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Cancers
Special Issues
Multimodal and Multi-Sequential Treatment of Hepatocellular Carcinoma
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Multimodal and Multi-Sequential Treatment of Hepatocellular Carcinoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 9592

Special Issue Editor

Prof. Dr. Matteo Cescon

E-Mail Website
Guest Editor
Department of Organ Insufficiency and Transplantation, General Surgery and Transplantation, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy
Interests: liver surgery; liver transplantation; hepatocellular carcinoma; liver metastases; cholangiocarcinoma

Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) represents the fifth most common cancer and a leading cause of death worldwide, with 854,000 new cases per year. Once diagnosis is completed, the treatment of HCC depends on many factors particularly related to tumor status, liver function, and health performance status. Several staging systems have been proposed with the aim of helping clinicians with treatment strategy; however, since HCC actually represents a highly heterogeneous disease, a multimodal approach has to be considered for these patients. Established therapies include both surgical interventions (liver resection, transplantation) and locoregional therapies (radiofrequency ablation, transarterial chemoembolization, selective internal radiotherapy, and radioembolization). The role of systemic therapies is more controversial. The multityrosine kinase inhibitor sorafenib is the standard of care for patients with advanced tumors, and several substances have also been tested, including the tyrosine kinase inhibitors lenvatinib, regorafenib, and cabozantinib as well as the VEGF-receptor inhibitor ramucirumab. More interestingly, multisequential combinations of systemic agents together with surgery and/or locoregional treatments are currently being investigated. Whilst markers for early diagnosis and surveillance of patients at risk are awaited, a multidisciplinary team approach is needed to select the best treatment. This Special Issue will highlight the current state-of-the-art in multimodal treatment of HCC, in order to identify sequences and combinations of effective therapies.

Prof. Dr. Matteo Cescon
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Hepatocellular carcinoma
  • Treatment strategies

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Published Papers (3 papers)

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Research

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11 pages, 1290 KiB  
Article
Pulsed Microwave Liver Ablation: An Additional Tool to Treat Hepatocellular Carcinoma
by Giacomo Zanus, Giovanni Tagliente, Serena Rossi, Alessandro Bonis, Mattia Zambon, Michele Scopelliti, Marco Brizzolari, Ugo Grossi, Maurizio Romano and Michele Finotti
Cancers 2022, 14(3), 748; https://doi.org/10.3390/cancers14030748 - 31 Jan 2022
Cited by 3 | Viewed by 2424
Abstract
This study aimed to analyze the outcomes of HCC patients treated with a novel technique—pulsed microwave ablation (MWA)—in terms of safety, local tumor progression (LTP), intrahepatic recurrence (IHR), and overall survival (OS). A total of 126 pulsed microwave procedures have been performed in [...] Read more.
This study aimed to analyze the outcomes of HCC patients treated with a novel technique—pulsed microwave ablation (MWA)—in terms of safety, local tumor progression (LTP), intrahepatic recurrence (IHR), and overall survival (OS). A total of 126 pulsed microwave procedures have been performed in our center. We included patients with mono- or multifocal HCC (BCLC 0 to D). The LTP at 12 months was 9.9%, with an IHR rate of 27.8% at one year. Survival was 92.0% at 12 months with 29.4% experiencing post-operative complications (28.6% Clavien–Dindo 1–2, 0.8% Clavien–Dindo 3–4). Stratifying patients by BCLC, we achieved BCLC 0, A, B, C, and D survival rates of 100%, 93.2%, 93.3%, 50%, and 100%, respectively, at one year, which was generally superior to or in line with the expected survival rates among patients who are started on standard treatment. The pulsed MWA technique is safe and effective. The technique can be proposed not only in patients with BCLC A staging but also in the highly selected cases of BCLC B, C, and D, confirming the importance of the concept of stage migration. This procedure, especially if performed with a minimally invasive technique (laparoscopic or percutaneous), is repeatable with a short postoperative hospital stay. Full article
(This article belongs to the Special Issue Multimodal and Multi-Sequential Treatment of Hepatocellular Carcinoma)
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15 pages, 1489 KiB  
Article
Impact of Local Liver Irradiation Concurrent Versus Sequential with Lenvatinib on Pharmacokinetics and Biodistribution
by Tung-Hu Tsai, Yu-Jen Chen, Li-Ying Wang and Chen-Hsi Hsieh
Cancers 2021, 13(7), 1598; https://doi.org/10.3390/cancers13071598 - 30 Mar 2021
Cited by 5 | Viewed by 2588
Abstract
Concurrent and sequential regimens involving radiotherapy (RT) and lenvatinib were designed with off-target or stereotactic body radiation therapy (SBRT) doses in a freely moving rat model to evaluate the effect of RT on the pharmacokinetics (PK) of lenvatinib. Liver RT concurrent with lenvatinib [...] Read more.
Concurrent and sequential regimens involving radiotherapy (RT) and lenvatinib were designed with off-target or stereotactic body radiation therapy (SBRT) doses in a freely moving rat model to evaluate the effect of RT on the pharmacokinetics (PK) of lenvatinib. Liver RT concurrent with lenvatinib decreased the area under the concentration–time curve of lenvatinib concentration (AUClenvatinib) by 51.1% with three fractions of 2 Gy (RT2Gy×3f’x, p = 0.03), and 48.9% with RT9Gy×3f’x (p = 0.03). The AUClenvatinib increased by 148.8% (p = 0.008) with RT2Gy×3f’x, and 68.9% (p = 0.009) with RT9Gy×3f’x in the sequential regimen compared to the concurrent regimen. There were no differences in the AUClenvatinib between RT2Gy×3f’x and RT9Gy×3f’x in the concurrent or sequential regimen. Both the RT2Gy×3f’x and RT9Gy×3f’x concurrent regimens markedly decreased the biodistribution of lenvatinib in the heart, liver, lung, spleen, and kidneys, which ranged from 31% to 100% for RT2Gy×3f’x, and 11% to 100% for RT9Gy×3f’x, compared to the sham regimen. The PK and biodistribution of lenvatinib can be modulated by simultaneous off-target irradiation and SBRT doses. The timing of lenvatinib administration with respect to RT, impacted the PK and biodistribution of the drug. Additionally, off-target and SBRT doses had a similar ability to modulate the effect of systemic therapy. Full article
(This article belongs to the Special Issue Multimodal and Multi-Sequential Treatment of Hepatocellular Carcinoma)
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Review

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32 pages, 3620 KiB  
Review
Intraarterial Therapies for the Management of Hepatocellular Carcinoma
by Tushar Garg, Apurva Shrigiriwar, Peiman Habibollahi, Mircea Cristescu, Robert P. Liddell, Julius Chapiro, Peter Inglis, Juan C. Camacho and Nariman Nezami
Cancers 2022, 14(14), 3351; https://doi.org/10.3390/cancers14143351 - 10 Jul 2022
Cited by 15 | Viewed by 3913
Abstract
Image-guided locoregional therapies play a crucial role in the management of patients with hepatocellular carcinoma (HCC). Transarterial therapies consist of a group of catheter-based treatments where embolic agents are delivered directly into the tumor via their supplying arteries. Some of the transarterial therapies [...] Read more.
Image-guided locoregional therapies play a crucial role in the management of patients with hepatocellular carcinoma (HCC). Transarterial therapies consist of a group of catheter-based treatments where embolic agents are delivered directly into the tumor via their supplying arteries. Some of the transarterial therapies available include bland embolization (TAE), transarterial chemoembolization (TACE), drug-eluting beads–transarterial chemoembolization (DEB–TACE), selective internal radioembolization therapy (SIRT), and hepatic artery infusion (HAI). This article provides a review of pre-procedural, intra-procedural, and post-procedural aspects of each therapy, along with a review of the literature. Newer embolotherapy options and future directions are also briefly discussed. Full article
(This article belongs to the Special Issue Multimodal and Multi-Sequential Treatment of Hepatocellular Carcinoma)
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