Research Communication: Serum Metabolomic Signatures Predict Tumour Recurrence After Resection or Ablation in Patients With Early-Stage Hepatocellular Carcinoma.

Patients with hepatocellular carcinoma (HCC) often experience recurrence after curative therapies, underscoring a need for risk stratification models. We validated 6 and 13-metabolite signatures in patients who achieved complete response following surgical resection or local ablation. Of 78 patients, 32 (41.

Value of HCC surveillance in a landscape of emerging surveillance options: Perspectives of a multi-stakeholder modified Delphi panel.

HCC surveillance is recommended by liver professional societies but lacks broad acceptance by several primary care and cancer societies due to limitations in the existing data. We convened a diverse multidisciplinary group of cancer screening experts to evaluate current and future paradigms of HCC prevention and early detection using a rigorous Delphi panel approach. The experts had high agreement on 21 statements about primary prevention, HCC surveillance benefits, HCC surveillance harms, and the evaluation of emerging surveillance modalities.

Use of liver stiffness measurement for HCC risk stratification in metabolic dysfunction-associated steatotic liver disease.

Background And Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the fastest-rising cause of HCC. A third of MASLD-HCC occur in the absence of cirrhosis, but tools to predict MASLD-HCC are lacking. Our study aimed to examine whether liver stiffness measurement (LSM) is associated with HCC risk in MASLD, identify if LSM thresholds can predict HCC risk, and identify patients for cost-effective HCC surveillance.

Review Article: Liver Transplantation for Hepatocellular Carcinoma in the Era of Immune Checkpoint Inhibitors.

Background: Ablation, surgical resection and liver transplantation (LT) are curative therapies for patients with hepatocellular carcinoma (HCC). Milan Criteria and University of California San Francisco Criteria are traditionally accepted for liver transplantation, with the expectation of favourable outcomes. In recent years, immune checkpoint inhibitors (ICI) have revolutionised the management of unresectable HCC (uHCC) and are now considered first-line systemic therapy.

Racial and Ethnic Disparities in Survival Among Patients with Cholangiocarcinoma in the United States: A Systematic Review and Meta-Analysis.

Background: Cholangiocarcinoma (CCA) is an increasing cause of mortality in the U.S.; however, the burden of CCA disproportionately impacts racial and ethnic minority groups.

Causes of mortality among patients with early-stage hepatocellular carcinoma.

Background And Aims: Early detection of hepatocellular carcinoma (HCC) can reduce cancer-related mortality; however, there are often competing risks from comorbid conditions, including cirrhosis. Understanding causes of death among patients with early-stage HCC can inform strategies to improve surveillance effectiveness.

Approach And Results: We conducted a retrospective cohort study of patients with early-stage HCC [Barcelona Clinic Liver Cancer (BCLC) stages 0/A] at 4 U.

Opioid use after adult liver transplantation: Incidence, high-risk use, and adverse events in a large US cohort.

Background: Opioid use contributes to significant morbidity, posing specific risks to liver transplant recipients (LTRs). This study aimed to characterize outpatient opioid use before and after liver transplantation (LT) and identify risk factors for high-risk, incident, and chronic use and related complications.

Methods: Adult LTRs were identified from 2006 to 2021 in IQVIA PharMetrics Plus for Academics, a claims database representative of the commercially insured US population.

Efficacy of atezolizumab plus bevacizumab for unresectable HCC: Systematic review and meta-analysis of real-world evidence.

Background & Aims: Atezolizumab plus bevacizumab (A+B) is a standard-of-care treatment in unresectable hepatocellular carcinoma (uHCC). Verification of its effectiveness outside clinical trials is an area of unmet need, especially in estimating long-term survival outcomes.

Methods: We conducted a systematic review and meta-analysis of the MEDLINE, Embase, and Cochrane libraries to evaluate therapy outcomes in patients treated with frontline A+B for uHCC outside trials.

Survivorship interventions after liver transplantation (LT): A systematic review of interventions targeting physical and psychosocial well-being after LT.

Despite improved survival, liver transplantation (LT) recipients need interventions that promote survivorship including better quality of life. This systematic review describes the goals and quality of existing post-LT interventions to identify gaps in post-LT care. Published manuscripts and registered clinical trials were identified using MEDLINE, PsycINFO, Cochrane, and Scopus from inception to January 1, 2024.

Comparative Effects of Hospital Volume and Safety-Net Status on Treatment Use and Outcome Measures in Hepatocellular Carcinoma.

Background: Comparing patient outcomes across health systems can identify mechanisms contributing to disparities. We aimed to characterize the intersectionality of hospital volume and safety-net hospital (SNH) status in the treatment and survival of patients with hepatocellular carcinoma (HCC).

Methods: Patients diagnosed with HCC from 2004 to 2019 were identified in the Texas and California Cancer Registries.

Impact of LI-RADS CT and MRI Ancillary Features on Diagnostic Performance: An Individual Participant Data Meta-Analysis.

Background A recent meta-analysis showed independent associations between most Liver Imaging Reporting and Data System (LI-RADS) ancillary features (AFs) and hepatocellular carcinoma (HCC), malignancy, and benignity. However, the impact of AFs on the diagnostic performance of LI-RADS remains unclear. Purpose To evaluate the impact of applying individual AFs on the diagnostic performance of CT and MRI LI-RADS using an individual participant data (IPD) meta-analysis.

The association between stage migration and overall survival after radiation-based therapies in patients with hepatocellular carcinoma.

Background & Aims: Stereotactic body radiation therapy (SBRT) and transarterial radioembolization (TARE) are common locoregional therapies for hepatocellular carcinoma (HCC). However, lack of surrogate endpoints has limited the feasibility of conducting comparative effectiveness clinical trials.

Methods: We conducted a multicenter retrospective cohort study of adult patients with HCC who received SBRT or TARE as initial treatment between 2008 and 2019.

Hepatocellular Carcinoma Surveillance in Patients With Cirrhosis at US Safety-Net Health Systems.

Introduction: Surveillance for hepatocellular carcinoma (HCC) in patients with cirrhosis is associated with improved patient outcomes. We aim to evaluate real-world utilization of HCC surveillance among safety-net populations with cirrhosis.

Methods: We performed a retrospective cohort study of adults with cirrhosis across 4 safety-net health systems from March 1, 2017, to February 28, 2022.

Impact of age on clinical outcomes among patients with hepatocellular carcinoma: A systematic review and meta-analysis.

Background & Aims: Older adults have lower treatment eligibility and worse survival across cancer types; however, the association between age and outcomes in patients with hepatocellular carcinoma (HCC) has not been well characterized.

Methods: We performed a search of the PubMed, Ovid MEDLINE, and EMBASE databases from January 2000 to July 2022 to identify studies reporting tumor stage, curative treatment, and overall survival among patients with HCC, stratified by age. Using the DerSimonian and Laird method for a random-effects model, we calculated pooled risk ratios (RRs) for curative treatment receipt and hazard ratios (HRs) for overall survival among younger and older patients (per age thresholds in each study).

Diagnostic Performance of CT/MRI LI-RADS Version 2018 Major Feature Combinations: Individual Participant Data Meta-Analysis.

Background The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) diagnostic algorithm classifies liver observations in patients with high-risk hepatocellular carcinoma (HCC) using imaging features. However, data regarding the diagnostic performance of specific LI-RADS major feature combinations is limited. Purpose To conduct a systematic review and individual participant data (IPD) meta-analysis to establish the positive predictive values (PPVs) of LI-RADS major feature combinations using CT/MRI LI-RADS version 2018 in patients at risk for HCC.

Racial and ethnic differences in social determinants of health among patients with HCC.

Background: Racial and ethnic minority populations are disproportionately impacted by HCC due to more advanced tumor burden and underuse of treatments. We explored racial and ethnic differences in medical mistrust, barriers to treatment, and health literacy among patients with HCC.

Methods: We conducted a multicenter survey among patients with newly diagnosed HCC between September 2018 and July 2023 at 4 large U.

Immune-Related Adverse Events Are Associated With Improved Outcomes After Immune Checkpoint Inhibitor Treatment in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

Introduction: Immune checkpoint inhibitors (ICIs) have become the first-line treatment of unresectable hepatocellular carcinoma (HCC). The prognostic value of immune-related adverse events (irAEs) in these patients remains controversial. We aimed to investigate the association between irAEs and clinical outcomes in patients with HCC treated with ICIs.