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Patients who experienced recurrent hepatocellular carcinoma (HCC) and underwent either liver resection or orthotopic liver transplantation (OLT) between January 2001 and June 2018 were subjects of this retrospective study. The resected specimens were analyzed to determine the HCC subtype/morphology, the presence of vessels encapsulating tumor clusters (VETC) pattern, and MVI. The procedure for analyzing dichotomous parameters was initiated.

P-values less than 0.05 were deemed significant for test and value comparisons.

Of 230 recurrent HCC cases, 37 (16.1% of the total) experienced repeated treatment involving liver resection in 22 cases and OLT in 15 cases. foretinib inhibitor 676% of these initially demonstrated exceeding the Milan criteria. A correlation was observed between MVI and Milan criteria (P=0.0005), tumor size (P=0.0015), and VETC-pattern (P=0.0034) in the primary specimen. Similarities between the recurrences and the primary HCC were observed in the following aspects: tumor grade (P=0002), VETC-pattern (P=0035), and MVI (P=0046). Concerning recurrences, the Milan criteria’s agreement was uniquely correlated with MVI, with a statistically significant association (P=0.0018). In primary hepatocellular carcinoma (HCC) cases, the absence of micronodular variant (MVI) at initial diagnosis was associated with a lack of MVI in early recurrence (less than two years), a significant finding (P=0.0035).

The biological make-up of HCC recurrences bears a striking resemblance to that of the primary tumor. Subsequently, early recurrences of HCC, categorized as MVI-negative, never manifested the presence of MVI. This study highlights innovative concepts, including, for example, the process of patient selection for a follow-up liver transplant procedure.

The biology of HCC recurrences bears a strong resemblance to the biological profile of the initial tumor. Additionally, early instances of recurrence in MVI-negative HCC patients failed to show MVI. This observation introduces novel considerations, in particular, the identification of optimal candidates for salvage organ transplantation.

China’s hepatocellular carcinoma (HCC) management has undergone substantial improvements within the past three years, demanding that existing clinical guidelines be updated promptly. The aMAP score has recently been identified as an effective risk stratification tool for predicting the occurrence of hepatocellular carcinoma (HCC), particularly in patients lacking cirrhosis. The use of biomarker-based surveillance, including a 7-microRNA panel and the GALAD score, is championed for earlier diagnosis. The China liver cancer (CNLC) staging system of the 2017 guideline stays the standard, with alterations to treatment allocation procedures. To prepare for subsequent resection, patients with CNLC stage Ia, Ib, IIa HCC (technically unresectable) or IIb, IIIa HCC (technically resectable) are candidates for multi-modal, high-intensity conversion therapies. To maximize the success of transcatheter arterial chemoembolization (TACE), a super-selective approach, supported by Cone-Beam CT if necessary, is considered crucial. Hepatocellular carcinoma (HCC) patients with transarterial chemoembolization (TACE) failure, or those presenting with locally advanced disease, may benefit from hepatic arterial infusion chemotherapy (HAIC) employing the FOLFOX regimen (oxaliplatin, fluorouracil, and leucovorin) combined or not with additional systemic therapies. The significant advancement of systemic treatments for hepatocellular carcinoma (HCC) is marked by the incorporation of atezolizumab plus bevacizumab, and suntilimab plus bevacizumab analogue, which demonstrated superior survival compared to sorafenib, while donafenib showed comparable efficacy to sorafenib. To address sorafenib resistance, regorafenib, apatinib, camrelizumab, and tislelizumab are introduced as additional second-line systemic therapies. The updated 2022 Barcelona Clinic Liver Cancer (BCLC) and Japanese Society of Hepatology (JSH) guidelines are reviewed, and a comparative analysis with the 2022 Chinese guidelines is performed, evaluating their differences and similarities.

Due to the substantial heterogeneity in Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC), identifying the most appropriate treatment for each patient is a major clinical problem. Despite the presence of alternative therapies, transarterial chemoembolization (TACE) constitutes the only appropriate therapeutic choice. In this light, we explored the attributes of patients undergoing living donor liver transplantation (LDLT) and their subsequent outcomes, specifically for those with BCLC stage B hepatocellular carcinoma.

An analysis of 516 patients with BCLC stage B HCC, categorized into those who underwent (n=104) or did not undergo (non-LDLT; n=412) liver donor-live transplant (LDLT) between 2004 and 2018, was performed using propensity score matching (PSM; 14) analysis. An examination of overall survival (OS) and recurrence factors was conducted using Cox’s proportional hazards models.

LDLT-treated patients experienced a more favorable overall survival (OS) than their non-LDLT counterparts, demonstrating enhanced survival rates for both liver- and non-liver-related causes (all p<0.0001). In multivariate Cox regression analysis, factors independently associated with HCC recurrence included age greater than 60 years (P=0.0006), a neutrophil-lymphocyte ratio (NLR) exceeding 4 (P=0.0016), and more than three locoregional therapies (LRT) before liver-directed local ablation (LDLT) (P<0.0001). Further analysis revealed that age greater than 60 years (P<0.0001) and over three liver lesions prior to LDLT (P=0.0001) were independent contributors to a worse prognosis in terms of overall survival (OS). Pre-liver transplantation (LT) assessment of patients, leveraging age, NLR, and LRT factors, allows for stratification into low (no risk factors), intermediate (one risk factor), and high (more than two risk factors) risk categories. A marked difference (P<0.0001) in the cumulative HCC recurrence and mortality rates was present among the three groups.

In certain BCLC stage B HCC patients, LDLT could represent a valuable therapeutic alternative.

LDLT could be a valuable therapeutic solution for some patients exhibiting BCLC stage B HCC.

Laparoscopic (LLR) and robotic (RLR) liver resections have proven to be a safe surgical approach for treating liver tumors in numerous institutions. A significant, international, multi-center study exploring the application of these techniques on 10-cm liver tumors would furnish stronger evidence and a more insightful perspective.

Between 2002 and 2020, a review of 971 patients treated at 42 international centers for large (10cm) tumors, who underwent LLR and RLR, was undertaken.

For the purposes of the study, one hundred RLR and 699 LLR were considered eligible and thus were included. A study comparing two strategies for treating patients with substantial tumors implemented 13 propensity score matching (PSM) variables (73).

219). This JSON schema, a list of sentences, is requested to be returned. LLR, preceding the PSM procedure, was associated with a significantly higher prevalence of previous abdominal surgeries, malignant conditions, liver cirrhosis, and higher median blood concentrations. Post-PSM, RLR and LLR yielded no discernible variance in critical perioperative results, such as media operation time, which clocked in at 242 minutes.

Statistical analysis of the 290-minute observation period showed a transfusion rate of 192% (P=0.286).

A significant increase, 169% (P=0.652), was observed in median blood loss, reaching 200 units.

The open conversion rate, observed at 82%, was established from a 300 mL sample, with a statistically insignificant p-value of 0.694.

The measure of interest increased by 110%, while morbidity experienced a substantial escalation of 288%, resulting in a statistically significant outcome (P=0.0519).

The observed 219% increase (P=0.0221) demonstrated a strong correlation with major morbidity, affecting 41% of participants.

Postoperative length of stay was observed to be influenced by the high mortality rate of 96% (P=0.0152).

The probability registered 0.435, after six days.

The safety and exceptional outcomes of RLR and LLR procedures are achievable in chosen patients presenting with extensive hepatic neoplasms. Patients undergoing either right or left laparoscopic liver resection (RLR or LLR) displayed similar perioperative results.

RLR and LLR, when applied to appropriate patients presenting with sizable liver tumors, frequently yield outstanding outcomes. No significant divergence in perioperative outcomes was found between patients undergoing RLR and those undergoing LLR.

Hepatocellular carcinoma (HCC) frequently recurs in patients who have undergone hepatic resection, which significantly compromises their long-term survival. Our study sought to determine the predictors of early and late recurrence, along with the long-term prognosis, after hepatocellular carcinoma (HCC) had been surgically excised.

A study of patients who underwent HCC resection between 2002 and 2016 was conducted using data pooled from multiple centers. Recurrence was segmented into early recurrence (occurring within a timeframe of two years after surgery) and late recurrence (appearing more than two years post-surgery). Predictors of early and late recurrence and prognostic factors for post-recurrence survival (PRS) were established via both univariate and multivariate analyses.

Of the 1426 patients examined, 554 experienced early recurrence, while 348 encountered late recurrence. Preoperative alpha-fetoprotein levels greater than 400 g/L, resection margins narrower than 1 cm, and tumor sizes exceeding 50 cm, along with tumor multiplicity, macrovascular and microvascular invasion, and tumor satellites at initial HCC diagnosis, all independently predicted early tumor recurrence. Individuals experiencing an early recurrence of the condition exhibited a diminished propensity for undergoing potentially curative treatments for the recurrence.