Background And Aims: Smoking induces a proinflammatory state, yet its role in advanced chronic liver disease (ACLD) remains understudied. This study evaluated its impact on disease-driving mechanisms and clinical outcomes in ACLD patients.
Methods: ACLD patients undergoing hepatic venous pressure gradient measurements from 2017 to 2021 were included.
Background: Liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) represent non-invasive surrogates of portal hypertension (PH) that both correlate with hepatic venous pressure gradient (HVPG). SSM may overcome limitations of HVPG and LSM in detecting presinusoidal PH components. We investigated the SSM/LSM ratio as a PH surrogate and its relationship to HVPG and spleen diameter across different liver disease aetiologies.
View Article and Find Full Text PDFAdvanced hepatocellular carcinoma (HCC) treatment has evolved with the introduction of atezolizumab/bevacizumab, showing improved outcomes over sorafenib. However, the response varies among patients, particularly between viral and non-viral etiologies. The present study aimed to develop and evaluate multimodal prediction models combining quantitative imaging and clinical markers to predict the treatment response in patients with HCC.
View Article and Find Full Text PDFBackground & 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.
Introduction: In hepatocellular carcinoma (HCC) comorbidities related to decreased liver function or to portal hypertension often limit treatment options. Traditionally, low platelet count has been considered a negative prognostic factor in HCC, especially in early stages. However, recent evidence suggests that elevated platelet count may also predict worse outcomes in advanced stages, suggesting a stage-dependent prognostic impact.
View Article and Find Full Text PDFBackground & Aims: The course of BCR::ABL1-negative myeloproliferative neoplasms (MPN) is frequently complicated by thromboembolic events in the splanchnic venous system, resulting in portal hypertension (PH). Therefore, the introduction of spleen stiffness measurement (SSM) might improve the diagnosis of PH. The aim of this study was to evaluate the clinical utility of SSM (performed by using the 100 Hz probe) in non-invasive stratification of PH in these patients.
View Article and Find Full Text PDFPeople living with HIV (PLWH) carry a higher risk of developing chronic liver disease and hepatocellular carcinoma (HCC). This relates to shared transmission pathways of HIV and viral hepatitis and a plethora of direct and indirect effects of HIV on the progression of chronic liver disease and HCC. In the absence of active cancer treatment, the prognosis of PLWH affected by HCC is worse than matched controls without HIV.
View Article and Find Full Text PDFSystemic therapy represents the standard of care treatment for patients with advanced hepatocellular carcinoma (HCC). Given the increased risk of death from cirrhosis-related complications in patients with advanced liver dysfunction, pivotal phase III trials traditionally limited inclusion to patients with Child-Pugh class A, where death is more likely to be attributed to HCC progression. Therefore, Western guidelines recommend the use of systemic therapies primarily in patients with preserved liver function.
View Article and Find Full Text PDFBackground: The gut microbiota is often altered in chronic liver diseases and hepatocellular carcinoma (HCC), and increasing evidence suggests that it may influence response to cancer immunotherapy. Strategies to modulate the gut microbiome (i.e.
View Article and Find Full Text PDFBackground And Aims: Atezolizumab and bevacizumab (A+B) are recommended for treating unresectable hepatocellular carcinoma (HCC). Although highly effective, A+B can lead to potentially life-threatening adverse events including bleeding. We investigated whether albumin-bilirubin (ALBI) grade identifies patients with a higher risk of bleeding and its impact on prognosis than the Child-Pugh (CP) score.
View Article and Find Full Text PDFBackground & Aims: Immunotherapy with atezolizumab and bevacizumab (a + b) has improved the prognosis of patients with unresectable hepatocellular carcinoma (HCC). However, the outcome for individual patients is highly variable. This study aimed to (i) develop and validate a prognostic prediction model to estimate individual prognosis and (ii) compare it with established models.
View Article and Find Full Text PDFBackground & Aims: Atezolizumab/bevacizumab (A/B) is now a standard first-line treatment for advanced hepatocellular carcinoma (HCC), but the optimal second-line regimen is not known. We evaluated real-world treatment patterns and outcomes to investigate factors associated with post-progression survival (PPS).
Methods: In this multicenter, international, retrospective study, we examined clinical characteristics and outcomes of patients with advanced HCC who progressed on first-line A/B.
Background And Aims: Porto-sinusoidal vascular disorder (PSVD) is a rare vascular liver disorder characterised by specific histological findings in the absence of cirrhosis, which is poorly understood in terms of pathophysiology. While elevated hepatic copper content serves as diagnostic hallmark in Wilson disease (WD), hepatic copper content has not yet been investigated in PSVD.
Methods: Patients with a verified diagnosis of PSVD at the Medical University of Vienna and available hepatic copper content at the time of diagnosis of PSVD were retrospectively included.
Age and biological sex are risk factors for hepatocellular carcinoma (HCC) occurrence, but their impact on overall survival (OS) is a matter of debate. This study aims to investigate how sex and age at diagnosis, along with other associated factors (i.e.
View Article and Find Full Text PDFBackground And Aims: The outcome of patients with HCC who achieved complete response (CR) to immune-checkpoint inhibitor (ICI)-based systemic therapies is unclear.
Approach And Results: Retrospective study of patients with HCC who had CR according to modified Response Evaluation Criteria in Solid Tumors (CR-mRECIST) to ICI-based systemic therapies from 28 centers in Asia, Europe, and the United States. Of 3933 patients with HCC treated with ICI-based noncurative systemic therapies, 174 (4.
J Cachexia Sarcopenia Muscle
December 2024
Aliment Pharmacol Ther
January 2025
Aliment Pharmacol Ther
November 2024
Background And Aims: We aimed to characterise insulin-like growth factor-1 (IGF-1) signalling in patients with advanced chronic liver disease (ACLD).
Methods: Consecutive patients undergoing hepatic venous pressure gradient [HVPG] measurement were prospectively included. Clinical stages were defined as follows: probable ACLD (pACLD): liver stiffness ≥10 kPa and HVPG ≤5 mmHg, S0: mild PH (HVPG 6-9 mmHg), S1: clinically significant PH (CSPH), S2: CSPH with varices, S3: past variceal bleeding, S4: past/current non-bleeding hepatic decompensation and S5: further decompensation.