Effect of Direct Acting Antiviral Drugs on the Occurrence and Recurrence of Intra- and Extra-Hepatic Malignancies in Patients with Chronic Hepatitis C Virus Infection.

The use of direct-acting antivirals (DAAs) has drastically changed the management of HCV-infected patients by achieving a 95-98% sustained virologic response (SVR) and reducing morbidity and mortality in this population. However, despite their effectiveness, controversy exists concerning the occurrence of oncologic events following DAA therapy. A retrospective analysis was conducted on data from the Swiss Hepatitis C Cohort Study, a prospective cohort involving patients with positive HCV viremia upon inclusion, enrolled in various Swiss centers from September 2000 to November 2021.

Association of modifiable metabolic risk factors and lifestyle with all-cause mortality in patients with hepatocellular carcinoma.

We aimed to investigate the potential impact of metabolic risk factors and lifestyles on mortality in hepatocellular carcinoma (HCC) patients. From the Korean Central Cancer Registry database (2008-2016), 8,505 HCC patients were included in the analysis. Patients with 2 or more metabolic risk factors (n = 2384, 28.

Efficacy and safety of immune checkpoint inhibitor rechallenge in individuals with hepatocellular carcinoma.

Background & Aims: We investigated the efficacy and safety of immune checkpoint inhibitor (ICI) rechallenge in patients with hepatocellular carcinoma (HCC) who received ICI-based therapies in a previous systemic line.

Methods: In this international, retrospective multicenter study, patients with HCC who received at least two lines of ICI-based therapies (ICI-1, ICI-2) at 14 institutions were eligible. The main outcomes included best overall response and treatment-related adverse events.

Molecular Markers of Response to Anti-PD1 Therapy in Advanced Hepatocellular Carcinoma.

Background & Aims: Single-agent anti-PD1 checkpoint inhibitors convey outstanding clinical benefits in a small fraction (∼20%) of patients with advanced hepatocellular carcinoma (aHCC) but the molecular mechanisms determining response are unknown. To fill this gap, we herein analyze the molecular and immune traits of aHCC in patients treated with anti-PD1.

Methods: Overall, 111 tumor samples from patients with aHCC were obtained from 13 centers before systemic therapies.

Combined treatments in hepatocellular carcinoma: Time to put them in the guidelines?

The time for battling cancer has never been more suitable than nowadays and fortunately against hepatocellular carcinoma (HCC) we do have a far-reaching arsenal. Moreover, because liver cancer comprises a plethora of stages-from very early to advanced disease and with many treatment options-from surgery to immunotherapy trials-it leaves the clinician a wide range of options. The scope of our review is to throw light on combination treatments that seem to be beyond guidelines and to highlight these using evidence-based analysis of the most frequently used combination therapies, discussing their advantages and flaws in comparison to the current standard of care.

Prognosis of patients with hepatocellular carcinoma treated with immunotherapy - development and validation of the CRAFITY score.

Background & Aims: Immunotherapy with atezolizumab plus bevacizumab represents the new standard of care in systemic front-line treatment of hepatocellular carcinoma (HCC). However, biomarkers that predict treatment success and survival remain an unmet need.

Methods: Patients with HCC put on PD-(L)1-based immunotherapy were included in a training set (n = 190; 6 European centers) and a validation set (n = 102; 8 European centers).

Cabozantinib in Advanced Hepatocellular Carcinoma: Efficacy and Safety Data from an International Multicenter Real-Life Cohort.

Background And Aims: The multikinase inhibitor cabozantinib has been approved for hepatocellular carcinoma (HCC) previously treated with sorafenib. We report safety and efficacy data of an international, multicenter, real-life cohort of patients with advanced HCC treated with cabozantinib.

Methods: Patients with HCC who were treated with cabozantinib were retrospectively identified across 11 centers in Austria, Switzerland, and Germany.

Prevention of NAFLD-associated HCC: Role of lifestyle and chemoprevention.

In many countries worldwide, the burden of hepatocellular carcinoma (HCC) associated with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) is increasing. Preventive strategies are needed to counteract this trend. In this review, we provide an overview of the evidence on preventive strategies in NAFLD-associated HCC.

Clinical and Genetic Tumor Characteristics of Responding and Non-Responding Patients to PD-1 Inhibition in Hepatocellular Carcinoma.

Immune checkpoint inhibitors (ICIs) belong to the therapeutic armamentarium in advanced hepatocellular carcinoma (HCC). However, only a minority of patients benefit from immunotherapy. Therefore, we aimed to identify indicators of therapy response.

High subcutaneous adipose tissue density correlates negatively with survival in patients with hepatocellular carcinoma.

Background & Aims: Body composition parameters have been reported to add information, which can lead to tailored treatment and prognostication for oncological patients. Data for patients with hepatocellular carcinoma (HCC) are scarce. We assessed the association between different body composition parameters and overall survival (OS) in two different newly diagnosed HCC populations.

Microwave ablation in the treatment of liver tumors. A better tool or simply more power?

It has been a long time since tumor ablation was first tested in patients with liver cancer, especially hepatocellular carcinoma. Since than it has become a first line treatment modality for hepatocellular carcinoma. Over the years, the indications of thermal ablation have expanded to colorectal cancer liver metastases and intrahepatic cholangiocarcinoma as well.

Prognostic Factors after Percutaneous Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma. Impact of Incomplete Ablation on Recurrence and Overall Survival Rates.

Aims: To report on the long-term impact of tumor and non-tumor related parameters on local recurrence, distant recurrence and survival in patients with naïve or recurrent type hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA).

Methods: We performed 240 RFA sessions on 133 patients with 156 HCC nodules developed on a background of liver cirrhosis and analyzed the outcomes.

Results: Contrast-enhanced ultrasound performed one month after RFA showed complete ablation in 119 out of 133 (89.

Contrast enhanced ultrasonography in assessing the treatment response to transarterial chemoembolization in patients with hepatocellular carcinoma.

The last decades have known continuous development of therapeutic strategies in hepatocellular carcinoma (HCC). Unfortunately the disease it still not diagnosed until it is already at an intermediate or even an advanced disease. In these circumstances transarterial chemoembolization (TACE) is considered an effective treatment for HCC.

Prospective comparison between real time contrast enhanced and conventional ultrasound guidance in percutaneous biopsies of liver tumors.

Aims: The performance of percutaneous echo-guided biopsy in the hepatic tumoral diagnosis is limited (90% sensitivity) by several factors, among which tumor characteristics (type, size, and location) play an important role. Contrast enhanced ultrasound guided percutaneous biopsy (CEUS-PLB) is a new developed technique aimed at increasing the accuracy of percutaneous biopsies. The objective of our study was to evaluate the feasibility and performance of CEUS as a guiding method in performing liver biopsy (PLB).

Contrast enhanced ultrasound of renal masses. A reappraisal of EFSUMB recommendations and possible emerging applications.

The main imagistic method for characterization of renal lesions is contrast enhanced computed tomography (CECT). Disadvantages of CECT are a contrast-induced nephropathy in patients with renal impairment, allergic reactions and high costs. Contrast-enhanced ultrasound (CEUS) evaluation of hepatic and non-hepatic lesions is a relatively new, but increasingly utilised, diagnostic method.

Primary biliary cirrhosis--autoimmune hepatitis overlap syndrome associated with dermatomyositis, autoimmune thyroiditis and antiphospholipid syndrome.

Autoimmune liver diseases may be associated with extrahepatic autoimmune pathology. We report the case of a 52-year old woman who initially presented to the gastroenterology department for extreme fatigue, pale stools, dark urine and pruritus. Laboratory tests showed significant cholestasis and elevation of aminotransferase levels.

Percutaneous treatment of symptomatic non-parasitic hepatic cysts. Initial experience with single-session sclerotherapy with polidocanol.

Aims: Hepatic cysts have a prevalence of 2.5-7% and most of them are asymptomatic. However, large cysts may cause complaints; in such cases an appropriate treatment is necessary (open surgery, laparoscopic deroofing, removal of cystic fluid and injection of a sclerosing agent.

Role of contrast enhanced ultrasound in the assessment of biliary duct disease.

The introduction of microbubble contrast agents (CA), which act as blood pool tracers, has overcome the limitations of conventional B-Mode, colour or power Doppler ultrasound, enabling the display of parenchymal microvasculature. Initially, the use of CA was accepted for hepatic lesions. In the following years, experts have expanded recommendations, as a result of the method's efficiency in extrahepatic applications.

Intracavitary applications of ultrasound contrast agents in hepatogastroenterology.

The era of the real time low mechanical index (MI) contrast enhanced ultrasound (CEUS) began in 2004. Since then, CEUS with second generation contrast agents like SonoVue has been able to offer a new clinical utility both in diagnosis and in interventional therapies. Intracavitary administration of SonoVue is an off-label, extravascular application of CEUS.

Treatment of hepatocellular carcinoma in a tertiary Romanian center. Deviations from BCLC recommendations and influence on survival rate.

Background & Aim: The Barcelona-Clinic Liver Cancer (BCLC) staging system is based on the results obtained in the setting of several cohort studies and randomized clinical trials. We have evaluated the applicability of the BCLC staging system and the effect of treatment allocation according to BCLC on the survival rate and prognosis in patients with hepatocellular carcinoma (HCC) in a tertiary center.

Methods: Treatment indications for 473 patients referred to our center with the diagnosis of HCC were retrospectively analyzed.

Role of CEUS in the diagnosis of gallbladder disease.

Conventional ultrasound (US) is the first imaging investigation recommended for diagnosis of gallbladder pathology. However, it has an important limit of ability to depict microcirculation of some biliary lesions which may lead to failure in diagnosis. The use of contrast-enhanced US (CEUS) seems to overcome these limits and allows a more confident diagnosis.

Contrast-enhanced ultrasound guided biopsy of superficial toraco-abdominal and neck lesions. Initial experience in 20 patients.

Aim: In the diagnostic workup of superficial located tumors, percutaneous biopsy plays an important role. However, a successful retrieval of an adequate tissue sample is achievable in only 80-90% of the cases, mainly due to tissue inhomogenities. Contrast-enhanced ultrasound (CEUS) was successfully used to optimize the percutaneous biopsy in several tumors.