI experienced significantly worse survival among HCC patients treated with sorafenib. Contrary to our results, several reports have suggested that low SAT volume is not associated with increased mortality in HCC patients (15, 25, 26). However, most of these studies were conducted in Western countries, where hepatitis C virus (HCV) infection and alcohol abuse are the leading causes of cirrhosis and HCC (27). By contrast, hepatitis B is the most prevalent underlying etiology in China (28). Patients with liver tumors in the setting of alcoholic liver disease and patients with cirrhosis due to HBV or HCV infection may have differential metabonomic profiles (29). In addition, the prevalence of obesity is always higher in westerners than in Asians (30). Thus, the heterogeneity may contribute to a poor international comparability between study cohorts from different regions.