Publications by authors named "Giuliana Amaddeo"

Background And Objective: Selective internal radiation therapy (SIRT) represents an endovascular treatment option for patients with hepatocellular carcinoma (HCC). Its use is widely recognized in the intermediate and advanced HCC, but it has become more prevalent in recent years in different Barcelona Clinic Liver Cancer (BCLC) stages. The aim of this review is to summarize the role of SIRT and its clinical implications through different stages of HCC.

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Background & Aims: Despite its growing incidence, hepatocellular carcinoma (HCC) related to metabolic dysfunction-associated steatotic liver disease (MASLD) in non-cirrhotic livers remains poorly characterized. We compared the characteristics, management, survival, and trends of MASLD-related HCC in patients with or without underlying cirrhosis in a large multicenter cohort.

Methods: A total of 354 cases of MASLD-related HCC presented at the liver tumor meetings of four French university hospitals between 2007 and 2018 were included in the study.

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Article Synopsis
  • High compliance with enhanced recovery programs (ERP) is correlated with better healthcare outcomes, specifically in liver surgery (LS) patients.
  • A study analyzed 706 LS patients and found that those with over 70% ERP compliance had significantly higher rates of achieving textbook outcomes (TO) compared to those with lower compliance.
  • Key factors negatively affecting TO achievement included having cholangiocarcinoma, undergoing high complexity LS, experiencing intraoperative hypotension, and suffering from postoperative ileus.
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Selective internal radiation therapy (SIRT) has emerged as a viable endovascular treatment strategy for hepatocellular carcinoma (HCC). According to the Barcelona Clinic Liver Cancer (BCLC) classification, SIRT is currently recommended for early- and intermediate-stage HCC that is unsuitable for alternative locoregional therapies. Additionally, SIRT remains a recommended treatment for patients with advanced-stage HCC and portal vein thrombosis (PVT) without extrahepatic metastasis.

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Rationale And Objectives: A new microcatheter was recently developed claiming to reduce beads reflux in drug-eluting bead transarterial chemoembolization (DEB-TACE). The aim of this study was to compare the reflux control microcatheter ability versus a standard microcatheter for TACE treatment in patients with hepatocellular carcinoma.

Material And Methods: Patients were prospectively included between November 2017 and February 2022.

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Purpose: The aim of this study was to report the safety and tumor response rate of combined transarterial radioembolization (TARE) through the intrahepatic arteries and transarterial chemoembolization (TACE) through the extrahepatic feeding arteries (EHFA) in patients with hepatocellular carcinoma (HCC).

Methods: Patients with HCC, who had both intrahepatic and extrahepatic arterial supply visible on preinterventional multiphase CT and were treated between 2016 and 2021 with a combination of TACE and TARE on the same nodule, were retrospectively included. Epidemiological, clinical, biological, and radiological characteristics were recorded.

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Background: Current guidelines do not indicate any comprehensive management of hepatic hypervascular incidentalomas (HVIs) discovered in hepatocellular carcinoma (HCC) patients during intra-arterial therapies (IATs). This study aims to evaluate the prognostic value of HVIs detected on per-interventional cone beam computed tomography (CBCT) during IAT for HCC in patients waiting for liver transplantation (LT).

Material And Methods: In this retrospective single-institutional study, all liver-transplanted HCC patients between January 2014 and December 2018 who received transarterial chemoembolization (TACE) or radioembolization (TARE) before LT were included.

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Background: Selective internal radiation therapy (SIRT) is recommended as a downstaging (DS) strategy for solitary unresectable HCC <8 cm. The aim of this study was to report the results of acquired experience in a tertiary center for all unresectable HCCs.

Methods: We conducted a retrospective, observational study using data collected from consecutive patients undergoing SIRT between October 2013 and June 2020.

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Interim analysis of the DOSISPHERE-01 study demonstrated a strong improvement in response and overall survival (OS) on using Y-loaded glass microspheres with personalized dosimetry compared with standard dosimetry in patients with nonoperable locally advanced hepatocellular carcinoma. This report sought to provide a long-term analysis of OS. In this phase II study (ClinicalTrials.

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Background: In recent years, Acinetobacter baumannii-calcoaceticus complex (ABC) infections have attracted attention, mainly because of the impact of carbapenem-resistant isolates in hospital-acquired infections. However, acute community-acquired ABC infections are not uncommon in warm and humid countries, where they are responsible for community-acquired infections with specific clinical features. To date, such infection has not been reported in France.

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Article Synopsis
  • Primary liver cancer can originate from two cell types, leading to different types of tumors: hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICCA), with combined tumors (cHCC-CCA) displaying mixed characteristics.
  • Researchers utilized deep learning to categorize tumors in a study involving 405 cHCC-CCA patients, successfully distinguishing between HCC and ICCA types.
  • This deep learning method showed potential for enhancing treatment strategies and improving patient outcomes for those with complex liver cancers.
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Backgrounds: The efficacy of atezolizumab/bevacizumab has never been reported in patients with metastatic/unresectable combined hepatocellular-cholangiocarcinoma (cHCC-CCA).

Patients And Methods: We retrospectively included patients with a histological diagnosis of unresectable/metastatic cHCC-CCA and treated with atezolizumab/bevacizumab (2020-2022) in 7 centers. Clinical and radiological features were collected at the beginning of atezolizumab/bevacizumab.

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The clinical features and short-term prognosis of patients admitted to the intensive care unit for herpes hepatitis are lacking. Of 33 patients admitted between 2006 and 2022, 22 were immunocompromised, 4 were pregnant women, and 23 died. Sixteen patients developed a hemophagocytic syndrome.

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Article Synopsis
  • The ELITor study analyzed real-world data from the CHIEF cohort to understand treatment patterns and patient characteristics for unresectable hepatocellular carcinoma in France, focusing on sociodemographic, clinical, and quality of life factors.
  • A total of 367 patients were included, with most presenting at advanced BCLC C stage and a high prevalence of cirrhosis; alcohol was identified as the main cause of the disease.
  • Results showed that tyrosine-kinase inhibitors were the most common systemic treatment, and patients receiving atezolizumab plus bevacizumab demonstrated better health statuses, although many experienced a decline in health quality post-treatment.
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  • This study evaluated the effectiveness and safety of second-line tyrosine kinase inhibitors (TKIs) in patients with advanced hepatocellular carcinoma (HCC) who previously progressed after treatment with atezolizumab and bevacizumab.
  • A total of 82 patients were analyzed, with those receiving regorafenib showing significantly better overall survival (OS) compared to other TKIs like sorafenib, lenvatinib, and cabozantinib.
  • Safety results indicated that 20% of patients experienced grade 3 adverse events, but there were no severe grade 4 or 5 events reported.
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Introduction And Objectives: The lockdown policy introduced in 2020 to minimize the spread of the COVID-19 pandemic, significantly affected the management and care of patients affected by hepatocellular carcinoma (HCC). The aim of this follow-up study was to determine the 12 months impact of the COVID-19 pandemic on the cohort of patients affected by HCC during the lockdown, within six French academic referral centers in the metropolitan area of Paris.

Materials And Methods: We performed a 12 months follow-up of the cross-sectional study cohort included in 2020 on the management of patients affected by HCC during the first six weeks of the COVID-19 pandemic (exposed), compared to the same period in 2019 (unexposed).

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Background: Eastern data highlight the oncological benefits of the anterior approach (AA) during right hepatectomy (RH) for hepatocellular carcinoma (HCC). However, to our knowledge, previous western data on this topic are scarce. In this study, the oncological outcomes of AA and classical approach (CA) during RH for HCC were compared.

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Background: The SARS-CoV-2 (COVID-19) pandemic required a rapid surge of healthcare capacity to face a growing number of critically ill patients. For this reason, a support reserve of physicians, including surgeons, were required to be reassigned to offer support.

Objective: To realize a survey on the educational programs deployed (face-to-face or e-learning focusing on infective area, basic gestures, COVID clinical management and intensive care medicine), and their impact on behavior change (Kirkpatrick 3) of the target population of surgeons, measured on a five modalities Likert scale.

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Article Synopsis
  • The study evaluates the efficacy of first-line systemic treatments, specifically tyrosine kinase inhibitors (TKIs) and platinum-based chemotherapy, for patients with unresectable hepatocellular-cholangiocarcinoma (cHCC-CCA) in comparison to hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA).
  • A total of 83 male-dominated patients (72%) with cHCC-CCA were analyzed; many had cirrhosis (55%) and a significant portion presented with extrahepatic metastases (67%).
  • The overall survival for patients with cHCC-CCA was similar to that of HCC and iCCA after adjusting for factors like liver function
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Objectives: To evaluate if preoperative MRI can predict the most frequent HCC subtypes in North American and European patients treated with surgical resection.

Methods: A total of 119 HCCs in 97 patients were included in the North American group and 191 HCCs in 176 patients were included in the European group. Lesion subtyping was based on morphologic features and immuno-histopathological analysis.

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Background & Aims: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer (PLC) associated with a poor prognosis. Given the challenges in its identification and its clinical implications, biomarkers are critically needed. We aimed to investigate the diagnostic and prognostic value of the immunohistochemical expression of Nestin, a progenitor cell marker, in a large multicentric series of PLCs.

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Background And Aims: The natural history of hepatocellular adenomas (HCAs) remains to be better described, especially in nonresected patients. We aim to identify the predictive factors of HCA evolution after estrogen-based contraception discontinuation.

Approach And Results: We retrospectively included patients with a histological diagnosis of HCA from three centers.

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The subject of this narrative review is macrotrabecular-massive hepatocellular carcinoma (MTM-HCC). Despite their rarity, these tumours are of general interest because of their epidemiological and clinical features and for representing a distinct model of the interaction between the angiogenetic system and neoplastic cells. The MTM-HCC subtype is associated with various adverse biological and pathological parameters (the Alfa-foetoprotein (AFP) serum level, tumour size, vascular invasion, and satellite nodules) and is a key determinant of patient prognosis, with a strong and independent predictive value for early and overall tumour recurrence.

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Introduction And Objectives: Liver resection is the only curative therapeutic option for large hepatocellular carcinoma (> 5 cm), but survival is worse than in smaller tumours, mostly due to the high recurrence rate. There is currently no proper tool for stratifying relapse risk. Herein, we investigated prognostic factors before hepatectomy in patients with a single large hepatocellular carcinoma (HCC).

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Background: To evaluate the cost-effectiveness of the extended use of ablation for the treatment of hepatocellular carcinoma (HCC) with cirrhosis in an expert ablation center when compared to the non-extended use of ablation in equivalent tertiary care centers.

Methods: Consecutive cirrhotic patients with non-metastatic HCC, no prior treatment, and referred to three tertiary care centers between 2012 and 2016 were retrospectively identified. The Bondy group, including all of the patients treated at Jean Verdier Hospital, where the extended use of ablation is routinely performed, was compared to the standard of care (SOC) group, including all of the patients treated at the Beaujon and Mondor Hospitals, using propensity score matching.

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