Circulating galectin-9 as a novel prognosticator in patients with intrahepatic cholangiocarcinoma undergoing surgical resection.

Background: Intrahepatic cholangiocarcinoma (ICC) is a rare but highly malignant liver cancer. Surgical resection provides the best long-term survival, yet poor prognosis requires improved treatments. Galectin-9 (GAL9) has gained attention for its role in tumor biology.

Impact of Surgical Resection on Hepatocellular Carcinoma Following Systemic Drug Therapy: A Multicenter Retrospective Observational Study.

Aim: This study is aimed to evaluate the safety and outcomes of surgical resection in patients with hepatocellular carcinoma (HCC) treated with systemic therapy, address the therapeutic benefit, and identify candidates for surgery after systemic treatment.

Methods: This retrospective cohort study was conducted at seven high-volume centers in Japan, enrolling patients who underwent surgical resection for HCC after systemic drug therapy. Pre- and post-treatment resectability criteria and oncological outcomes (progression-free survival [PFS], overall survival [OS], pathological complete response [pCR], and postoperative complications) were analyzed.

Surgical complexity and long-term outcomes after liver resection for intrahepatic cholangiocarcinoma: a multicenter study.

Introduction: Intrahepatic cholangiocarcinoma (ICC) can invade surrounding structures such as inferior vena cava or hepatic hilum, leading to the surgical complexity; however, its effect on long-term outcomes remains poorly understood.

Methods: Data from consecutive patients with ICC who underwent liver resection (LR) between 2000 and 2020 at three tertiary hepatobiliary centers were retrospectively analyzed. Surgical complexity was defined as follows: Class I; LR, Class II; LR with biliary resection and reconstruction only, and Class III; LR with major vascular resection and reconstruction.

Liver transplantation as a new treatment option for perihilar cholangiocarcinoma and colorectal liver metastases: a review.

Liver transplantation (LT) has become widespread in recent years owing to advances in the elucidation of its pathogenesis, surgical procedures, and perioperative management. Historically, LT was only performed in patients with end-stage liver disease and certain malignancies, such as hepatocellular carcinoma, but its indications have recently been expanded to include unresectable perihilar cholangiocarcinoma (pCCA) and colorectal liver metastases (CRLM). In this review, we discuss the current status and future prospects of LT for these expanded indications.

Current Perspectives on Perioperative Combination Therapy for Hepatocellular Carcinoma.

Background: Multidisciplinary treatment of hepatocellular carcinoma (HCC) has made notable advancements with the emergence of novel agents for systemic therapies, including receptor tyrosine kinase inhibitors (TKIs) and cancer immuno-oncology (IO) therapy utilizing immune checkpoint inhibitors. Although each of these regimens is effective as monotherapy for advanced HCCs, combining them with locoregional therapy (LRT), such as transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and radiotherapy (RT), provides an additional antitumor effect. The emergence of novel systemic therapies has given rise to anticipation for the development of multidisciplinary treatments with a combination of systemic therapy and LRT, which aim to achieve curative-intent resection and improve long-term prognosis after resection.

Defining advanced lymph node metastasis in intrahepatic cholangiocarcinoma: A multicenter study.

Background: There is no specific boundary for stratifying survival outcomes in patients with node-positive intrahepatic cholangiocarcinoma (ICC). This study aimed to propose advanced nodal status in ICC.

Methods: Data from patients with pathologically confirmed node-positive ICC who underwent liver resection (LR) with lymph node dissection (LND) from 2000 to 2020 at three tertiary centers were retrospectively analyzed.

Proposing oligo-recurrence criteria in pancreatic ductal adenocarcinoma: A stratified analysis of locoregional treatment benefits.

Background: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis with high recurrence rates following curative resection. Locoregional treatment (LT), including metastasectomy, radiation therapy, and radiofrequency ablation, has shown potential survival benefits in selected patients with recurrent PDAC. However, criteria for selecting patients who may benefit from LT remain unclear.

Personalized prognostic model for colorectal cancer in the era of precision medicine: a dynamic approach based on real-world data.

Background: Predicting individual prognosis is required for patients with colorectal cancer in the era of precision medicine. However, this may be challenging for the conventional survival analysis such as the Cox proportional hazards model. This study aims to develop a personalized prognostic prediction that incorporates longitudinal data to improve predictions for colorectal cancer patients.

Prognostic factors and clinical significance of preoperative systemic therapy in patients with borderline resectable hepatocellular carcinoma: A JSHBPS project study 2023, Part 2.

Purpose: To explore factors influencing the prognosis in patients with borderline-resectable hepatocellular carcinoma (BR-HCC) undergoing surgery.

Methods: The clinical data of patients with BR-HCC according to the definition in the Expert Consensus Statement 2023 were collected from board-certified HPB training centers and analyzed in detail.

Results: Data of a total of 1509 patients with BR-HCC (BR1, n = 718 and BR2, n = 791) who underwent surgery were collected.

Safety and efficacy of living donor liver transplantation for unresectable perihilar cholangiocarcinoma: A single center prospective study.

Background: The prognosis for unresectable perihilar cholangiocarcinoma (phCCA) is extremely poor. Liver transplantation in combination with neoadjuvant chemoradiation therapy has become the treatment of choice for unresectable phCCA in the USA. In 2018, we launched a prospective study to evaluate the safety and efficacy of living donor liver transplantation (LDLT) for unresectable phCCA.

[Conversion Surgery for Initially Unresectable Hepatocellular Carcinoma].

Conversion surgery means surgery for initially unresectable tumors which are converted to resectable tumors by multidisciplinary treatment. Since the introduction of highly effective drug therapies including immune checkpoint inhibitors for hepatocellular carcinoma(HCC), conversion surgery for HCC has become a common experience. Recently, the Japanese Expert Consensus 2023 have reported on the oncological criteria of resectability for HCC, allowing us to use common terms to describe unresectable HCC, which had been ambiguously defined in the past.

Outcomes and Role of Lymphadenectomy in Hypervascular Intrahepatic Cholangiocarcinoma Based on CT-Vascularity.

Background: This study aimed to evaluate the outcomes and role of lymphadenectomy in hypervascular intrahepatic cholangiocarcinoma (ICC) quantified using the arterial phase of contrast-enhanced computed tomography (CT).

Methods: Consecutive patients with mass-forming (MF) or predominantly MF type ICC who underwent surgical resection from 2000 to 2019 were retrospectively analyzed. Using the image of the late arterial phase, CT-vascularity was calculated by dividing the CT value of the tumor (Hounsfield units) with that of the liver parenchyma.

Novel Technique for Liver Segmentation by Fluorescence Intensity Gradient Using Two Different Doses of Indocyanine Green.

Background: Techniques involving dye injection or regional ischemia are commonly used for the precise identification of liver regions during hepatectomy. The visualization of regions with indocyanine green (ICG) has been widely used for liver segmentation. ICG is typically administered only once during each hepatectomy.

Aggressive Multidisciplinary Treatment for Unresectable Hepatocellular Carcinoma: The Achievement of a Pathologic Complete Response and Long-Term Survival.

Background: Hepatocellular carcinoma (HCC) with inferior vena cava (IVC) tumor thrombus is generally considered to be borderline resectable because of its poor prognosis. This report describes a patient who underwent multidisciplinary treatment for HCC with massive IVC tumor thrombus.

Methods: The 56-year-old woman in this study had diffuse HCC of the medial and anterior segments.

Living-donor liver transplantation for non-resectable colorectal liver metastases: protocol for a multicentric, single-arm study.

Introduction: The only treatment for non-resectable colorectal liver metastasis (CRLM) is medical therapy, and the overall survival (OS) rate at 3 and 5 years is approximately 30%-40% and less than 10%, respectively. In 2020, a group in Norway reported that liver transplantation for non-resectable CRLM improved the 5-year OS rate to up to 83%. Clinical trials have been launched since that report was published, but most have involved deceased-donor liver transplantation rather than living-donor liver transplantation.

Liver transplantation for gastroenteropancreatic neuroendocrine liver metastasis: optimal patient selection and perioperative management in the era of multimodal treatments.

Gastroenteropancreatic neuroendocrine tumors (NET) often metastasize to the liver. Although curative liver resection provides a favorable prognosis for patients with neuroendocrine liver metastasis (NELM), with a 5-year survival rate of 70-80%, recurrence is almost inevitable, mainly in the remnant liver. In Western countries, liver transplantation (LT) has been performed in patients with NELM, with the objective of complete removal of macro- and micro-NELMs.

A classification model for resectability in hepatocellular carcinoma patients.

Aim: Some patients undergoing liver resection for hepatocellular carcinoma (HCC) have poor outcomes. Therefore, we aimed to propose a new resectability classification for patients with HCC.

Methods: We classified patients into three categories: resectable (R), borderline resectable (BR), and unresectable (UR).

Clinical Outcomes and Histologic Findings of Patients With Hepatocellular Carcinoma With Durable Partial Response or Durable Stable Disease After Receiving Atezolizumab Plus Bevacizumab.

Purpose: Durable partial response (PR) and durable stable disease (SD) are often seen in patients with hepatocellular carcinoma (HCC) receiving atezolizumab plus bevacizumab (atezo-bev). This study investigates the outcome of these patients and the histopathology of the residual tumors.

Patients And Methods: The IMbrave150 study's atezo-bev group was analyzed.

Optimizing terminology for pancreatectomy: Introducing a new notation system.

We introduce a novel notation system for pancreatectomy designed to provide a clear and concise representation of surgical procedures. As surgical techniques and the scope of pancreatic surgeries continue to diversify, existing communication methods among medical professionals regarding the specifics of the surgeries have proven inadequate. Our proposed notation system clearly indicates the approach (open, laparoscopic, or robot-assisted), type of surgery (e.

Liver Retransplantation Using Living Donor Grafts: A Feasible Approach for Chronic Allograft Failure.

Background: The indication of living donor liver retransplantation (re-LDLT) for retransplant candidates with chronic allograft failure (CAF) is increasing because of the high mortality rate of patients on the waiting list. However, evidence supporting re-LDLT for CAF remains scarce because of technical difficulties. We aimed to examine the feasibility based on our significant case experience.