The role of liver biopsy in the diagnosis of hepatocellular carcinoma(HCC)has been challenged over time by the ability of imaging techniques to characterize liver lesions in patients with known cirrhosis.In fact,in th...The role of liver biopsy in the diagnosis of hepatocellular carcinoma(HCC)has been challenged over time by the ability of imaging techniques to characterize liver lesions in patients with known cirrhosis.In fact,in the diagnostic algorithm for this tumor,histology is currently relegated to controversial cases.Furthermore,the risk of complications,such as tumor seeding and bleeding,as well as inadequate sampling have further limited the use of liver biopsy for HCC management.However,there is growing evidence of prognostic and therapeutic information available from microscopic and molecular analysis of HCC and,as the information content of the tissue sample increases,the advantages of liver biopsy might modify the current risk/benefit ratio.We herein review the role and potentiality of liver biopsy in the diagnosis and management of HCC.As the potentiality of precision medicine comes to the management of HCC,it will be crucial to have rapid pathways to define prognosis,and even treatment,by identifying the patients who could most benefit from target-driven therapies.All of the above reasons suggest that the current role of liver biopsy in the management of HCC needs substantial reconsideration.展开更多
In the recent years,several development in liver surgery have contributed in increasing resectability while maintaining safety.Particularly parenchyma-sparing techniques are progressively gaining higher relevance as a...In the recent years,several development in liver surgery have contributed in increasing resectability while maintaining safety.Particularly parenchyma-sparing techniques are progressively gaining higher relevance as alternative to major hepatectomy for complex cases(1).Proceeding in this direction the provocative concept of parenchyma sparing major hepatectomies has been introduced(2).展开更多
To the Editor:Hepatocellular carcinoma (HCC) is the most common primary livertumorandthethirdcauseofcancer-relateddeathsworldwide. HCC is the consequence of malignant transformation of hepatocytes and mainly occurs in...To the Editor:Hepatocellular carcinoma (HCC) is the most common primary livertumorandthethirdcauseofcancer-relateddeathsworldwide. HCC is the consequence of malignant transformation of hepatocytes and mainly occurs in patients with cirrhosis. Hepatitis C virus (HCV) chronic infection is a leading cause of end-stage liver diseaseandHCCintheWesterncountries[1].Theapprovalof direct-acting antiviral agents (DAAs) for the treatment of HCV has revolutionized the management of the disease, as no absolute contraindication to treatment exists and sustained virological response展开更多
Hepatocellular carcinoma(HCC)is the fifth most common cancer and the second leading cause of cancer-related death worldwide.Solid data suggest that the epidemiology of HCC is changing;while the frequencies of hepatiti...Hepatocellular carcinoma(HCC)is the fifth most common cancer and the second leading cause of cancer-related death worldwide.Solid data suggest that the epidemiology of HCC is changing;while the frequencies of hepatitis B virus(HBV)-and hepatitis C virus(HCV)-related HCC are progressively decreasing owing to the development of nucleo(t)side-based therapies and directly acting antiviral agents,respectively,the frequency of cryptogenic HCC continues to increase(15–30%of cases)(1).The rise of cryptogenic HCC is mainly related to non-alcoholic fatty liver disease(NAFLD)(1,2).NAFLD encompasses a wide spectrum of liver injuries,ranging from steatosis to non-alcoholic steatohepatitis(NASH),which may progress to cirrhosis(1,3).展开更多
Introduction Hepatocellular carcinoma(HCC)stands as a significant contributor to cancer-related mortality,ranking as the fifth leading cause of cancer-related death(1).In 80%of cases,HCC arises from an underlying live...Introduction Hepatocellular carcinoma(HCC)stands as a significant contributor to cancer-related mortality,ranking as the fifth leading cause of cancer-related death(1).In 80%of cases,HCC arises from an underlying liver disease(2).Despite screening programs for at-risk patients,the prognosis for HCC remains even dismal because of late diagnosis.The only curative options currently available are liver resection for selected cases,and liver transplantation.However,the high rate of recurrence after surgery makes the prognosis bleak.In fact,following curative intent resection,the 5-year recurrence is approximately 60%(3),with 5-year survival after recurrence of 35%(4).展开更多
The rationale of the performance of anatomic resection(AR)of the liver in case of hepatocellular carcinoma(HCC)is the removal of portal pedicle feeding the tumor because of the tumor’s tendency to invade the portal v...The rationale of the performance of anatomic resection(AR)of the liver in case of hepatocellular carcinoma(HCC)is the removal of portal pedicle feeding the tumor because of the tumor’s tendency to invade the portal veins(1).This technical approach is expected to be effective from an oncological perspective for a disease such as HCC,which is associated with a high rate of intrahepatic recurrence(2,3).In the eighties,Makuuchi et al.proposed the systematic subsegmentectomy(4)reporting excellent results(5),and later some other authors reported new techniques to identify the portal territory of a given HCC and perform a true AR of the liver(5-7).展开更多
文摘The role of liver biopsy in the diagnosis of hepatocellular carcinoma(HCC)has been challenged over time by the ability of imaging techniques to characterize liver lesions in patients with known cirrhosis.In fact,in the diagnostic algorithm for this tumor,histology is currently relegated to controversial cases.Furthermore,the risk of complications,such as tumor seeding and bleeding,as well as inadequate sampling have further limited the use of liver biopsy for HCC management.However,there is growing evidence of prognostic and therapeutic information available from microscopic and molecular analysis of HCC and,as the information content of the tissue sample increases,the advantages of liver biopsy might modify the current risk/benefit ratio.We herein review the role and potentiality of liver biopsy in the diagnosis and management of HCC.As the potentiality of precision medicine comes to the management of HCC,it will be crucial to have rapid pathways to define prognosis,and even treatment,by identifying the patients who could most benefit from target-driven therapies.All of the above reasons suggest that the current role of liver biopsy in the management of HCC needs substantial reconsideration.
文摘In the recent years,several development in liver surgery have contributed in increasing resectability while maintaining safety.Particularly parenchyma-sparing techniques are progressively gaining higher relevance as alternative to major hepatectomy for complex cases(1).Proceeding in this direction the provocative concept of parenchyma sparing major hepatectomies has been introduced(2).
文摘To the Editor:Hepatocellular carcinoma (HCC) is the most common primary livertumorandthethirdcauseofcancer-relateddeathsworldwide. HCC is the consequence of malignant transformation of hepatocytes and mainly occurs in patients with cirrhosis. Hepatitis C virus (HCV) chronic infection is a leading cause of end-stage liver diseaseandHCCintheWesterncountries[1].Theapprovalof direct-acting antiviral agents (DAAs) for the treatment of HCV has revolutionized the management of the disease, as no absolute contraindication to treatment exists and sustained virological response
文摘Hepatocellular carcinoma(HCC)is the fifth most common cancer and the second leading cause of cancer-related death worldwide.Solid data suggest that the epidemiology of HCC is changing;while the frequencies of hepatitis B virus(HBV)-and hepatitis C virus(HCV)-related HCC are progressively decreasing owing to the development of nucleo(t)side-based therapies and directly acting antiviral agents,respectively,the frequency of cryptogenic HCC continues to increase(15–30%of cases)(1).The rise of cryptogenic HCC is mainly related to non-alcoholic fatty liver disease(NAFLD)(1,2).NAFLD encompasses a wide spectrum of liver injuries,ranging from steatosis to non-alcoholic steatohepatitis(NASH),which may progress to cirrhosis(1,3).
文摘Introduction Hepatocellular carcinoma(HCC)stands as a significant contributor to cancer-related mortality,ranking as the fifth leading cause of cancer-related death(1).In 80%of cases,HCC arises from an underlying liver disease(2).Despite screening programs for at-risk patients,the prognosis for HCC remains even dismal because of late diagnosis.The only curative options currently available are liver resection for selected cases,and liver transplantation.However,the high rate of recurrence after surgery makes the prognosis bleak.In fact,following curative intent resection,the 5-year recurrence is approximately 60%(3),with 5-year survival after recurrence of 35%(4).
文摘The rationale of the performance of anatomic resection(AR)of the liver in case of hepatocellular carcinoma(HCC)is the removal of portal pedicle feeding the tumor because of the tumor’s tendency to invade the portal veins(1).This technical approach is expected to be effective from an oncological perspective for a disease such as HCC,which is associated with a high rate of intrahepatic recurrence(2,3).In the eighties,Makuuchi et al.proposed the systematic subsegmentectomy(4)reporting excellent results(5),and later some other authors reported new techniques to identify the portal territory of a given HCC and perform a true AR of the liver(5-7).
