Purpose: Although transcatheter arterial chemoembolization (TACE) is the most common treatment option in patients with hepatocellular carcinoma (HCC), its clinical benefits remain still controversial. Since TACE induces hypoxic necrosis in tumors, hypoxia-inducible factor 1α (HIF-1α) could critically affect biology in residual tumors after TACE treatment and subsequent prognosis. However, HIF-1α and its prognostic relevance in TACE have rarely been examined in human specimens. In the current study, we investigated the prognosis and expression of genes regulated by HIF-1α in HCC patients receiving preoperative TACE for the first time.
Methods: In total, 35 patients with HCC (10 patients undergoing preoperative TACE) were retrospectively studied. The prognostic significance of TACE was analyzed using Kaplan-Meier and Cox regression models. Protein levels of HIF-1α and mRNA levels of HIF-1α-associated genes were examined using immunohistochemistry (IHC) and real-time RT-PCR, respectively.
Results: Preoperative TACE was significantly associated with increased 2-year recurrence rate (80 vs. 36 %, P = 0.00402) and shorter disease-free survival (DFS) time (11.9 vs. 35.7 months, P = 0.0182). TACE was an independent prognostic factor for recurrence (P = 0.007) and poor DFS (P = 0.010) in a multivariate analysis. Immunohistochemical staining revealed in vivo activation of HIF-1α in human specimens treated with TACE. Notably, protein levels of HIF-1α were significantly increased in TACE tissues demonstrated by IHC. Transcriptional targets of HIF-1α showed mRNA expression patterns consistent with activation of HIF-1α in TACE tissues.
Conclusions: Our findings collectively demonstrate that preoperative TACE confers poor prognosis in HCC patients through activation of HIF-1α.
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http://dx.doi.org/10.1007/s00432-014-1713-4 | DOI Listing |
World J Surg
December 2024
Division of Gastrointestinal and Hepatobiliary Surgery, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Introduction: Transarterial chemoembolization (TACE) has an established role in advanced HCC. The present study evaluates the role of TACE as a neoadjuvant modality in the management of intermediate HCC [Hong Kong Liver Cancer (HKLC) stage IIB].
Materials And Methods: A retrospective analysis of HCC patients treated between January 2010 and August 2022 was performed.
Medicina (Kaunas)
October 2024
Department of Transplant Surgery, Virginia Commonwealth University Health System, West Hospital, 1200 E. Broad St, Richmond, VA 23298, USA.
: Hepatic resection offers promising outcomes for patients with hepatocellular carcinoma (HCC) but can be constrained by factors like patient suitability. Continuous advancements in laparoscopic and robotic technologies have made minimally invasive hepatectomies (MIHs) a viable alternative to open hepatectomies with benefits in terms of recovery and complications. : We completed a retrospective review on 138 HCC patients who underwent OH or MIH between 2010 and 2020 at the Hume-Lee Transplant Center.
View Article and Find Full Text PDFJ Gastrointest Oncol
October 2024
Department of Hepatic Surgery, First People's Hospital of Foshan, Foshan, China.
Background: Hepatocellular carcinoma (HCC) is currently one of the most common malignant tumors with the highest mortality rates in the world. Most patients with HCC have lost the opportunity for surgery at the time of initial diagnosis. This study aims to introduce a new conversion strategy: trans-arterial chemo-emobilization (TACE) combined with laparoscopic portal vein ligation (PVL) and terminal branches portal vein embolization (PVE).
View Article and Find Full Text PDFJ Hepatocell Carcinoma
October 2024
Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
Purpose: Hepatocellular carcinoma (HCC) represents a significant global health problem, requiring precise prognostic tools for optimal treatment stratification. This study aimed to develop a new risk prediction score, called AD score, based on the serum markers alpha-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP), to offer an objective and accurate preoperative assessment of HCC in patients undergoing transarterial chemoembolization (TACE).
Patients And Methods: This was a retrospective study that included 295 HCC patients who were subjected to TACE (training set, n=147; testing set, n=148).
Cancers (Basel)
October 2024
Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand.
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