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Hepatocellular Carcinoma: The Current Recommendations for Clinical Practice

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 14674

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Special Issue Editors

Dr. Miroslaw Kornek

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Guest Editor

Department of Internal Medicine I, University Medical Center Bonn, Bonn, Germany
Interests: liver cancer; HCC; CCA; hepatobiliary cancer; extracellular vesicles; liquid biopsy
Special Issues, Collections and Topics in MDPI journals

Dr. Tudor Mocan

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Guest Editor

Institute for Gastroenterology and Hepatology "O.Fodor", University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
Interests: liver cancer; liver biopsy; immunotherapy

Dr. Zeno Spârchez

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Guest Editor

Institute of Gastroenterology and Hepatology, "Prof. Dr. Octavian Fodor", University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
Interests: liver cancer; thermal ablation; minimal invasive therapies; interventional ultrasound; liver cirrhosis; pancreatistis; biliary cancers
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce an upcoming Special Issue of JCM entitled “Hepatocellular Carcinoma: The Current Recommendations for Clinical Practice”. In recent decades, significant improvments in the management of chronic liver diseases, cirrohosis and hepatocellular carcinoma (HCC) have occurred. Notably, treatment has moved from interferon-based to interferon-free regimens, from liver biopsy to liquid biopsy, from percutaneous ethanol injection to percutaneous radiofrequency or microwave ablation, and from tyrosine kinase inhibitors to immunotherapies. However, HCC, the most common liver malignancy worldwide, still remains a major cause of cancer-related mortality. This Special Issue aims to cover the most relevant information on both preclinical (mainly translational studies with possible clinical applications) and clinical areas ranging from new diagnosis or prognostic biomarkers to novel treatment options. Special consideration will be given to papers covering hot topics including differential diagnosis between HCC and other focal liver lesions in patients with cirrhosis, clinical application of liquid biopsis for the diagnosis or prognosis of patients with HCC, novel immunotherapy strategies, and the importance of HCC variants and tumor heterogeneity in clinical practice.

Dr. Miroslaw Kornek
Dr. Tudor Mocan
Dr. Zeno Spârchez
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 short 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. Journal of Clinical Medicine 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 2600 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

Liver
HCC
Heptobiliary carcinoma
Minimal invasive
Liquid biopsy
Ablation

Published Papers (4 papers)

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Research

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8 pages, 1433 KiB

Open AccessArticle

Is There a Place for Elastography in the Diagnosis of Hepatocellular Carcinoma?

by Ana-Maria Ghiuchici, Ioan Sporea, Mirela Dănilă, Roxana Șirli, Tudor Moga, Felix Bende and Alina Popescu

J. Clin. Med. 2021, 10(8), 1710; https://doi.org/10.3390/jcm10081710 - 15 Apr 2021

Cited by 2 | Viewed by 2326

Abstract

Background and Aims: Elastography can provide information regarding tissue stiffness (TS). This study aimed to analyze the elastographic features of hepatocellular carcinoma (HCC) and the factors that influence intratumoral elastographic variability in patients with liver cirrhosis. Methods: This prospective study included 115 patients with liver cirrhosis and hepatocellular carcinoma evaluated between June 2016–November 2019. A total of 88 HCC nodules visualized in conventional abdominal ultrasound (US) met the inclusion criteria and underwent elastographic evaluation. Elastographic measurements (EM) were performed in HCC and liver parenchyma using VTQ (Virtual Touch Quantification), a point shear wave elastography (pSWE) technique. In all patients, we performed contrast-enhanced ultrasound (CEUS), and the final diagnosis of HCC was established by contrast-enhanced-CT or contrast-enhanced-MRI. Results: The mean VTQ values in HCCs were 2.16 ± 0.75 m/s. TS was significantly lower in HCCs than in the surrounding liver parenchyma 2.16 ± 0.75 m/s vs. 2.78 ± 0.92 (p < 0.001). We did not find significant differences between the first five and the last five EM, and the intra-observer reproducibility was excellent ICC: 0.902 (95% CI: 0.87–0.950). However, the tumor size, heterogeneity, and depth correlated with higher intralesional stiffness variability (p < 0.001). Conclusions: VTQ brings additional information for HCC characterization. Intra-observer reproducibility for both HCC and liver parenchyma was excellent. Knowing the stiffness of HCC’s might endorse an algorithm-based approach towards focal liver lesions (FLLs) in liver cirrhosis. Full article

(This article belongs to the Special Issue Hepatocellular Carcinoma: The Current Recommendations for Clinical Practice)

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12 pages, 1012 KiB

Open AccessArticle

A Real-World Comparative Analysis of Lenvatinib and Sorafenib as a Salvage Therapy for Transarterial Treatments in Unresectable HCC

by Jaejun Lee, Pil Soo Sung, Hyun Yang, Soon Kyu Lee, Hee Chul Nam, Sun Hong Yoo, Hae Lim Lee, Hee Yeon Kim, Sung Won Lee, Jung Hyun Kwon, Jeong Won Jang, Chang Wook Kim, Soon Woo Nam, Si Hyun Bae, Jong Young Choi and Seung Kew Yoon

J. Clin. Med. 2020, 9(12), 4121; https://doi.org/10.3390/jcm9124121 - 21 Dec 2020

Cited by 28 | Viewed by 2798

Abstract

Background/Aims: Lenvatinib was recently approved as a first-line oral multikinase inhibitor for unresectable hepatocellular carcinoma (HCC). In this study, we aimed to compare the efficacy and safety of lenvatinib and sorafenib for the treatment of unresectable HCC in patients with prior failure of transarterial treatment. Methods: Between January 2019 and September 2020, 98 unresectable HCC patients treated with lenvatinib or sorafenib as salvage therapy were enrolled from five Korean university-affiliated hospitals. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate were calculated to assess the antitumor response. Results: A total of 43 and 55 patients were treated with lenvatinib and sorafenib, respectively, as salvage therapy after the failure of transarterial treatments. The median PFS was 4.97 months in the lenvatinib group and 2.47 months in the sorafenib group (p = 0.001, log-rank test). The ORR was significantly higher in the lenvatinib group (25.6%) than in the sorafenib group (3.6%, p = 0.002). Use of lenvatinib over sorafenib (hazard ratio: 0.359, 95% confidence interval: 0.203–0.635, p < 0.001) was the most significant factor for a favorable PFS after the failure of transarterial treatments in all enrolled patients. For favorable OS, achieving objective response was the significant factor (hazard ratio 0.356, 95% confidence interval: 0.132–0.957, p = 0.041). There were no significant differences in the safety profile between the two groups. Conclusions: In this real-world study, lenvatinib was demonstrated to be more efficacious than sorafenib as a salvage therapy for transarterial treatments in unresectable HCC. Full article

(This article belongs to the Special Issue Hepatocellular Carcinoma: The Current Recommendations for Clinical Practice)

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Review

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20 pages, 1481 KiB

Open AccessReview

Ultrasound or Sectional Imaging Techniques as Screening Tools for Hepatocellular Carcinoma: Fall Forward or Move Forward?

by Zeno Sparchez, Rares Craciun, Cosmin Caraiani, Adelina Horhat, Iuliana Nenu, Bogdan Procopet, Mihaela Sparchez, Horia Stefanescu and Tudor Mocan

J. Clin. Med. 2021, 10(5), 903; https://doi.org/10.3390/jcm10050903 - 25 Feb 2021

Cited by 9 | Viewed by 4207

Abstract

Hepatocellular carcinoma (HCC) is probably the epitome of a screening target, with a well-defined high-risk population, accessible screening methods, and multiple curative-intent treatments available for early disease. Per major societies guideline consensus, biannual ultrasound (US) surveillance of the at-risk patients is the current standard of care worldwide. Yet, despite its documented success in the past decades, this standard is far from perfect. While the whole community is working to further tighten the knots, a worrying number of cases still slip through this safety net. Consequently, these patients lose their chance to a curative solution which leads to a high disease burden with disproportionate mortality. While US will probably remain the fundamental staple in the screening strategy, key questions are seeking better answers. How can its caveats be addressed, and the technique be improved? When are further steps needed? How to increase accuracy without giving up on accessibility? This narrative review discusses the place of US surveillance in the bigger HCC picture, trying to navigate through its strengths and limits based on the most recent available evidence. Full article

(This article belongs to the Special Issue Hepatocellular Carcinoma: The Current Recommendations for Clinical Practice)

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26 pages, 890 KiB

Open AccessReview

Liquid Biopsies in Hepatocellular Carcinoma: Are We Winning?

by Tudor Mocan, André L. Simão, Rui E. Castro, Cecília M. P. Rodrigues, Artur Słomka, Bingduo Wang, Christian Strassburg, Aliona Wöhler, Arnulf G. Willms and Miroslaw Kornek

J. Clin. Med. 2020, 9(5), 1541; https://doi.org/10.3390/jcm9051541 - 20 May 2020

Cited by 39 | Viewed by 4494

Abstract

Hepatocellular carcinoma (HCC) represents the sixth most common cancer worldwide and the third most common cause of cancer-related death. One of the major problems faced by researchers and clinicians in this area is the lack of reliable disease biomarkers, which would allow for an earlier diagnosis, follow-up or prediction of treatment response, among others. In this regard, the “HCC circulome”, defined as the pool of circulating molecules in the bloodstream derived from the primary tumor, represents an appealing target, the so called liquid biopsy. Such molecules encompass circulating tumor proteins, circulating tumor cells (CTCs), extracellular vesicles (EVs), tumor-educated platelets (TEPs), and circulating tumor nucleic acids, namely circulating tumor DNA (ctDNA) and circulating tumor RNA (ctRNA). In this article, we summarize recent findings highlighting the promising role of liquid biopsies as novel potential biomarkers in HCC, emphasizing on its clinical performance. Full article

(This article belongs to the Special Issue Hepatocellular Carcinoma: The Current Recommendations for Clinical Practice)

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