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Prognostic factors in the surgical treatment of caudate lobe hepatocellular carcinoma

World Journal of Gastroenterology 2010年第9期16卷 1123-1128页

作者： Peng Liu,Jia-Mei Yang,Wen-Yang Niu,Tong Kan,Feng Xie,Dian-Qi Li,Ye Wang,Yan-Ming Zhou,Department of Special Treatment and Liver Transplantation,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University,Shanghai 200438,China Peng Liu,department of Hepatobiliary Surgery,Navy General Hospital,Beijing 100037,China Department of Special Treatment and Liver Transplantation Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China.

AIM:To evaluate the short-and long-term outcomes of liver resection for caudate lobe hepatocellular carcinoma (HCC).METHODS:We retrospectively analyzed 114 consecutive patients with HCC,originating from the caudate lobe,who underwent resection between January 2001 and January 2007.Univariate and multivariate analyses were performed on several clinicopathologic variables to determine the factors affecting long-term outcome and intrahepatic recurrence.RESULTS:Overall mortality and morbidity were 0% and 18%,respectively.After a median follow-up of 31 mo (interquartile range,11-66 mo),tumor recurrence had occurred in 76 patients (66.7%).The 1-,3-,and 5-year disease-free survival rates were 65.7%,38.1%,and 18.4%,respectively.The 1-,3-,and 5-year overall survival rates were 76.1%,54.7%,and 31.8%,respectively.Univariate analysis showed that subsegmental location of the tumor (45.7% vs 16.2%,P=0.01),liver cirrhosis (12.3% vs 47.9%,P=0.03),surgical margin (18.5% vs 54.6%,P=0.04),vascular invasion (37.9% vs 23.2%,P=0.04) and extended caudate resection (42.1% vs 15.4%,P=0.04) were related to poorer long-term survival.Multivariate analysis showed that only subsegmental location of the tumor,liver cirrhosis and surgical margin were significant independent prognostic factors.CONCLUSION:Hepatectomy was an effective treatment for HCC in the caudate lobe.The subsegmental location of the tumor,liver cirrhosis and surgical margin affected long-term survival.

关键词： Hepatectomy Hepatocellular carcinoma Caudate lobe Prognostic factors

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treatment of liver metastases from uveal melanoma: a retrospective single-center analysis

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Hepatobiliary & Pancreatic Diseases International 2013年第6期12卷 602-606页

作者： Xiao-Yu Yang Feng Xie Ran Tao Ai-Jun Li Meng-Chao Wu Division of special treatment II Eastern Hepatobiliary Surgery Hospital Second Military Medical University Division of special treatment I Eastern Hepatobiliary Surgery Hospital Second Military Medical University Center for Organ transplantation and department of General Surgery Ruijin Hospital

BACKGROUND:Metastatic liver melanoma is a rare event in the Chinese population with extremely poor prognosis.Any treatment that controls a metastatic hepatic lesion potentially prolongs survival.This study aimed to evaluate the survival of patients with isolated liver metastases from uveal melanoma treated with partial hepatectomy or non-surgical management and to find the best therapeutic modality for these patients.METHODS:From January 1996 to September 2008,eight patients with liver metastases secondary to uveal melanoma were admitted to our hospital.Five patients underwent partial hepatectomy and 3 received other treatments(TACE,RFA,PEI).Their medical records were reviewed and overall survival was analyzed.RESULTS:The patients comprised 3 men and 5 women,with a median age of 44 years.Six patients presented with liver metastases at the time the primary tumor was diagnosed.The interval from the diagnosis of uveal melanoma to liver metastasis in the remaining 2 patients was 9.5 and 32.5 months,respectively.The median survival after the treatment of liver metastasis was 11.5 and 7.5 months in the surgical and nonsurgical groups,respectively.There was no procedure-related mortality in the whole study cohort.CONCLUSIONS:Partial hepatectomy or other therapies were safe and feasible for isolated liver metastases from uveal mela-noma.Aggressive treatment with multidisciplinary modalities may result in prolonged survival.

关键词： liver metastasis uveal melanoma therapy

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Peripheral naïve CD8^(+)T cells as a predictive biomarker of response to lenvatinib plus an anti-PD-1 antibody in advanced hepatocellular carcinoma:a biomarker study

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Cancer Communications 2022年第11期42卷 1226-1230页

作者： Cheng Huang Bin Xu Xiao-Dong Zhu Ying-Hao Shen Mei-Ling Li Jin-Jin Zhu Jian Zhou Jia Fan Hui-Chuan Sun department of liver Surgery and transplantation Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of EducationLiver Cancer Institute and Zhongshan HospitalFudan UniversityShanghai 200032P.R.China

Dear Editor,Most patients with hepatocellular carcinoma(HCC)are diagnosed at an advanced stage and are ineligible for rad-ical surgery[1].As anti-programmed cell death protein 1(PD-1)monotherapy has not shown promising anti-tumor effects in advanced HCC in first-line settings,combination therapy with targeted therapy plus immunotherapy,such as atezolizumab plus bevacizumab,has become the new first-line treatment for advanced HCC.Similarly,lenva-tinib combined with an anti–PD-1 antibody has shown an objective response rate(ORR)of around 40%in a phase I trial in advanced HCC[2].

关键词： hepatocellular therapy surgery

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Risk factors for combined hepatocellular-cholangiocarcinoma:A hospital-based case-control study

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World Journal of Gastroenterology 2014年第35期20卷 12615-12620页

作者： Yan-Ming Zhou Xiao-Feng Zhang Lu-Peng Wu Cheng-Jun Sui Jia-Mei Yang department of Hepato-Biliary-Pancreato-Vascular Surgery the First Affiliated Hospital of Xiamen University Department of Special Treatment and Liver Transplantation Eastern Hepa-tobiliary Surgery HospitalSecond Military Medical University

AIM:To identify risk factors contributing to the development of combined hepatocellular-cholangiocarcinoma(CHC) in China.METHODS:One hundred and twenty-six patients with CHC and 4:1 matched healthy controls were interviewed during the period from February 2000 to October 2012.Logistic regression analysis was used to calculate odds ratios(OR)and 95%confidence intervals(CI)for each risk factor.RESULTS:Univariate analysis showed that the significant risk factors for CHC development were hepatitis B virus(HBV)infection,heavy alcohol consumption,a family history of liver cancer,and diabetes mellitus.Multivariate stepwise logistic regression analysis showed that HBV infection(OR=19.245,95%CI:13.260-27.931)and heavy alcohol consumption(OR=2.186,95%CI:1.070-4.466)were independent factors contributing to the development of CHC.CONCLUSION:HBV infection and heavy alcohol consumption may play a role in the development of CHC in China.

关键词： Risk factors Combined hepatocellular-chol-angiocar

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P16 gene hypermethylation and hepatocellular carcinoma:A systematic review and meta-analysis

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World Journal of Gastroenterology 2011年第25期17卷 3043-3048页

作者： Jia-Jie Zang Feng Xie Jin-Fang Xu Ying-Yi Qin Rong-Xi Shen Jia-Mei Yang Jia He department of Health Statistics Second Military Medical Univer-sity Shanghai 200433 China Department of Special Treatment and Liver Transplantation Eastern HepatobiliarySurgery Hospital Second Military Medical University Shanghai200438 China

AIM:To quantitatively investigate the effect of p16 hypermethylation on hepatocellular carcinoma (HCC) and hepatocirrhosis using a meta-analysis of available casecontrol studies.METHODS:Previous studies have primarily evaluated the incidence of p16 hypermethylation in HCC and corresponding control groups,and compared the incidence of p16 hypermethylation in tumor tissues,pericancer liver tissues,normal liver tissues and non-tumor liver tissues with that in other diseases.Data regarding publication information,study characteristics,and incidence of p16 hypermethylation in both groups were collected from these studies and summarized.RESULTS:Fifteen studies,including 744 cases of HCC and 645 non-tumor cases,were identified for meta-analysis.Statistically significant odds ratios (ORs) of p16 hypermethylation were obtained from tumor tissues and non-tumorous liver tissues of HCC patients (OR 7.04,95% CI:3.87%-12.78%,P liver tissues of patients with other diseases (OR 12.17,95% CI:6.64%-22.31%,P liver tissues of patients with non-tumorous liver diseases (OR 6.82,95% CI:4.31%-10.79%,P liver tissues and non-cirrhotic liver tissues (OR 4.96,95% CI:1.45%-16.96%,P=0.01).The pooled analysis showed significantly increased ORs of p16 hypermethylation (OR 6.98,95% CI:4.64%-10.49%,P liver cirrhosis.

关键词：基因甲基化 P16 肝癌肿瘤组织评价系统肝脏疾病肝组织

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Intraoperative pulmonary hypertension occurred in an asymptomatic patient with pre-existent liver cirrhotic and portal hypertension

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World Journal of Gastroenterology 2008年第47期14卷 7260-7263页

作者： Ling Lu Feng Zhang Xiang-Cheng Li Guo-Qiang Li Chuan-Yong Zhang Xue-Hao Wang Key Laboratory of LivingDonor liver transplantation of Ministry of Public Health Department of Liver Transplantation the First AffiliatedHospital of Nanjing Medical University Nanjing 210029Jiangsu Province China

Portopulmonary hypertension(PPH) is clinically defined as the development of pulmonary arterial hypertension complicated by portal hypertension,with or without advanced hepatic disease.Physical signs may be absent in mild to moderate PPH and only appear in a hyperdynamic circulatory state.Similar signs of advanced liver disease can be observed in severe PPH,with ascites and lower extremity edema.Pulmonary hypertension is usually diagnosed after anesthetic induction during liver transplantation(LT).We present intraoperative pulmonary hypertension in a 41-year-old male patient with hepatic cirrhosis.Since this patient had no preoperation laboratory data supporting the diagnosises of pulmonary hypertension and was asymptomatic for a number of years,it was necessary to send him to the intensive care unit after operation.Further study should be focued on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.

关键词：肺动脉高压肝移植门静脉高压肝硬化肝炎

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Adjuvant therapies after curative treatments for hepatocellular carcinoma: Current status and prospects

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Genes & Diseases 2020年第3期7卷 359-369页

作者： Xiao-Dong Zhu Kang-Shuai Li Hui-Chuan Sun department of liver Surgery and transplantation Liver Cancer Institute and Zhongshan HospitalFudan UniversityShanghai200032China

Tumor recurrence rate after surgery or ablation of hepatocellular carcinoma(HCC)is as high as 70%.However,there are no widely accepted adjuvant therapies;therefore,no treatment has been recommended by guidelines from the American Association for the Study of liver Disease or the European Association for the Study of the liver.All the registered trials failed to find any treatment to prolong recurrence-free survival,which is the primary outcome in most studies,including sorafenib.Some investigator-initiated studies revealed that antihepatitis B virus agents,interferon-a,transcatheter chemoembolization,chemokine-induced killer cells,and other treatments prolonged patient recurrence-free survival or overall survival after curative therapies.In this review,we summarize the current status of adjuvant treatments for HCC and explain the challenges associated with designing a clinical trial for adjuvant therapy.Promising new treatments being used as adjuvant therapy,especially anti-PD-1 antibodies,are also discussed.

关键词： Adjuvant therapy Anti-PD-1 antibody Clinical trial Hepatocellular carcinoma Molecular targeted therapy Recurrence-free survival

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Targeting angiogenesis for liver cancer: Past, present, and future

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Genes & Diseases 2020年第3期7卷 328-335页

作者： Xiao-Dong Zhu Zhao-You Tang Hui-Chuan Sun department of liver Surgery and transplantation Liver Cancer Institute and Zhongshan HospitalFudan UniversityShanghai200032China

liver cancer,mostly hepatocellular carcinoma(HCC),is the second leading cause of cancer mortality globally.Most patients were diagnosed at an advanced stage,and systemic therapy is the standard of care.All the approved systemic therapies for HCC are molecular targeted therapies with anti-angiogenic effects targeting the vascular endothelial growth factor signaling pathway.Sorafenib and lenvatinib are the first-line treatment,and regorafenib,ramucirumab,and cabozantinib are second-line treatment options.Although anti-PD-1 antibodies,including nivolumab and pembrolizumab,demonstrated promising anti-tumor effects as monotherapy for advanced HCC in phase II clinical trials,both failed in phase III studies.Anti-angiogenic treatment remains the backbone of systemic therapy for HCC.In this review,we summarized the approved anti-angiogenic medicines and discussed the potential strategies to improve the efficacy of anti-angiogenic therapy,including combination therapy with other treatments,and discussed the approaches to overcome the drawbacks of anti-angiogenic therapies.

关键词： Anti-angiogenic therapy Combinational therapy Hepatocellular carcinoma Molecular targeted therapy Systemic therapy

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Diagnosis and therapy of tacrolimus toxicity in a liver transplant recipient during COVID-19 treatment

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 326-330页

作者： Feng Zhu Yi-Ming Wang Ming Ni Yuan Liang Jie-Hui Huang Xue-Hao Wang Feng Cheng Ling Lu Hepatobiliary Center The First Affiliated Hospital of Nanjing Medical UniversityKey Laboratory of Liver TransplantationChinese Academy of Medical SciencesNHC Key Laboratory of Liver TransplantationResearch Unit of Liver Transplantation and Transplant ImmunologyChinese Academy of Medical SciencesNanjing 210000China department of Respiratory and Critical Care Medicine Wuxi Fifth People’s HospitalWuxi 214000China Jiangsu Key Laboratory of Cancer Biomarkers Prevention and TreatmentCollaborative Innovation Center for Cancer Personalized MedicineNanjing Medical UniversityNanjing 210000China

To the Editor:SARS-CoV-2,the pathogen responsible for the pandemic of coronavirus disease 2019(COVID-19),has had profound impacts on human health,and its antagonist Paxlovid is a commonly used treatment option[1].However,treatment selection for immunosuppressed patients,such as liver recipients,remains uncertain due to potential drug interactions and the risk of immunosuppressant dosage adjustment,which can cause liver injury[2].

关键词： dosage treatment antagonist

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Diagnosis and treatment of bacterial pneumonia in liver transplantation recipients:report of 33 cases

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Chinese Medical Journal 2005年第22期118卷 1879-1885页

作者： MA Yu-kui YAN Lu-nan LI Bo LU Shi-chun HUANG An-hua WEN Tian-fu ZENG Yong CHENG Nan-sheng liver transplantation Center Department of General Surgery WestChina Hospital Sichuan University Chengdu 610041 China

Background Bacterial pneumonia in the recipients of liver transplantation （LTX） is a common postoperative complication influencing the prognosis greatly. In this article, the diagnosis and treatment of bacterial pneumonia in 33 LTX recipients are reported.Methods From February 1999 to January 2003, a total of 103 patients underwent allogeneic LTX at our center; afterwards, a retrospective analysis was made on their postoperative clinical manifestations, including symptoms （expectoration, panting and fever）, sign （rale）, results of laboratory examinations （white blood cell count and sputum culture of tracheal secretions or pleural fluid culture） , and chest X-ray films. The following data of the pneumonia and non-pneumonia groups were collected, and the rank sum test （SPSS 11.0, Wilcoxon＇ s method） was used to analyze the duration of postoperative respirator utilization and the volume of pleural effusion through pleurocentesis or pleural drainage. Results In the 103 patients, 33 experienced 53 transplantation, 14 of them （42.42%） had more episodes of bacterial pneumonia during their hospital stay after than three manifestations of the seven mentioned above. The pathogens causing bacterial pneumonia included Pseudomonas aeruginosa （ 17.48% ） , Klebsiella pneumoniae （15.53%）, Acinetobacter baumannii （ 10.68% ）, and Staphylococcus aureus （7.77%）. Amilkacin, tienam, ciprofloxacin, vancomycin, etc. were the antibiotics of choice against those bacteria. Acute rejection occurred during the treatment of bacterial pneumonia in 16 patients, and 5 of them died. Wilcoxon＇ s rank sum test of the data indicated that the pneumonia group had longer duration of postoperative ventilator treatment and larger volume of pleural effusion than the non-pneumonia group （P 〈 0. 05 ）. Conclusions The clinical manifestations of pneumonia after LTX might be atypical, and special attention should be paid to the respiratory symptoms and signs within 2 months after LTX. Whenever the diagnosis of bacterial pneumonia is confirmed, considerat

关键词： liver transplantation· pneumonia bacterial· diagnosis · therapeutics

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