Updates on Liver Cancer Management

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

Deadline for manuscript submissions: 1 October 2025 | Viewed by 1155

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Guest Editor
Department of Surgery, School of Medicine, Fujita Health University Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi 444-0827, Japan
Interests: liver resection; laparoscopic liver resection; hepatocellular carcinoma; liver metastasis; chemotherapy (neoadjuvant, induction); liver venoocclusive disease; anus neoplasms; intensity modulated radiation therapy; chemoradiotherapy
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Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) remains a significant global health burden due to its high incidence and mortality. Over the past few decades, significant progress has been achieved in the management of HCC, with advanced surgeries, including minimally invasive and robot-assisted procedures, liver transplantation, and local ablation therapy potentially offering a cure. Trans-arterial treatment techniques and radiation therapies are being developed further, while the recent introduction of immunotherapy opened a new systemic treatment landscape. The introduction of several classification system for HCC (such as BCLC), clearly defining patient groups and assigning reasonable treatment options, has standardized treatment. Currently, a comprehensive and multidisciplinary approach is crucial for the effective management of this disease.

On the other hand, intrahepatic cholangiocarcinoma (ICC) is the second most frequent primary liver cancer after HCC, showing increasing incidence and mortality. It originates from intrahepatic bile ducts and has a silent presentation, with a highly aggressive nature. Upon diagnosis, less than 40% of ICC are suitable for curative surgical therapy, which is, so far, the only curative treatment. Although there have been attempts at early diagnoses and providing patient-personalized treatment by molecular characterization, these aims are not easily achieved because of the heterogeneity of this tumor. However, recent progress has been made in the molecular characterization, surgical treatment, and management of this disease.

In this SI on “Updates on Liver Cancer Management” (including metastatic cancers), a comprehensive overview of the evolving management landscape and challenges to its improvements will be provided.

Prof. Dr. Zenichi Morise
Guest Editor

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Keywords

  • laparoscopic liver resection
  • minimally invasive liver resection
  • deteriorated liver function
  • anatomical resection
  • preoperative simulation
  • intraoperative navigation
  • liver metastasis
  • hepatocellular carcinoma biliary tract cancers
  • robot-assisted liver resection

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Published Papers (1 paper)

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15 pages, 2731 KiB  
Systematic Review
The Role of Lymphadenectomy in the Surgical Treatment of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
by Gabriele Spoletini, Alberto Mauro, Miriam Caimano, Giuseppe Marrone, Francesco Frongillo, Salvatore Agnes, Quirino Lai and Giuseppe Bianco
Cancers 2024, 16(24), 4166; https://doi.org/10.3390/cancers16244166 - 13 Dec 2024
Viewed by 853
Abstract
Background: Lymphadenectomy in the operative management of hepatocellular carcinoma (HCC) remains controversial, with no recommendation for routine practice. Our study aimed to assess the effects of lymphadenectomy in addition to hepatic resection (HR) compared to HR alone for adults with HCC. Methods [...] Read more.
Background: Lymphadenectomy in the operative management of hepatocellular carcinoma (HCC) remains controversial, with no recommendation for routine practice. Our study aimed to assess the effects of lymphadenectomy in addition to hepatic resection (HR) compared to HR alone for adults with HCC. Methods: This systematic review was conducted according to PRISMA guidelines until March 2023, searching and selecting the relevant literature comparing lymph node dissection or sampling, combined with HR, and with no lymph node removal. Critical appraisal of the included studies was performed using the ROBINS-I tool. Fixed- or random-effect meta-analysis models were carried out, and inter-studies were assessed for heterogeneity. Results: Fourteen studies were selected during the screening process. Data from eight studies containing 32,041 HCC patients were included in the quantitative synthesis. In total, 12,694 patients underwent lymph node dissection (LND), either selectively for preoperatively diagnosed or intraoperatively suspected lymph node metastasis (LNM) or unselectively (i.e., regardless of suspected LNM). According to LN status, 1-, 3- and 5-year mortality rates were higher in the LNM group with respect to both clinically negative LN (OR 3.25, 95% CI 2.52–4.21; p < 0.001; OR 3.79, 95% CI 2.74–5.24; p < 0.001; OR 3.92, 95% CI 2.61–5.88; p < 0.001) and proven LN0 (OR 1.75, 95% CI 1.0–3.04; p = 0.05; OR 2.88, 95% CI 1.79–4.63; p < 0.001; OR 2.54, 95% CI 1.33–4.84; p < 0.001). Moreover, the summary estimates of two controlled trials showed no significant difference in overall survival between LND groups and those without LND for negative LN patients. Conclusions: Lymph node dissection does not appear to improve overall survival, according to the available literature; thus, this does not support its routine adoption as part of standard liver resection for HCC. A case-by-case decision remains advisable. Full article
(This article belongs to the Special Issue Updates on Liver Cancer Management)
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