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Treatment Strategies for Hepatocellular Carcinoma

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 22294

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Special Issue Editor

Prof. Dr. Takahiro Yamasaki

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Guest Editor

Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan
Interests: hepatocellular carcinoma; hematology and coagulation; biochemistry; microbiology

Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) is the most common malignancy, and the fourth leading cause of death in the world. To improve outcomes in HCC patients, international guidelines from several regions show the treatment algorithm for HCC. Treatments, such as surgical resection, local ablation, transarterial chemoembolization, systemic therapy, liver transplantation, and others, are adopted based on HCC staging (e.g., BCLC staging system) and fiver function (Child-Pugh classification), in almost all guidelines. However, novel molecular target agents, such as regorafenib, lenvatinib, cabozantinib, and ramucirumab; the appearance of immune checkpoint inhibitors; advances in technology and technique; and recent evidences may promote the change of treatment strategies in HCC patients in several stages.

In this Special Issue, I invite you to submit your research on “Treatment Strategies for Hepatocellular Carcinoma”, in the form of original reseach or reviews.

Prof. Dr. Takahiro Yamasaki
Guest Editor

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Keywords

hepatocellular carcinoma
treatment strategy
surgical resection
locoregional therapy
systemic chemotherapy
liver transplantation
hepatic arterial infusion chemotherapy
multidisciplinary treatment

Published Papers (7 papers)

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Research

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11 pages, 1568 KiB

Open AccessArticle

Hepatic Reirradiation for Patients with Recurrent Hepatocellular Carcinoma

by Yaoru Huang, Po-Yung Chen, Tzu-Yen Cheng and Jeng-Fong Chiou

Appl. Sci. 2021, 11(4), 1598; https://doi.org/10.3390/app11041598 - 10 Feb 2021

Cited by 1 | Viewed by 1332

Abstract

For treating hepatocellular carcinoma (HCC), local therapies and surgery, including liver transplant, are the first line treatment options; however, several contraindications limit their clinical use. The improvement of radiotherapy (RT) established RT in treating HCC contraindicated against local therapies, including transarterial chemoembolization and radiofrequency ablation. For HCC that recurs after RT and still contradicts against local therapies, there is a need to investigate the use of reirradiation. This study recruited patients receiving two courses of RT for recurrent HCC between January 2007 and December 2019. The result suggested that patients who experienced tumor regression after reirradiation had better survival over those with a stable form of the disease, with the mean overall survival (OS) as 30.0 and 4.0 months, respectively (p < 0.001). The analysis also revealed that systemic therapy had no benefit on both the OS and controlling distant metastasis; the result was limited to a small study number and diversity of drugs. Considering systemic therapy and portal vein tumor thrombosis, which are commonly viewed to affect prognosis, multivariate analysis suggested that the Child–Pugh score and local control were the only two independent factors for the OS, with p = 0.017 and p = 0.028, respectively. Our findings suggested that reirradiation could be the choice for treating recurrent HCC. Full article

(This article belongs to the Special Issue Treatment Strategies for Hepatocellular Carcinoma)

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13 pages, 757 KiB

Open AccessFeature PaperArticle

Effect of Handgrip Strength on Clinical Outcomes of Patients with Hepatocellular Carcinoma Treated with Lenvatinib

by Yurika Kotoh, Issei Saeki, Takahiro Yamasaki, Ryo Sasaki, Norikazu Tanabe, Takashi Oono, Takashi Matsuda, Takuro Hisanaga, Toshihiko Matsumoto, Isao Hidaka, Tsuyoshi Ishikawa, Taro Takami and Isao Sakaida

Appl. Sci. 2020, 10(16), 5403; https://doi.org/10.3390/app10165403 - 05 Aug 2020

Cited by 4 | Viewed by 2022

Abstract

Previous studies have reported prognostic factors for hepatocellular carcinoma (HCC) patients receiving lenvatinib; however, no studies have evaluated the effects of both handgrip strength and skeletal muscle mass on the clinical outcomes. Therefore, this retrospective study investigated the individual effect of handgrip strength, skeletal muscle mass, and sarcopenia on clinical outcomes of 53 HCC patients treated with lenvatinib. Before receiving lenvatinib, handgrip strength and skeletal muscle index (SMI) were measured. Low handgrip strength and muscle depletion were defined as <26 and <18 kg and SMI <42 and SMI <38 cm²/m² in men and women, respectively. Sarcopenia was defined as having low handgrip strength and muscle depletion. Multivariate analysis identified modified albumin–bilirubin grade 1–2a (p = 0.010), Barcelona Clinic Liver Cancer stage A–B (p = 0.011), and absence of low handgrip strength (p = 0.015) as favorable prognostic factors for survival. Furthermore, sarcopenia was an independent significant prognostic factor for survival. Time to treatment failure was associated with handgrip strength and sarcopenia. Our findings suggest that handgrip strength may be a useful marker of clinical outcomes in HCC patients treated with lenvatinib. Full article

(This article belongs to the Special Issue Treatment Strategies for Hepatocellular Carcinoma)

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Review

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11 pages, 286 KiB

Open AccessFeature PaperReview

The Recent Development of the Surgical Treatment for Hepatocellular Carcinoma

by Masao Nakajima, Yukio Tokumitsu, Yoshitaro Shindo, Hiroto Matsui, Satoshi Matsukuma, Michihisa Iida, Nobuaki Suzuki, Shigeru Takeda, Tatsuya Ioka and Hiroaki Nagano

Appl. Sci. 2021, 11(5), 2023; https://doi.org/10.3390/app11052023 - 25 Feb 2021

Cited by 4 | Viewed by 1833

Abstract

The optimal treatment for hepatocellular carcinoma (HCC) should be selected based on tumor conditions, liver functional reserve, and performance status. Surgical treatment, such as liver resection and liver transplantation, is the most favorable treatment method; however, its indication criteria differ according to each country’s guidelines. In Western countries, liver resection is indicated only for early-stage HCC patients with Barcelona-Clinic Liver Cancer staging classification (BCLC) 0/A. While in Asian countries, liver resection is one of the treatment options for advanced HCC, such as BCLC B/C. Recently, the treatment of HCC is about to enter a drastic transitional period. It started with the widespread use of minimally invasive surgery for HCC, followed by a high rate of hepatitis C virus eradication with the advent of direct acting antivirals and developing a multidisciplinary treatment for highly advanced HCC. As a result, the importance of liver resection for HCC is increasing, and it is time to reconsider the criteria for selecting treatment methods for HCC patients. This article outlines current topics in the surgical treatment of HCC. Full article

(This article belongs to the Special Issue Treatment Strategies for Hepatocellular Carcinoma)

12 pages, 631 KiB

Open AccessReview

Clinical Benefits of Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma

by Takahiro Yamasaki, Issei Saeki, Yurika Kotoh-Yamauchi, Ryo Sasaki, Norikazu Tanabe, Takashi Oono, Takashi Matsuda, Takuro Hisanaga, Toshihiko Matsumoto, Isao Hidaka, Tsuyoshi Ishikawa, Taro Takami, Yutaka Suehiro and Isao Sakaida

Appl. Sci. 2021, 11(4), 1882; https://doi.org/10.3390/app11041882 - 20 Feb 2021

Cited by 3 | Viewed by 2231

Abstract

Recent success of systemic therapeutic agents, including combination immunotherapy, could promote a change in the treatment strategy in patients with advanced hepatocellular carcinoma (HCC). Although hepatic arterial infusion chemotherapy (HAIC) is a treatment option for advanced HCC in Japan, it is not recommended by other guidelines. We discuss the clinical benefits of HAIC compared to sorafenib. The clinical benefits of HAIC are as follows: (1) even a patient with Child–Pugh B HCC (7 or 8 points) is a candidate for HAIC (2) Child–Pugh scores barely decline with the use of HAIC compared with sorafenib (3) HAIC is highly effective in patients with vascular invasion compared with sorafenib; and (4) survival in patients receiving HAIC may not be associated with skeletal muscle volume. In contrast, the disadvantages are problems related with the reservoir system. HAIC has clinical benefits in a subpopulation of patients without extrahepatic metastasis with Child–Pugh A HCC and vascular invasion (especially primary branch invasion or main portal vein invasion) or with Child–Pugh B HCC. Full article

(This article belongs to the Special Issue Treatment Strategies for Hepatocellular Carcinoma)

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19 pages, 3325 KiB

Open AccessReview

Treatment Strategy of Transarterial Chemoembolization for Hepatocellular Carcinoma

by Shiro Miyayama

Appl. Sci. 2020, 10(20), 7337; https://doi.org/10.3390/app10207337 - 20 Oct 2020

Cited by 16 | Viewed by 10639

Abstract

Transarterial chemoembolization (TACE) is a first-line treatment for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer stage B (BCLC-B). There are two major techniques of TACE: conventional TACE (cTACE) using iodized oil and gelatin sponge particles, and TACE using drug-eluting beads (DEB-TACE). The latest randomized controlled trial proved the superiority of cTACE regarding local effects over DEB-TACE; however, cTACE also damages the liver more severely. Therefore, cTACE should be performed for localized HCCs as selectively as possible. On the other hand, DEB-TACE has less liver toxicity and is favorable for patients with an advanced age, large and/or bilobar tumors, or a poor liver function. However, some BCLC-B HCCs are TACE-resistant and the concept of TACE unsuitability (mainly up-to-7 criteria out) has been proposed by Asia-Pacific Primary Liver Cancer Expert Meeting. Systemic therapy is recommended for patients with TACE-unsuitable HCC; however, the condition of TACE-unsuitable HCC does not always rule out TACE monotherapy and some up-to-7 criteria out tumors may also be good candidates for superselective cTACE when localized in limited liver segments. The sequential therapy of an antiangiogenic and TACE is also a novel option for patients with TACE-unsuitable HCC, antiangiogenic-refractory HCC, or even down-staged HCC. Full article

(This article belongs to the Special Issue Treatment Strategies for Hepatocellular Carcinoma)

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16 pages, 438 KiB

Open AccessReview

Clinical Role of Newly Developed ALBI and mALBI Grades for Treatment of Hepatocellular Carcinoma

by Atsushi Hiraoka and Takashi Kumada

Appl. Sci. 2020, 10(20), 7178; https://doi.org/10.3390/app10207178 - 15 Oct 2020

Cited by 1 | Viewed by 1836

Abstract

Hepatocellular carcinoma (HCC) is a leading cause of death worldwide. The selection of therapeutic modalities and the prognosis of affected patients are well known to be dependent not only on the tumor burden but also on the hepatic reserve function. Antiviral treatments for chronic hepatitis related to a viral infection and an increase in cases of nonviral HCC associated with the aging of society have resulted in dramatic changes regarding the characteristics of HCC patients. With recent developments in therapeutic modalities for HCC, a more detailed assessment of hepatic function has become an important need. Studies in which the relationship of albumin-bilirubin (ALBI) grade with the prognosis of HCC patients was investigated were reviewed in order to evaluate the usefulness of newly developed ALBI and modified ALBI (mALBI) grades for HCC treatment, as those scoring methods are considered helpful for predicting the prognosis and selecting therapeutic modalities based on the expected prognosis. Full article

(This article belongs to the Special Issue Treatment Strategies for Hepatocellular Carcinoma)

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7 pages, 788 KiB

Open AccessFeature PaperReview

Treatment Selection for Early to Intermediate Hepatocellular Carcinoma

by Kazuhiro Nouso, Takamasa Ohki, Tatsuya Yamashita, Haruyuki Takaki, Chien-Au Liu, Tae Wook Kang, Dong Ho Lee, So Jung Lee, Suyash Kulkarni, Deepa Shree and Masatoshi Tanaka

Appl. Sci. 2020, 10(13), 4607; https://doi.org/10.3390/app10134607 - 03 Jul 2020

Cited by 1 | Viewed by 1765

Abstract

Many guidelines and standard therapies have been published for the treatment of hepatocellular carcinoma (HCC). Multiple options for the treatment of early to intermediate-stage HCC have resulted in several differences between the guidelines. In addition, more than a few non-standard therapies have been used in a real-world clinical setting. Radiofrequency ablation or chemotherapy, including hepatic arterial infusion chemotherapy and molecular target agents, are sometimes selected for the treatment of intermediate HCC, whereas in many guidelines, the recommended therapy for these patients is transcatheter arterial chemoembolization. The present status of these topics is reviewed and summarized. Full article

(This article belongs to the Special Issue Treatment Strategies for Hepatocellular Carcinoma)

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