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A mixed blessing for liver transplantation patients—Rapamycin

Hepatobiliary & Pancreatic Diseases International 2023年第1期22卷 14-21页

作者： Guang-Han Fan Chen-Zhi Zhang Feng-Qiang Gao Xu-Yong Wei Sun-Bin Ling Kai Wang Jian-Guo Wang Shu-Sen Zheng Mehrdad Nikfarjam Xiao Xu Department of Hepatobiliary and Pancreatic Surgery Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006China Zhejiang University School of Medicine Hangzhou 310058China Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Hangzhou 310006China Institute of Organ Transplantation Zhejiang UniversityHangzhou 310003China State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicineSun Yat-sen University CancerGuangzhou 510060China Westlake Laboratory of Life Sciences and Biomedicine Hangzhou 310024China Department of Hepatobiliary and Pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Hepatobiliary and Pancreatic Surgery Shulan(Hangzhou)HospitalHangzhou 310000China NHC Key Laboratory of Combined Multi-Organ Transplantation Hangzhou 310003China Department of Surgery University of MelbourneAustin HealthHeidelbergVIC 3084Australia

Background:Liver transplantation(LT)is an effective treatment option for end-stage liver *** target of rapamycin(m TOR)inhibitors,such as rapamycin,are widely used post *** sources:In this review,we focused on the anti-cancer activities and metabolic side effects of rapamycin after *** literature available on Pub Med for the period of January 1999-September 2022 was *** key words were rapamycin,sirolimus,liver transplantation,hepatocellular carcinoma,diabetes,and lipid metabolism ***:Rapamycin has shown excellent effects and is safer than other immunosuppressive *** has exhibited excellent anti-cancer activity and has the potential in preventing hepatocellular carcinoma(HCC)recurrence post *** is closely related to two long-term complications after LT,diabetes and lipid metabolism ***:Rapamycin prevents HCC recurrence post LT in some patients,but it also induces metabolic *** use of rapamycin benefits the liver recipients.

关键词： Liver transplantation Rapamycin Metabolic disease Hepatocellular carcinoma tumor recurrence

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Sirolimus improves the prognosis of liver recipients with hepatocellular carcinoma:A single-center experience

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Hepatobiliary & Pancreatic Diseases International 2023年第1期22卷 34-40页

作者： Peng Liu Xin Wang Huan Liu Shu-Xian Wang Qing-Guo Xu Lin Wang Xiao Xu Jin-Zhen Cai Organ Transplantation Center The Affiliated Hospital of Qingdao UniversityQingdao 266100China Institute of Organ Donation and Transplantation Department of MedicineQingdao UniversityQingdao 266100China Department of Hepatobiliary and Pancreatic Surgery The Center for Integrated Oncology and Precision MedicineAffiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310003China National Health Commission(NHC)Key Laboratory of Combined Multi-Organ Transplantation Hangzhou 310003China Institute of Organ Transplantation Zhejiang UniversityHangzhou 310003China

Background:tumor recurrence after liver transplantation(LT)for selective patients diagnosed with hepatocellular carcinoma(HCC)in the setting of cirrhosis is the greatest challenge effecting the prognosis of these *** aim of this study was to evaluate the efficacy of sirolimus on the prognosis for these ***:The data from 193 consecutive HCC patients who had undergone LT from January 2015 to December 2019 were retrospectively *** patients were divided into the sirolimus group[patients took sirolimus combined with calcineurin inhibitors(CNIs)(n=125)]and non-sirolimus group[patients took CNI-based therapy without sirolimus(n=68)].recurrence-free survival(RFS)and overall survival(OS)were compared between the two *** prognostic factors and independent risk factors for RFS and OS were further ***:Non-sirolimus was an independent risk factor for RFS(HR=2.990;95%CI:1.050-8.470;P=0.040)and OS(HR=3.100;95%CI:1.190-8.000;P=0.020).A higher proportion of patients beyond Hangzhou criteria was divided into the sirolimus group(69.6%vs.80.9%,P=0.030).Compared with the non-sirolimus group,the sirolimus group had significantly better RFS(Precurrence and prolonged RFS and OS in LT patients with different stage of HCC.

关键词： Hepatocellular carcinoma Liver transplantation Sirolimus tumor recurrence recurrence-free survival Overall survival

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Liver transplantation for malignant liver tumors

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iLIVER 2022年第1期1卷 3-11页

作者： Richard X.Sousa Da Silva Beat Muellhaupt Philipp Dutkowski Pierre-Alain Clavien Department of Surgery and Transplantation Swiss Hepato-Pancreato-Biliary(HPB)and Transplant CenterUniversity Hospital ZurichRaemistrasse 1008091 ZurichSwitzerland Wyss Zurich ETH ZurichUniversity of ZurichWeinbergstrasse 358006 ZurichSwitzerland Department of Gastroenterology and Hepatology University Hospital ZurichRaemistrasse 1008091 ZurichSwitzerland

Liver transplantation is a highly effective treatment not only for acute or chronic liver failure but also for primary liver cancer such as hepatocellular carcinoma,perihilar cholangiocarcinoma,intrahepatic cholangiocarcinoma,and metastatic tumors such as from neuroendocrine or colorectal liver *** success strongly relies on strict adherence to stringent selection criteria,which lead to excellent outcomes,while previously regarded as contraindication for liver *** impressive results are,however,mostly achieved with a combination of pretreatment strategies and convincing control of the tumor growth prior to transplantation,as well as minimizing long-term *** this emergence of oncologic liver transplantation,we expect an increasing need of grafts,and therefore included in this report strategies to improve the number of available grafts by maximizing liver utilization *** machine liver perfusion approaches may play in this respect an important role.

关键词： Liver transplantation Selection criteria Malignant tumor Machine perfusion tumor recurrence

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Modified preoperative score to predict disease-free survival for hepatocellular carcinoma patients with surgical resections

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World Journal of Hepatology 2022年第9期14卷 1778-1789页

作者： Yin Lai Jin-Chiao Lee Hao-Chien Hung Yu-Chao Wang Chih-Hsien Cheng Tsung-Han Wu Chen-Fang Lee Ting-Jung Wu Hong-Shiue Chou Kun-Ming Chan Chen-Yao Kao Wei-Chen Lee Department of General Surgery Chang-Gung Memorial HospitalChang-Gung University College of MedicineTaoyuan 333Taiwan Department of Special Education National University of TainanTainan 700Taiwan

BACKGROUND No prognostic models specific to hepatocellular carcinoma patients receiving surgical resection have been considered strong and convincing enough for survival prediction thus far,and there are no models including only preoperative *** derived a nomogram to predict disease-free survival in a previous *** To simplify our score and compare research outcomes among other scoring *** We retrospectively reviewed data from 1106 patients with hepatocellular carcinoma who underwent liver resection at the Linkou Chang Gung Memorial Hospital between April 2003 and December *** analyses were conducted to identify the significant survival ***,Harrell’s C-index,and Akaike information criterion were compared between our score,AJCC 8^(th)edition,Tokyo score,and Taipei Integrated Scoring System(TTV-CTPAFP model).RESULTS Among the 1106 patients,731(66.1%)had tumor recurrence at a median followup of 83.9 *** risk factors were identified:platelet count,albumin level,indocyanine green retention rate,multiplicity,and radiologic total tumor *** were divided into three risk groups,and the 5-year survival rates were 61.7%,39%,and 25.7%,*** C-index was 0.617,which was higher than the Tokyo score(0.613)and the Taipei Integrated Scoring System(0.562)and equal to the value of the AJCC 8th edition(0.617).CONCLUSION The modified score provides an easier method to predict *** treatment can be planned preoperatively by dividing patients into risk groups.

关键词： Hepatocellular carcinoma Preoperative Prediction tumor recurrence

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Three‐dimensional magnetic resonance elastography in chronic liver disease

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Portal Hypertension & Cirrhosis 2023年第1期2卷 32-39页

作者： Chunli Li He Zhu Yan Wang Ye Gu Yu Shi Department of Radiology Shengjing Hospital of China Medical UniversityShenyangLiaoningChina The Intervention Department The Sixth People's Hospital of ShenyangShenyangLiaoningChina Department of Infectious Disease The Sixth People's Hospital of ShenyangShenyangLiaoningChina

Chronic liver disease(CLD)has become a major health problem worldwide owing to its increased morbidity and *** of the degree of liver injury is crucial for the clinical management and treatment of CLD *** the current clinical practice,liver biopsy with histological analysis is the clinical standard for assessing the degree of CLD ***,liver biopsy is an invasive procedure that is limited by sampling errors and interobserver variability and is insufficient for screening and *** three‐dimensional magnetic resonance elastography(3D MRE)is a simple,fast,safe,and noninvasive *** offers comprehensive insight into increased liver stiffness beyond stage‐specific *** technology exhibits considerable potential for comprehensively and simultaneously assessing early necroinflammation,discriminating necroinflammation from fibrosis,detecting nonalcoholic steatohepatitis severity,predicting cirrhosis complications,and identifying tumor ***,the clinical application and promotion of this technology are currently required in China.3D MRE should evolve towards better clinical convenience and satisfaction to provide an imaging basis to improve treatment selection in CLD patients and facilitate its widespread use.

关键词： 3D MRE chronic liver disease cirrhosis fibrosis inflammation tumor recurrence

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Monoclonal immunoscintigraphy for detection of metastasis and recurrence of colorectal cancer

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World Journal of Gastroenterology 2011年第19期17卷 2424-2430页

作者： Vera Artiko Ana Koljevic Markovi Dragana obi-aranovi Milorad Petrovi Andrija Anti Mirjana Stojkovi Marinko Zuvela Djordjije aranovi Milica Stojkovi Neboja Radovanovi Danijel Galun Aleksandar Milovanovi Jovica Milovanovi Anica Bobi-Radovanovi Zoran Krivokapic Vladimir Obradovi School of Medicine University of BelgradeClinical Center of Serbia National Research Cancer Center Institute for Ocupational Medicine Belgrade University School of Medicine Paterova 2 11000 BelgradeSerbia

AIM:To assess the clinical role of monoclonal immunoscintigraphy for the detection of metastasis and recurrence of colorectal ***:Monoclonal immunoscintigraphy was performed in patients operated on for colorectal adenocar-cinoma suspected of local recurrence and metastatic *** results were compared with conventional ***:Immunoscintigraphic investigation was done in 53 *** recurrence occurred in 38 patients,and was confirmed by other diagnostic modalities in *** 15 patients,immunoscintigraphic findings were negative,and confirmed in 14 with other diagnostic *** analysis confirmed good correlation of immunoscintigraphic findings and the results of conventional diagnostics and the level of tumor marker carcinoembryonic *** analysis of parameters of radiopharmaceutical groups imacis,indimacis and oncoscint presented homogenous characteristics all of three *** analysis of immunoscintigraphic target focus was clearly improved using ***:Immunoscintigraphy is highly specific and has a good predictive value in local recurrence of colorectal cancer.

关键词： Immunoscintigraphy Monoclonal antibodies Colorectal carcinoma tumor metastasis tumor recurrence

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Impact of treatment modalities on patients with recurrent hepatocellular carcinoma after liver transplantation:Preliminary experience

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Hepatobiliary & Pancreatic Diseases International 2020年第4期19卷 365-370页

作者： Zhe Yang Shuo Wang Xin-Yao Tian Qin-Fen Xie Li Zhuang Qi-Yong Li Cheng-Ze Chen Shu-Sen Zheng Department of Hepatobiliarynd Pancreatic Surgery Department of Liver TransplantationShulan(Hangzhou)HospitalZhejiang Shuren University School of Medicine848 Dongxin RoadHangzhou 310022China Division of Hepatobiliary Pancreatic Surgery the First Affiliated HospitalZhejiang University School of Medicine79 Qingchun RoadHangzhou 310003China National Clinical Research Center of Infectious Diseases 79 Qingchun RoadHangzhou 310003China

Background:Post-liver transplantation(LT)hepatocellular carcinoma(HCC)recurrence still occurs in approximately 20%of patients and drastically affects their *** study aimed to evaluate the efficacy of various treatments for recurrent HCC after LT in a Chinese ***:A total of 64 HCC patients with tumor recurrence after LT were enrolled in this *** and multivariate analyses were performed to identify factors affecting post-recurrence ***:Of the 64 patients with recurrent HCC after LT,those who received radical resection followed by nonsurgical therapy had a median overall survival(OS)of 20.9 months after HCC recurrence,significantly superior to patients who received only nonsurgical therapy(9.4 months)or best supportive care(2.4 months).The one-and two-year OS following recurrence was favorable for patients receiving radical resection followed by nonsurgical therapy(93.8%,52.6%),poor for patients receiving only nonsurgical therapy(30.8%,10.8%),and dismal for patients receiving best supportive care(0%,0%;overall Precurrence(P=0.035).Multivariate analysis showed radical resection combined with nonsurgical therapy for recurrent HCC and sorafenib-lenvatinib sequential therapy were independent favorable factors for post-recurrence ***:Aggressive surgical intervention in well-selected patients significantly improves OS after recurrence.A multidisciplinary treatment approach is required to slow down disease progression for patients with unresectable recurrent HCC.

关键词： Hepatocellular carcinoma Liver transplantation Treatment modality tumor recurrence Prognosis

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Risk factors associated with early recurrence of adenocarcinoma of gastroesophageal junction after curative resection

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Chinese Journal of Cancer Research 2013年第3期25卷 334-338页

作者： Guodong Wang Aiwen Wu Xiaojing Cheng Jiafu Ji Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education) Department of Gastrointestinal Surgical Oncology Peking University Cancer Hospital & Institute

Objective： To clarify the important clinicopathological factors affecting the early recurrence of adenocarcinoma of esophagogastric junction （/kEG）. Methods： We retrospectively reviewed the clinical data of 147 AEG patients who underwent R0 resection during the period from December 1995 to December 2007. Risk factors asssociated with the early recurrence were analyzed by X2 test and logistic regression test. Results： The mean time to tumor recurrence was 16.3 months after R0 resection, and the 1-year recurrence rate was 48.3%. Univariate analysis showed that the histological grade （poorly and moderately differentiated）, number of positive lymph nodes, and vascular invasion were significantly related with the early recurrence （P〈0.05）. Logistic multivariate regression analysis showed that only histological grade and vascular invasion were independently related with early tumor recurrence （P〈0.05）, Conclusions： Histological grade and vascular tumor recurrence after R0 resection for/kEG. invasion are independent factors for predicting the early

关键词： Adenocarcinoma of esophagogastric junction (AEG) tumor recurrence risk factor

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Nomogram based on tumor-associated neutrophil-tolymphocyte ratio to predict survival of patients with gastric neuroendocrine neoplasms

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World Journal of Gastroenterology 2017年第47期23卷 8376-8386页

作者： long-long cao jun lu jian-xian lin chao-hui zheng ping li jian-wei xie jia-bin wang qi-yue chen mi lin ru-hong tu chang-ming huang department of gastricsurgery fujian medical university union hospital

AIM To assess the predictive value of the tumor-associated neutrophil-to-lymphocyte ratio in terms of the clinical outcomes of patients with gastric neuroendocrine neoplasms after radical *** Data were retrospectively collected from 142 patients who were diagnosed with gastric neuroendocrine neoplasms and who underwent radical gastrectomy at our department from March 2006 to March 2015. These data were retrospectively analyzed, and a receiver operating characteristic curve analysis was used to identify the optimal value of the tumorassociated neutrophil-to-lymphocyte ratio. Univariate and multivariate survival analyses were used to identify prognostic factors. A nomogram was then applied to predict clinical outcomes after *** The tumor-associated neutrophil-to-lymphocyte ratio was significantly associated with tumor recurrence, especially with liver metastasis and lymph node metastasis(P 0.05 for all). A multivariate Cox regression analysis identified the tumor-associatedneutrophil-to-lymphocyte ratio as an independent prognostic factor for recurrence-free survival and overall survival(P tumorassociated neutrophil-to-lymphocyte ratio, Ki-67 index, and lymph node ratio, was 0.788(0.759) for recurrence-free survival(overall survival) and was higher than the concordance index of the traditional TNM staging system [0.672(0.663)].CONCLUSION The tumor-associated neutrophil-to-lymphocyte ratio is an independent prognostic factor in patients with gastric neuroendocrine neoplasms. Nomograms that include the tumor-associated neutrophil-to-lymphocyte ratio, Ki-67 index, and lymph node ratio have a superior ability to predict clinical outcomes of postoperative patients.

关键词： Gastric neuroendocrine neoplasms tumorassociated neutrophil-to-lymphocyte ratio tumor recurrence Prognosis

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A case of primary malignant fibrous histiocytoma of the pancreas: CT and MRI findings

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World Journal of Gastroenterology 2008年第18期14卷 2942-2945页

作者： Ri-Sheng Yu Jia-Wei Wang Ying Chen Wen-Hong Ding Xiu-Fang Xu Li-Rong Chen Department of Radiology Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 Zhejiang Province China Department of Pathology Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 Zhejiang Province China

Primary malignant fibrous histiocytoma (MFH) of the pancreas is rare and a distinct clinical entity. We report a case of recurrence of pancreatic MFH with computed tomography (CT) and magnetic resonance imaging (MRI) findings. A 67-year-old man presented with a history of decreased body weight over the past 6 mo. Abdominal CT revealed a large, multilocular cystic mass in the head of the pancreas with obvious atrophy in the body and tail of the pancreas. After 6 mo postoperatively, MRI demonstrated a recurrent large mass in the primary area of the head of the pancreas. The lesion was heterogeneous, hypointense to the liver on T1-weighted imaging, and heterogeneously hyperintense to the liver with a hypointense area in the central part of the tumor on fat-saturated T2-weighted imaging. Contrast- enhanced T1-weighted imaging demonstrated a large multilocular cystic mass with a cystic wall, fibrous septa and enhancement of solid components. To the best of our knowledge, this is the first report on recurrence of primary MFH of the pancreas, and the first with MRI findings.

关键词： Pancreatic neoplasms Malignant fibrous histiocytoma Computed tomography Magnetic resonance imaging tumor recurrence

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