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Background/Aims Sarcopenia negatively affects the prognosis of cirrhotic patients, but clinical implications of changes in muscle mass remain unclear. We aimed to elucidate its role in the prognosis of outpatients with cirrhosis.
Methods Patients with cirrhosis who underwent annual abdominal computed tomography (CT) for hepatocellular carcinoma surveillance were included in the prospective cohort. The L3 skeletal muscle index (SMI) was adopted as a proxy for the amount of skeletal muscle, and the rate of SMI change between inclusion and after 1 year (ΔSMI/yr%) was calculated.
Results In total, 595 patients underwent a second CT after 1 year. Among them, 109 and 64 patients had sarcopenia and Child-Pugh class B/C decompensation at inclusion, which changed to 103 and 45 at the 1-year follow-up, respectively. During a median follow-up of 30.1 months after 1 year, 86 patients had at least one cirrhosis complication, and 18 died or received liver transplantation. In the development of cirrhosis complications, ΔSMI/yr% was independently associated, even after adjusting for the Child-Pugh and model for end stage liver disease (MELD)-Na scores. In addition, ΔSMI/yr% showed a good predictive performance for the development of cirrhosis complications within 6 months after 1-year follow-up in all subgroups, with a cut-off of -2.62 (sensitivity, 83.9%; specificity, 74.5%) in the overall population. SMI at 1-year and Child-Pugh score were independent factors associated with survival. In addition, changes in sarcopenia status significantly stratified survival.
Conclusion ΔSMI/yr% was a good predictor of the development of cirrhosis complications in outpatients with cirrhosis, independent of Child-Pugh and MELD scores.
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Background/Aims Useful biomarkers for metabolic syndrome have been insufficient. We investigated the performance of serum milk fat globule-EGF factor-8 (MFG-E8), the key mediator of inflammatory pathway, in diagnosis of metabolic syndrome.
Methods Subjects aged between 30 and 64 years were prospectively enrolled in the Seoul Metabolic Syndrome cohort. Serum MFG-E8 levels were measured at baseline.
Results A total of 556 subjects were included, comprising 279 women (50.2%) and 277 men (49.8%). Metabolic syndrome was diagnosed in 236 subjects (42.4%), and the mean MFG-E8 level of subjects with metabolic syndrome was significantly higher than that of subjects without metabolic syndrome (P<0.001). MFG-E8 level was significantly correlated with all metabolic syndrome components and pulse wave velocity (all P<0.05). Subjects were categorized into two groups according to the best MFG-E8 cut-off value as follows: group 1, MFG-E8 level <4,745.1 pg/mL (n=401, 72.1%); and group 2, MFG-E8 level ≥4,745.1 (n=155, 27.9%). At baseline, metabolic syndrome in group 2 was significantly more prevalent than in group 1 (63.9% vs. 34.2%, P<0.001). During median follow-up of 17 months, metabolic syndrome developed in 122 (38.1%) subjects among 320 subjects without it at baseline. The incidence of metabolic syndrome in group 2 was significantly higher than that in group 1 (55.4% vs. 34.5%, P=0.003). On multivariate analysis, MFG-E8 level ≥4,745.1 pg/mL was an independent predictor for diagnosis and development of metabolic syndrome after adjusting other factors (all P<0.05).
Conclusions Serum MFG-E8 level is a potent biomarker for the screening and prediction of metabolic syndrome.
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Since sorafenib was introduced in 2007 for treating advanced hepatocellular carcinoma (HCC), 15 patients have achieved a complete response (CR) in advanced HCC. However, only four of these reports can be regarded as real CRs involving adequate assessments including imaging, serum tumor markers, and histologic examinations of completely resected specimens. A 54-year-old man with hepatitis C virus (HCV)-related liver cirrhosis (LC) presented to our unit. A CT scan demonstrated a 3.8-cm arterial hypervascular/portal-washout mass in the right lobe and invasion in the right portal vein. Twelve weeks after beginning sorafenib therapy, the AFP level was normalized and a CT scan showed a prominent decrease in the hepatic mass and a significant decrease in the volume of portal vein thrombosis (PVT). The patient received a right liver hemihepatectomy after 12 months. No viable tumor cells were found in the resected specimen, and there was no thrombotic obstruction of the portal vein. Twelve months later the patient showed no clinical evidence of HCC recurrence. This is the first case of CR in HCC treatment following sorafenib with histologically confirmed HCVrelated HCC without LC evidence, HCC with PVT, and a follow-up of longer than 12 months. This case seems to be an extremely unusual clinical outcome in advanced HCC.
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A Practical Nomogram and Risk Stratification System Predicting the Cancer-Specific Survival for Patients With Advanced Hepatocellular Carcinoma Dashuai Yang, Yang Su, Fangrui Zhao, Chen Chen, Kailiang Zhao, Xiangyun Xiong, Youming Ding Frontiers in Oncology.2022;[Epub] CrossRef
Lenvatinib is independently associated with the reduced risk of progressive disease when compared with sorafenib in patients with advanced hepatocellular carcinoma Soojin Kim, Kyung Hyun Kim, Beom Kyung Kim, Jun Yong Park, Sang Hoon Ahn, Do Young Kim, Seung Up Kim Journal of Gastroenterology and Hepatology.2021; 36(5): 1317. CrossRef
Outcomes of reduction hepatectomy combined with postoperative multidisciplinary therapy for advanced hepatocellular carcinoma Yoh Asahi, Toshiya Kamiyama, Tatsuhiko Kakisaka, Tatsuya Orimo, Shingo Shimada, Akihisa Nagatsu, Takeshi Aiyama, Yuzuru Sakamoto, Hirofumi Kamachi, Akinobu Taketomi World Journal of Gastrointestinal Surgery.2021; 13(10): 1245. CrossRef
Complete Pathological Response of Hepatocellular Carcinoma with Portal Vein Thrombosis Treated with Sorafenib—Report of a Case— Tetsushi MIZUTANI, Mizuo HASHIMOTO, Hiroaki USUI, Tomoki KOBAYASHI, Motonobu NISHIMURA, Kenji SAKAGUCHI Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2021; 82(3): 635. CrossRef
Modeling Hepatocellular Carcinoma Cells Dynamics by Serological and Imaging Biomarkers to Explain the Different Responses to Sorafenib and Regorafenib Piero Colombatto, Coskun Ozer Demirtas, Gabriele Ricco, Luigi Civitano, Piero Boraschi, Paola Scalise, Daniela Cavallone, Filippo Oliveri, Veronica Romagnoli, Patrizia Bleve, Barbara Coco, Antonio Salvati, Lucio Urbani, Ferruccio Bonino, Maurizia Rossana Cancers.2021; 13(9): 2064. CrossRef
Laparoscopic bypass surgery as palliative treatment for duodenal obstruction due to lymph node metastasis invasion of hepatocellular carcinoma Akane Kurosugi, Tetsuhiro Chiba, Terunao Iwanaga, Hidemi Unozawa, Takafumi Sakuma, Naoto Fujita, Kengo Kanayama, Hiroaki Kanzaki, Keisuke Koroki, Kazufumi Kobayashi, Soichiro Kiyono, Ryo Nakagawa, Naoya Kanogawa, Masato Nakamura, Takayuki Kondo, Tomoko Sa Kanzo.2021; 62(10): 656. CrossRef
Sorafenib Treatment has the Potential to Downstage Advanced Hepatocellular Carcinoma before Liver Resection Alessandra Bertacco, Alessandro Vitale, Claudia Mescoli, Umberto Cillo Personalized Medicine.2020; 17(2): 83. CrossRef
A case report: Long-term complete response of metastatic hepatocellular carcinoma obtained after discontinuation of 2-month sorafenib monotherapy Suguru Hirose, Kazunori Ishige, Masamichi Yamaura, Tsuneo Mizui, Yoshiki Komatsu, Masaomi Nagase, Masashi Sato, Junji Hattori, Masato Endo, Naoyuki Hasegawa, Kuniaki Fukuda, Ichinosuke Hyodo Clinical Journal of Gastroenterology.2020; 13(5): 902. CrossRef
MTL-CEBPA, a Small Activating RNA Therapeutic Upregulating C/EBP-α, in Patients with Advanced Liver Cancer: A First-in-Human, Multicenter, Open-Label, Phase I Trial Debashis Sarker, Ruth Plummer, Tim Meyer, Mikael H. Sodergren, Bristi Basu, Cheng Ean Chee, Kai-Wen Huang, Daniel H. Palmer, Yuk Ting Ma, T.R. Jeff Evans, Duncan R.C. Spalding, Madhava Pai, Rohini Sharma, David J. Pinato, James Spicer, Sarah Hunter, Vinee Clinical Cancer Research.2020; 26(15): 3936. CrossRef
Preclinical efficacy of a novel dual PI3K/mTOR inhibitor, CMG002, alone and in combination with sorafenib in hepatocellular carcinoma Mi Na Kim, Seung Min Lee, Jin Sung Kim, Seong Gyu Hwang Cancer Chemotherapy and Pharmacology.2019; 84(4): 809. CrossRef
Reversion of tumor hepatocytes to normal hepatocytes during liver tumor regression in an oncogene-expressing transgenic zebrafish model Yan Li, Ira Agrawal, Zhiyuan Gong Disease Models & Mechanisms.2019;[Epub] CrossRef
Sustained complete response of advanced hepatocellular carcinoma with metronomic capecitabine: a report of three cases Giovanni Brandi, Michela Venturi, Stefania De Lorenzo, Francesca Garuti, Giorgio Frega, Andrea Palloni, Ingrid Garajovà, Francesca Abbati, Gioconda Saccoccio, Rita Golfieri, Maria Abbondanza Pantaleo, Maria Aurelia Barbera Cancer Communications.2018; 38(1): 1. CrossRef
Long-term remission in advanced stage hepatocellular carcinoma? A chance for cure? Matthias Pinter, Wolfgang Sieghart memo - Magazine of European Medical Oncology.2018; 11(3): 185. CrossRef