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Long-Term Results of Liver Resection in the Treatment of Patients with Hepatocellular Carcinoma

100%
Grąt M., Hołówko W., Grzegorczyk K., Skalski M., Krawczyk M.
Polish Journal of Surgery
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2011
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vol. 83
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issue 6
319-324
EN
The aim of the study was the analysis of the results of liver resection in the treatment of patients with hepatocellular carcinoma, taking into consideration the selected factors based on the department's material.Material and methods. Data of 122 patients subject to liver resection due to hepatocellular carcinoma at the Department of General, Transplantation and Liver Surgery, Medical University of Warsaw, were subject to retrospective analysis.The influence of selected factors on the long-term treatment results was determined, and the patient survival depending on the tumor stage as per the TNM scale was compared. The statistical significance threshold was set at p = 0.05.Results. 1- and 3-year overall survival and recurrence-free survival in the whole patient group was 82.1% and 56.3%, and 57.7% and 20.1%, respectively. The perioperative mortality rate was 1.6%. The neoplasm advancement exceeding the first stage on the TNM scale was associated with lower values of overall survival (p = 0.001, HR = 3.7) and recurrence-free survival (p = 0.00008, HR = 3.8). Elevation of AFP was the only independent prognostic factor for overall survival (p = 0.04, HR = 1.04 at alpha-fetoprotein levels > 1000 ng/ml), while the presence of neoplastic emboli in small blood vessels was an independent risk factor for HCC recurrence (p = 0.02, HR = 2.24).Conclusions. The alpha-fetoprotein levels and presence in the histopathological examination of neoplastic emboli in small blood vessels are independent prognostic factors for outcome of patients operated for hepatocellular carcinoma. The diagnosis of neoplasm at stage 1 as per TNM significantly improves long-term results of resective treatment.
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Increased expression of ribosomal protein S2 in liver tumors, posthepactomized livers, and proliferating hepatocytes in vitro.

80%
Kowalczyk P., Woszczyński M., Ostrowski J.
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vol. 49
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issue 3
615-624
EN
The ribosomal protein S2 (RPS2) is encoded by a gene from the highly conserved mammalian repetitive gene family LLRep3. It participates in aminoacyl-transfer RNA binding to ribosome, potentially affecting the fidelity of mRNA translation. These studies were designed to measure the expression of RPS2 during increased cell proliferation. Using Western and Northern blot analyses, we found that the levels of RPS2 protein and its corresponding mRNA were higher in mouse hepatocellular carcinoma, in mouse livers after one-third partial hepatectomy, and in serum-starved cultured hepatocytes following serum treatment. Our study shows that the increased expression of RPS2 correlates with increased cell proliferation. However, whether the altered expression of this protein reflects its involvement in cellular proliferation or represents an associated phenomena is still a key question that needs to be explored.
3
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Liver transplantation in the treatment of patients with hepatocelular carcinoma

80%
Krawczyk M., Grąt M., Kornasiewicz O., Zieniewicz K., Nyckowski P., Patkowski W., Grzelak I., Dudek K., Wróblewski T., Paluszkiewicz R.
Polish Journal of Surgery
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2010
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vol. 82
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issue 11
596-602
EN
The aim of the study was to analyse liver transplantation results in patients with hepatocellular carcinoma, considering selected factors.Material and methods. The study group comprised 82 patients subject to liver transplantation at the Department of General, Transplant and Liver Surgery, Warsaw Medical University, due to hepatocellular carcinoma. Retrospective analysis concerned the period between 2001 and 2010. Distant survival results were evaluated, depending on whether Milan criteria were fulfilled, and the preoperative level of alpha-fetoprotein estimated. The obtained results were subject to statistical analysis. p<0.05 was considered as statistically significant.Results. Mean survival time considering patients subject to liver transplantation, due to hepatocellular carcinoma amounted to 66.7 months (95% PU 58.9-74.4), while survival without tumor recurrence - 62.3 months (95% PU 54-70.6). The one, three and five - year survival rate was 88.7%, 74.8% and 72.0%, respectively. Survival without tumor recurrence was 87.5%, 67.1% and 67.1%, respectively. The overall survival of patients fulfilling the Milan criteria (44 of 82 patients - 53.7%) was significantly longer, in comparison to patients not fulfilling the above-mentioned (74.4 and 48.3 months, respectively, p=0.025). A significant difference was also observed, considering the overall survival in the absence of cancer recurrence (72.5 and 42.4 months, respectively, p=0.007). Considering patients not fulfilling the Milan criteria who presented with preoperative alpha-fetoprotein levels > 100 ng/ml, overall survival was shorter, as compared to the mean survival rate: 32.5 and 64.4 months, respectively, p = 0.009. Similar values were obtained in case of patients without tumor recurrence (27 and 57.1 months, p=0.011).Conclusions. The obtained results confirmed the significant value of Milan criteria, when qualifying patients with hepatocellular carcinoma for liver transplantation. The above-mentioned also showed the potential value of preoperative alpha-fetoprotein level measurements, not only in the diagnostics and early hepatocellular carcinoma diagnosis (patients with cirrhosis), but also in the prediction of survival and tumor recurrence after liver transplantation.
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One-Stage Emergency Right Hemihepatectomy Due to Spontaneous Rupture of Hepatocellular Carcinoma - Case Report

80%
Wszołek J., Burenok A.
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EN
Hepatocellular carcinoma (HCC) develops in 80% of patients diagnosed with liver cirrhosis. Spontaneous rupture of HCC is a life-threatening complication observed in 3-15% of cases. Hemorrhagic shock after a sudden episode of abdominal pain is a typical symptom of the above-mentioned complication. The abdominal ultrasound and CT examinations show the presence of peritoneal cavity fluid and hepatic tumor. The Authors presented a case of a 66-year old female patient subject to emergency hemihepatectomy, due to spontaneous rupture of a 9cm right hepatic lobe tumor.
5
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pVAX1 plasmid vector-mediated gene transfer of soluble TRAIL suppresses human hepatocellular carcinoma growth in nude mice

70%
Zhang Y., Ma C. H., Liu H., Zhang X. M., Sun W. S.
Acta Biochimica Polonica
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2007
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vol. 54
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issue 2
307-313
EN
The extracellular domain of the tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) may function as a soluble cytokine to selectively kill various cancer cells without toxicity to most normal cells. We used a high-biosafety plasmid pVAX1 as a vector and constructed a recombinant plasmid expressing the extracellular domain (95-281 aa) of human TRAIL fused with signal peptides of human IgGγ, designated as pVAX-sT. Transduction of human BEL7402 liver cancer cells with pVAX-sT led to high levels of sTRAIL protein in the cell culture media and induced apoptosis. The therapeutic potential of pVAX-sT was then evaluated in the BEL7402 transplanted naked mouse model. Subsequent intratumoral administration of naked pVAX-sT resulted in the expression of soluble TRAIL in the sera and the tumor site, as well as effective suppression of tumor growth, with no toxicity to liver. In conclusion, the successful inhibition of liver cancer growth and the absence of detectable toxicity suggest that pVAX-sT could be useful in the gene therapy of liver cancer.
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Current concepts in pathophysiology and management of hepatocellular carcinoma

70%
Hamza A., Abdulfattah H., Mahmoud R., Khalil W., Ahmed H.
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issue 3
573-580
EN
Additional approaches to control malignancies are needed due to the emerging trends in the incidence of cancer of different organ sites. Due to the high frequency of hepatocellular carcinoma (HCC) and its poor prognosis, preventing HCC is an urgent priority. To explore the antioxidant and apoptotic pathways of grape seed extract (GSE) we induce HCC experimentally by diethylnitrosoamine (DEN) and treated the animals with low and high doses of GSE. The results indicate good therapeutic possibilities for GSE use in treatment of HCC., This was evidenced via regression of liver enzymes' function (ALT&AST), the HCC markers; α-fucosidase, α-fetoprotein and carcinoembrionic antigen (CEA) in HCC groups treated with the grape seed extract. Also, tumor necrosis factor (TNF-α) showed a significant decrease using GSE in HCC bearing animals. Regarding the apoptotic pathways of GSE, we found a significant down regulation of apoptosis enhancing nuclease (Aen), Bcl2-associated X protein (Bax), B-cell translocation gene 2(Btg2), Cyclin G1 (Ccng1) and Cyclin-dependent kinase inhibitor 1A (Cdkn1a) gene expression in HCC+GSE groups as compared to HCC bearing group. In the same trend, the necrotic/apoptotic rates were significantly higher in the HCC groups treated with GSE vs. the HCC bearing group. Finally, the 8-OHdG/2-dG generation decreased by 73.8% and 52.9% in HCC+GSE at low and high doses, respectively. Based on these encouraging observations, grape seed extract could be a promising natural remedy for attenuating hepatocellular carcinoma that has a great future in approaches directed towards control of HCC.
7
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Glutathione and GSH-dependent enzymes in patients with liver cirrhosis and hepatocellular carcinoma

61%
Czeczot H., Ścibior D., Skrzycki M., Podsiad M.
Acta Biochimica Polonica
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2006
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vol. 53
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issue 1
237-242
EN
We investigated glutathione level, activities of selenium independent GSH peroxidase, selenium dependent GSH peroxidase, GSH S-transferase, GSH reductase and the rate of lipid peroxidation expressed as the level of malondialdehyde in liver tissues obtained from patients diagnosed with cirrhosis or hepatocellular carcinoma. GSH level was found to be lower in malignant tissues compared to adjacent normal tissues and it was higher in cancer than in cirrhotic tissue. Non-Se-GSH-Px activity was lower in cancer tissue compared with adjacent normal liver or cirrhotic tissue, while Se-GSH-Px activity in cancer was found to be similar to its activity in cirrhotic tissue and lower compared to control tissue. An increase in GST activity was observed in cirrhotic tissue compared with cancer tissue, whereas the GST activity in cancer was lower than in adjacent normal tissue. The activity of GSH-R was similar in cirrhotic and cancer tissues, but higher in cancer tissue compared to control liver tissue. An increased level of MDA was found in cancer tissue in comparison with control tissue, besides its level was higher in cancer tissue than in cirrhotic tissue. Our results show that the antioxidant system of cirrhosis and hepatocellular carcinoma is severely impaired. This is associated with changes of glutathione level and activities of GSH-dependent enzymes in liver tissue. GSH and enzymes cooperating with it are important factors in the process of liver diseases development.
8
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Influence of multi-tine electrode configuration in realistic hepatic RF ablative heating

61%
Gas P., Wyszkowska J., Gas P., Wyszkowska J.
Archives of Electrical Engineering
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2019
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vol. 68
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issue 3
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