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Cancers
Special Issues
Advances in the Multidisciplinary Management of Hepatocellular Carcinoma
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Advances in the Multidisciplinary Management of Hepatocellular Carcinoma

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

Deadline for manuscript submissions: 12 June 2025 | Viewed by 4330

Special Issue Editors

Prof. Dr. Mohammed Abu Hilal

E-Mail Website
Guest Editor
Unità Chirurgia Epatobiliopancreatica, Robotica e Mininvasiva, Fondazione Poliambulanza Istituto Ospedaliero, via Bissolati, 57, 25124 Brescia, Italy
Interests: liver surgery (liver cancer and benign liver conditions); pancreatic surgery (pancreatic cancer and benign pancreatic conditions); biliary and laparoscopic (keyhole) surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Timothy M. Pawlik

E-Mail Website
Guest Editor
Wexner Medical Center, Department of Surgery, Ohio State University, Columbus, OH 43210, USA
Interests: liver; hepatitis; cancer therapy; hepatocellular carcinoma; oncology; surgery; cancer diagnostics; biliary tract diseases; surgical oncology; colorectal cancer

Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) is a disease that imposes a substantial burden, primarily affecting patients whom have underlying liver disease. In recent years, a plethora of novel systemic and local treatment options have emerged, significantly augmenting the complexity of patient management. Besides disease burden, factors such as patient fitness and liver function remain important in determining suitable treatment paths. Thus, decisions on the optimal, personalized treatment strategy are preferably made within the setting of a multidisciplinary team.

The objective of this Special Issue is to present a comprehensive overview of recent advances in the multidisciplinary management of HCC. In this Special Issue, original research articles and reviews are welcome. Research domains encompass, but are not confined to, hepatology, hepatobiliary surgery, transplant surgery, (interventional) radiology, and medical oncology.

Prof. Dr. Mohammed Abu Hilal
Dr. Timothy M. Pawlik
Guest Editors

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
  • liver function
  • prognosis
  • systemic treatment
  • local treatment
  • resection
  • trans-plantation

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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14 pages, 970 KiB  
Article
An Investigative Analysis of Therapeutic Strategies in Hepatocellular Carcinoma: A Raetrospective Examination of 23 Biopsy-Confirmed Cases Emphasizing the Significance of Histopathological Insights
by Anca Zgura, Mugur Cristian Grasu, Radu Lucian Dumitru, Letitia Toma, Laura Iliescu and Cosmin Baciu
Cancers 2024, 16(10), 1916; https://doi.org/10.3390/cancers16101916 - 17 May 2024
Cited by 1 | Viewed by 1417
Abstract
Background: The Liver Imaging Reporting and Data System (LI-RADS) combines standardized terminology with a classification system for imaging findings in patients with HCC, therefore rendering diagnostic biopsy unnecessary in many cases. This retrospective study included 23 patients with a biopsy diagnosis of HCC, [...] Read more.
Background: The Liver Imaging Reporting and Data System (LI-RADS) combines standardized terminology with a classification system for imaging findings in patients with HCC, therefore rendering diagnostic biopsy unnecessary in many cases. This retrospective study included 23 patients with a biopsy diagnosis of HCC, performed either before or after local interventional procedures, in order to evaluate the histopathologic changes induced by previous procedures and their potential influence on the response to immune therapy. Material and Methods: The study encompassed a cohort of patients diagnosed with Hepatocellular Carcinoma (HCC). Diagnosis was established via contrast-enhanced computer tomography or magnetic resonance imaging that identified LI-RADS-5 nodules in conjunction with historical liver disease and elevated alpha-fetoprotein (AFP) levels or via histological examination confirming positivity for glypican3, heat shock protein 70, and glutamine synthetase. The study detailed the liver disease etiology, LI-RADS scores, characteristics and dimensions of HCC nodules, serum AFP concentrations, Edmondson–Steiner grading, and the expression of programmed cell death ligand 1 (PD-L1) in the tumor cells. Results: Among the study’s cohort of Hepatocellular Carcinoma (HCC) patients, a portion had not received any prior treatments, while the remainder experienced local HCC recurrence following trans-arterial chemoembolization or radiofrequency ablation. Observations indicated elevated alpha-fetoprotein (AFP) levels in those who had not undergone any previous interventions, showing statistical significance. The Edmondson–Steiner classification predominantly identified grade III differentiation across patients, irrespective of their treatment history. Furthermore, an increase in intra-tumoral programmed cell death ligand 1 (PD-L1) expression was noted in patients who had not been subjected to previous therapies. Conclusion: Liver biopsy offers valuable insights for patients with Hepatocellular Carcinoma (HCC), assisting in the tailoring of immune therapy strategies, particularly in cases of recurrence following prior local interventions. Full article
(This article belongs to the Special Issue Advances in the Multidisciplinary Management of Hepatocellular Carcinoma)
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19 pages, 433 KiB  
Systematic Review
The Definition of the Best Margin Cutoff and Related Oncological Outcomes After Liver Resection for Hepatocellular Carcinoma: A Systematic Review
by Abdallah Al Farai, Federico Sangiuolo, Dana Albaali, Mahmoud Ajoub, Fabio Giannone, Gianluca Cassese and Fabrizio Panaro
Cancers 2025, 17(11), 1759; https://doi.org/10.3390/cancers17111759 - 23 May 2025
Viewed by 125
Abstract
Background/Objectives: Different cutoffs have been proposed to be the optimal resection margin of liver resection for hepatocellular carcinoma (HCC). The aim of this study was to perform a systematic review, investigating the different impacts on disease-free survival (DFS) and overall survival (OS) [...] Read more.
Background/Objectives: Different cutoffs have been proposed to be the optimal resection margin of liver resection for hepatocellular carcinoma (HCC). The aim of this study was to perform a systematic review, investigating the different impacts on disease-free survival (DFS) and overall survival (OS) of different margin cutoffs. Methods: The PubMed, Embase, and Cochrane databases were searched for comparative studies evaluating the oncological impacts of different types of liver resection margin for HCC. Results: A total of 48 studies were included in the final analysis. Among them, 36 evaluated the impact of resection margin width on OS and 42 on DFS. The margin cutoffs assessed varied widely, including 20 mm, 10 mm, 5 mm, 4 mm, 2 mm, and 1 mm. While wider margins (≥10 mm) were generally associated with improved outcomes, particularly in high-risk subgroups such as patients with microvascular invasion (MVI), elevated alpha-fetoprotein (AFP) levels, or a non-cirrhotic liver, other studies reported no significant differences. The findings were highly heterogeneous across the studies due to differences in patient populations, tumor biology, and surgical approaches. Consequently, the evidence suggests that the optimal margin is context-dependent rather than universal. Conclusions: Wider resection margins should be considered in select high-risk patients, while a tailored, case-by-case approach remains necessary given the overall heterogeneity of HCC presentations. Full article
(This article belongs to the Special Issue Advances in the Multidisciplinary Management of Hepatocellular Carcinoma)
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15 pages, 1364 KiB  
Systematic Review
Hepatocellular Carcinoma (HCC) Metastasis to the Diaphragm Muscle: A Systematic Review and Meta-Analysis of Case Reports
by Janusz Kocjan, Mateusz Rydel and Mariusz Adamek
Cancers 2024, 16(17), 3076; https://doi.org/10.3390/cancers16173076 - 4 Sep 2024
Cited by 1 | Viewed by 2156
Abstract
The purpose of this study was to conduct a systematic review and meta-analysis of case reports presenting HCC spread to the diaphragm muscle and to determine possible risk factors for this condition. An extensive literature search was performed using the following electronic databases: [...] Read more.
The purpose of this study was to conduct a systematic review and meta-analysis of case reports presenting HCC spread to the diaphragm muscle and to determine possible risk factors for this condition. An extensive literature search was performed using the following electronic databases: MEDLINE, CINAHL, ScienceDirect, Google Scholar, and DOAJ. A total of 18 articles describing 27 hepatocellular carcinoma patients were included in this review. The presence of HCC cells in the superior liver segment is strongly associated with metastases to the diaphragm. Among the two types of diaphragm involvement by HCC cells, diaphragm infiltration occurs much more frequently than diaphragm adhesion. However, an HCC nodule in the 8th liver segment and a higher number of liver segments involved by HCC cells predispose patients to diaphragm adhesion. Hepatitis B is a risk factor for diaphragm metastases in recurrent HCC. The tumor diameter is not associated with HCC spread to the diaphragm muscle. We did not find specific symptoms reported by patients that could indicate HCC metastasis to the diaphragm muscle. The presence of hepatitis B and the localization of HCC cells in superior liver segments, especially in the 8th liver segment, should be take into consideration in the diagnostic process. Full article
(This article belongs to the Special Issue Advances in the Multidisciplinary Management of Hepatocellular Carcinoma)
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