Article

Fecal and mucosal microbiota have been the focus of much research. A study by Hou and colleagues that showed distinct differences in the intestinal and fecal microbiomes of patients with constipation-predominant or diarrhea-predominant IBS, compared with healthy controls, highlights the importance of a balanced and diverse microbiome to maintain a healthy gut. The article notes specific genera of microbiota that were associated with intestinal pain. When microbiota diversity is limited, the incidence of IBS is increased. This reinforces the importance of promoting a healthy microbiome in all patients and appreciating the correlation of the microbiome with the development of IBS.

 Internet-based cognitive-behavioral therapy may make it easier for patients to obtain therapy services. Kim and colleagues have shown this to be a cost-effective and efficacious way to deliver care. This care improves the quality of life for patients with IBS and is an effective intervention that is readily available. During pandemic times, the forum of online care also provides a safe way to deliver therapy services without the burden of the patient needing to commute to clinic and potentially be exposed to infectious disease. Given the relationship between IBS and psychiatric diagnoses noted by Creed and colleagues, it seems important to extend the availability of therapeutic interventions to as many patients with IBS as possible.

Fecal and mucosal microbiota have been the focus of much research. A study by Hou and colleagues that showed distinct differences in the intestinal and fecal microbiomes of patients with constipation-predominant or diarrhea-predominant IBS, compared with healthy controls, highlights the importance of a balanced and diverse microbiome to maintain a healthy gut. The article notes specific genera of microbiota that were associated with intestinal pain. When microbiota diversity is limited, the incidence of IBS is increased. This reinforces the importance of promoting a healthy microbiome in all patients and appreciating the correlation of the microbiome with the development of IBS.

 Internet-based cognitive-behavioral therapy may make it easier for patients to obtain therapy services. Kim and colleagues have shown this to be a cost-effective and efficacious way to deliver care. This care improves the quality of life for patients with IBS and is an effective intervention that is readily available. During pandemic times, the forum of online care also provides a safe way to deliver therapy services without the burden of the patient needing to commute to clinic and potentially be exposed to infectious disease. Given the relationship between IBS and psychiatric diagnoses noted by Creed and colleagues, it seems important to extend the availability of therapeutic interventions to as many patients with IBS as possible.

Fecal and mucosal microbiota have been the focus of much research. A study by Hou and colleagues that showed distinct differences in the intestinal and fecal microbiomes of patients with constipation-predominant or diarrhea-predominant IBS, compared with healthy controls, highlights the importance of a balanced and diverse microbiome to maintain a healthy gut. The article notes specific genera of microbiota that were associated with intestinal pain. When microbiota diversity is limited, the incidence of IBS is increased. This reinforces the importance of promoting a healthy microbiome in all patients and appreciating the correlation of the microbiome with the development of IBS.

 Internet-based cognitive-behavioral therapy may make it easier for patients to obtain therapy services. Kim and colleagues have shown this to be a cost-effective and efficacious way to deliver care. This care improves the quality of life for patients with IBS and is an effective intervention that is readily available. During pandemic times, the forum of online care also provides a safe way to deliver therapy services without the burden of the patient needing to commute to clinic and potentially be exposed to infectious disease. Given the relationship between IBS and psychiatric diagnoses noted by Creed and colleagues, it seems important to extend the availability of therapeutic interventions to as many patients with IBS as possible.

Liver transplantation has the opportunity to cure both localized HCC as well as underlying liver cirrhosis. Donor organ shortage has led to the implementation of the Milan criteria as a way to identify patients whose tumor burden is low enough to predict a good outcome. Downstaging liver cancer to fit within Milan criteria has been controversial.

Tabrizian and colleagues undertook a retrospective cohort analysis of 2645 adult patients with HCC who underwent liver transplant. Out of those, 2122 patients always had disease that was within the Milan criteria, 341 patients had HCC that was downstaged to fit within the Milan criteria, and 182 patients had HCC that was outside the Milan criteria at the time of liver transplantation. The authors report that the 10-year post-transplant survival and recurrence rates were 61.5% and 13.3%, respectively, in those always within the Milan criteria, 52.1% and 20.6% among those whose disease was downstaged, and 43.3% and 41.1% in those whose disease was never downstaged. Characteristics that predicted recurrence after downstaging were tumor size > 7 cm at diagnosis (odds ratio [OR] 2.62; 95% CI 1.20-5.75; P = .02), more than three tumors at diagnosis (OR 2.34; 95% CI 1.22-4.50; P = .01), and alpha-fetoprotein (AFP) response ≥ 20 ng/mL with < 50% improvement from maximum AFP before transplantation (OR 1.99; 95% CI 1.14-3.46; P = .02). Additionally, patients with recurrent tumors that were surgically resected had improved 5-year post-recurrence survival (31.6% vs 7.3%; P < .001). The conclusion was that the national downstaging policies were valid and should continue.

For patients who have unresectable HCC, systemic therapy is the mainstay of treatment. Peng and colleagues reported the results of the LAUNCH phase 3 clinical trial that randomized patients to receive lenvatinib alone or lenvatinib plus transarterial chemoembolization (TACE). Out of 338 patients, 170 received lenvatinib plus TACE. Unsurprisingly, the response rate was higher with the combination (54.1% vs 25.0%; P < .001); however, so was the median overall survival (17.8 vs 11.5 months; hazard ratio 0.45; P < .001), and median progression-free survival (10.6 vs 6.4 months; hazard ratio 0.43; P < .001). The investigators concluded that the addition of TACE to lenvatinib had manageable toxicities, improved clinical outcomes, and could be used as a potential first-line treatment for some patients with unresectable HCC.

Finally, in patients whose HCC progressed after a single TACE treatment, the question remains whether repeated TACE is worthwhile. Zhao and colleagues retrospectively reviewed the outcomes of 94 patients who underwent at least one TACE. Of these, 28 (29.8%) had a response to the first TACE, and these patients tended to have a longer OS compared with nonresponders (36.7 vs 21.5 months; P = .071). Of the 43 initial nonresponders who underwent a second TACE, 15 of 43 (34.9%) achieved a response and had an improved median overall survival (47.8 v. 13.6 months; P = .01), suggesting that repeat TACE may offer a benefit to some patients, even after no response to the initial treatment.

Liver transplantation has the opportunity to cure both localized HCC as well as underlying liver cirrhosis. Donor organ shortage has led to the implementation of the Milan criteria as a way to identify patients whose tumor burden is low enough to predict a good outcome. Downstaging liver cancer to fit within Milan criteria has been controversial.

Tabrizian and colleagues undertook a retrospective cohort analysis of 2645 adult patients with HCC who underwent liver transplant. Out of those, 2122 patients always had disease that was within the Milan criteria, 341 patients had HCC that was downstaged to fit within the Milan criteria, and 182 patients had HCC that was outside the Milan criteria at the time of liver transplantation. The authors report that the 10-year post-transplant survival and recurrence rates were 61.5% and 13.3%, respectively, in those always within the Milan criteria, 52.1% and 20.6% among those whose disease was downstaged, and 43.3% and 41.1% in those whose disease was never downstaged. Characteristics that predicted recurrence after downstaging were tumor size > 7 cm at diagnosis (odds ratio [OR] 2.62; 95% CI 1.20-5.75; P = .02), more than three tumors at diagnosis (OR 2.34; 95% CI 1.22-4.50; P = .01), and alpha-fetoprotein (AFP) response ≥ 20 ng/mL with < 50% improvement from maximum AFP before transplantation (OR 1.99; 95% CI 1.14-3.46; P = .02). Additionally, patients with recurrent tumors that were surgically resected had improved 5-year post-recurrence survival (31.6% vs 7.3%; P < .001). The conclusion was that the national downstaging policies were valid and should continue.

For patients who have unresectable HCC, systemic therapy is the mainstay of treatment. Peng and colleagues reported the results of the LAUNCH phase 3 clinical trial that randomized patients to receive lenvatinib alone or lenvatinib plus transarterial chemoembolization (TACE). Out of 338 patients, 170 received lenvatinib plus TACE. Unsurprisingly, the response rate was higher with the combination (54.1% vs 25.0%; P < .001); however, so was the median overall survival (17.8 vs 11.5 months; hazard ratio 0.45; P < .001), and median progression-free survival (10.6 vs 6.4 months; hazard ratio 0.43; P < .001). The investigators concluded that the addition of TACE to lenvatinib had manageable toxicities, improved clinical outcomes, and could be used as a potential first-line treatment for some patients with unresectable HCC.

Finally, in patients whose HCC progressed after a single TACE treatment, the question remains whether repeated TACE is worthwhile. Zhao and colleagues retrospectively reviewed the outcomes of 94 patients who underwent at least one TACE. Of these, 28 (29.8%) had a response to the first TACE, and these patients tended to have a longer OS compared with nonresponders (36.7 vs 21.5 months; P = .071). Of the 43 initial nonresponders who underwent a second TACE, 15 of 43 (34.9%) achieved a response and had an improved median overall survival (47.8 v. 13.6 months; P = .01), suggesting that repeat TACE may offer a benefit to some patients, even after no response to the initial treatment.

Liver transplantation has the opportunity to cure both localized HCC as well as underlying liver cirrhosis. Donor organ shortage has led to the implementation of the Milan criteria as a way to identify patients whose tumor burden is low enough to predict a good outcome. Downstaging liver cancer to fit within Milan criteria has been controversial.

Tabrizian and colleagues undertook a retrospective cohort analysis of 2645 adult patients with HCC who underwent liver transplant. Out of those, 2122 patients always had disease that was within the Milan criteria, 341 patients had HCC that was downstaged to fit within the Milan criteria, and 182 patients had HCC that was outside the Milan criteria at the time of liver transplantation. The authors report that the 10-year post-transplant survival and recurrence rates were 61.5% and 13.3%, respectively, in those always within the Milan criteria, 52.1% and 20.6% among those whose disease was downstaged, and 43.3% and 41.1% in those whose disease was never downstaged. Characteristics that predicted recurrence after downstaging were tumor size > 7 cm at diagnosis (odds ratio [OR] 2.62; 95% CI 1.20-5.75; P = .02), more than three tumors at diagnosis (OR 2.34; 95% CI 1.22-4.50; P = .01), and alpha-fetoprotein (AFP) response ≥ 20 ng/mL with < 50% improvement from maximum AFP before transplantation (OR 1.99; 95% CI 1.14-3.46; P = .02). Additionally, patients with recurrent tumors that were surgically resected had improved 5-year post-recurrence survival (31.6% vs 7.3%; P < .001). The conclusion was that the national downstaging policies were valid and should continue.

For patients who have unresectable HCC, systemic therapy is the mainstay of treatment. Peng and colleagues reported the results of the LAUNCH phase 3 clinical trial that randomized patients to receive lenvatinib alone or lenvatinib plus transarterial chemoembolization (TACE). Out of 338 patients, 170 received lenvatinib plus TACE. Unsurprisingly, the response rate was higher with the combination (54.1% vs 25.0%; P < .001); however, so was the median overall survival (17.8 vs 11.5 months; hazard ratio 0.45; P < .001), and median progression-free survival (10.6 vs 6.4 months; hazard ratio 0.43; P < .001). The investigators concluded that the addition of TACE to lenvatinib had manageable toxicities, improved clinical outcomes, and could be used as a potential first-line treatment for some patients with unresectable HCC.

Finally, in patients whose HCC progressed after a single TACE treatment, the question remains whether repeated TACE is worthwhile. Zhao and colleagues retrospectively reviewed the outcomes of 94 patients who underwent at least one TACE. Of these, 28 (29.8%) had a response to the first TACE, and these patients tended to have a longer OS compared with nonresponders (36.7 vs 21.5 months; P = .071). Of the 43 initial nonresponders who underwent a second TACE, 15 of 43 (34.9%) achieved a response and had an improved median overall survival (47.8 v. 13.6 months; P = .01), suggesting that repeat TACE may offer a benefit to some patients, even after no response to the initial treatment.

Key clinical point: A single session of transarterial chemoembolization (TACE) may not always confer significant survival benefits in patients with intermediate-stage hepatocellular carcinoma (HCC); initial nonresponders benefit from a second TACE session.

Major finding: The overall survival of responders to the first TACE was significantly better than that of nonresponders (36.7 vs 21.5 months; P  =  .071) and comparable with that of initial nonresponders who responded to the second TACE (36.7 vs 47.8 months; P  =  .701).

Study details: This retrospective study reviewed the data of 94 patients with intermediate-stage HCC who underwent TACE and magnetic resonance imaging before and after TACE.

Disclosures: This study was sponsored by the US National Institutes of Health/National Cancer Institute and Philips Research North America (PRNA), Cambridge, USA. Some authors reported being advisory board members or consultants for or receiving research grants from various sources. MD Lin is a former employee of PRNA.

Source: Zhao Y et al. Three-dimensional quantitative tumor response and survival analysis of hepatocellular carcinoma patients who failed initial transarterial chemoembolization: Repeat or switch treatment? Cancers (Basel). 2022;14(15):3615 (Jul 25). Doi: 10.3390/cancers14153615

Key clinical point: A single session of transarterial chemoembolization (TACE) may not always confer significant survival benefits in patients with intermediate-stage hepatocellular carcinoma (HCC); initial nonresponders benefit from a second TACE session.

Major finding: The overall survival of responders to the first TACE was significantly better than that of nonresponders (36.7 vs 21.5 months; P  =  .071) and comparable with that of initial nonresponders who responded to the second TACE (36.7 vs 47.8 months; P  =  .701).

Study details: This retrospective study reviewed the data of 94 patients with intermediate-stage HCC who underwent TACE and magnetic resonance imaging before and after TACE.

Disclosures: This study was sponsored by the US National Institutes of Health/National Cancer Institute and Philips Research North America (PRNA), Cambridge, USA. Some authors reported being advisory board members or consultants for or receiving research grants from various sources. MD Lin is a former employee of PRNA.

Source: Zhao Y et al. Three-dimensional quantitative tumor response and survival analysis of hepatocellular carcinoma patients who failed initial transarterial chemoembolization: Repeat or switch treatment? Cancers (Basel). 2022;14(15):3615 (Jul 25). Doi: 10.3390/cancers14153615

Key clinical point: A single session of transarterial chemoembolization (TACE) may not always confer significant survival benefits in patients with intermediate-stage hepatocellular carcinoma (HCC); initial nonresponders benefit from a second TACE session.

Major finding: The overall survival of responders to the first TACE was significantly better than that of nonresponders (36.7 vs 21.5 months; P  =  .071) and comparable with that of initial nonresponders who responded to the second TACE (36.7 vs 47.8 months; P  =  .701).

Study details: This retrospective study reviewed the data of 94 patients with intermediate-stage HCC who underwent TACE and magnetic resonance imaging before and after TACE.

Disclosures: This study was sponsored by the US National Institutes of Health/National Cancer Institute and Philips Research North America (PRNA), Cambridge, USA. Some authors reported being advisory board members or consultants for or receiving research grants from various sources. MD Lin is a former employee of PRNA.

Source: Zhao Y et al. Three-dimensional quantitative tumor response and survival analysis of hepatocellular carcinoma patients who failed initial transarterial chemoembolization: Repeat or switch treatment? Cancers (Basel). 2022;14(15):3615 (Jul 25). Doi: 10.3390/cancers14153615

Key clinical point: The combination of sorafenib, an immune checkpoint inhibitor (camrelizumab/tislelizumab), transcatheter arterial chemoembolization (TACE), and stereotactic body radiation therapy (SITS) is more effective than sorafenib plus TACE (ST) in advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT), especially as a downstaging strategy.

Major finding: The SITS vs ST group had a significantly higher objective response rate (53.3% vs 25.0%; P  =  .036) and longer median progression-free survival (10.4 vs 6.3 months; P  =  .015) and overall survival (13.8 vs 8.8 months; P  =  .013), with 12 patients vs none experiencing successful downstaging.

Study details: Findings are from a retrospective study including 62 patients with advanced HCC and PVTT who received SITS (n = 30) or ST (n = 32).

Disclosures: This study was supported by the Hubei Chen Xiaoping Science and Technology Development Foundation, China, and the Autonomous Exploration and Innovation Fund Subject for Graduate Student of Central South University, China. The authors declared no conflicts of interest.

Source: Zhang Z et al. A Combination of sorafenib, an immune checkpoint inhibitor, TACE and stereotactic body radiation therapy versus sorafenib and TACE in advanced hepatocellular carcinoma accompanied by portal vein tumor thrombus. Cancers (Basel). 2022;14(15):3619 (Jul 25). Doi:  10.3390/cancers14153619

Key clinical point: The combination of sorafenib, an immune checkpoint inhibitor (camrelizumab/tislelizumab), transcatheter arterial chemoembolization (TACE), and stereotactic body radiation therapy (SITS) is more effective than sorafenib plus TACE (ST) in advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT), especially as a downstaging strategy.

Major finding: The SITS vs ST group had a significantly higher objective response rate (53.3% vs 25.0%; P  =  .036) and longer median progression-free survival (10.4 vs 6.3 months; P  =  .015) and overall survival (13.8 vs 8.8 months; P  =  .013), with 12 patients vs none experiencing successful downstaging.

Study details: Findings are from a retrospective study including 62 patients with advanced HCC and PVTT who received SITS (n = 30) or ST (n = 32).

Disclosures: This study was supported by the Hubei Chen Xiaoping Science and Technology Development Foundation, China, and the Autonomous Exploration and Innovation Fund Subject for Graduate Student of Central South University, China. The authors declared no conflicts of interest.

Source: Zhang Z et al. A Combination of sorafenib, an immune checkpoint inhibitor, TACE and stereotactic body radiation therapy versus sorafenib and TACE in advanced hepatocellular carcinoma accompanied by portal vein tumor thrombus. Cancers (Basel). 2022;14(15):3619 (Jul 25). Doi:  10.3390/cancers14153619

Key clinical point: The combination of sorafenib, an immune checkpoint inhibitor (camrelizumab/tislelizumab), transcatheter arterial chemoembolization (TACE), and stereotactic body radiation therapy (SITS) is more effective than sorafenib plus TACE (ST) in advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT), especially as a downstaging strategy.

Major finding: The SITS vs ST group had a significantly higher objective response rate (53.3% vs 25.0%; P  =  .036) and longer median progression-free survival (10.4 vs 6.3 months; P  =  .015) and overall survival (13.8 vs 8.8 months; P  =  .013), with 12 patients vs none experiencing successful downstaging.

Study details: Findings are from a retrospective study including 62 patients with advanced HCC and PVTT who received SITS (n = 30) or ST (n = 32).

Disclosures: This study was supported by the Hubei Chen Xiaoping Science and Technology Development Foundation, China, and the Autonomous Exploration and Innovation Fund Subject for Graduate Student of Central South University, China. The authors declared no conflicts of interest.

Source: Zhang Z et al. A Combination of sorafenib, an immune checkpoint inhibitor, TACE and stereotactic body radiation therapy versus sorafenib and TACE in advanced hepatocellular carcinoma accompanied by portal vein tumor thrombus. Cancers (Basel). 2022;14(15):3619 (Jul 25). Doi:  10.3390/cancers14153619

Key clinical point: Percutaneous no-touch radiofrequency ablation (NtRFA) provides effective tumor control in the treatment of hepatocellular carcinoma (HCC) ≤5 cm, with a lower local tumor progression (LTP) rate than that with conventional RFA.

Major finding: NtRFA offered a pooled overall LTP rate of 6% (95% CI 4%-8%) and significantly lower LTP rates compared with conventional RFA (hazard ratio 0.28; relative risk 0.26; both P < .01).

Study details: This was a meta-analysis of 12 studies that included 900 patients and evaluated LTP after NtRFA for HCC ≤5 cm.

Disclosures: This study was supported by a Korea Medical Device Development Fund grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TH et al. Can “no-touch” radiofrequency ablation for hepatocellular carcinoma improve local tumor control? Systematic review and meta-analysis. Eur Radiol. 2022 (Jul 30). Doi: 10.1007/s00330-022-08991-1

Key clinical point: Percutaneous no-touch radiofrequency ablation (NtRFA) provides effective tumor control in the treatment of hepatocellular carcinoma (HCC) ≤5 cm, with a lower local tumor progression (LTP) rate than that with conventional RFA.

Major finding: NtRFA offered a pooled overall LTP rate of 6% (95% CI 4%-8%) and significantly lower LTP rates compared with conventional RFA (hazard ratio 0.28; relative risk 0.26; both P < .01).

Study details: This was a meta-analysis of 12 studies that included 900 patients and evaluated LTP after NtRFA for HCC ≤5 cm.

Disclosures: This study was supported by a Korea Medical Device Development Fund grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TH et al. Can “no-touch” radiofrequency ablation for hepatocellular carcinoma improve local tumor control? Systematic review and meta-analysis. Eur Radiol. 2022 (Jul 30). Doi: 10.1007/s00330-022-08991-1

Key clinical point: Percutaneous no-touch radiofrequency ablation (NtRFA) provides effective tumor control in the treatment of hepatocellular carcinoma (HCC) ≤5 cm, with a lower local tumor progression (LTP) rate than that with conventional RFA.

Major finding: NtRFA offered a pooled overall LTP rate of 6% (95% CI 4%-8%) and significantly lower LTP rates compared with conventional RFA (hazard ratio 0.28; relative risk 0.26; both P < .01).

Study details: This was a meta-analysis of 12 studies that included 900 patients and evaluated LTP after NtRFA for HCC ≤5 cm.

Disclosures: This study was supported by a Korea Medical Device Development Fund grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TH et al. Can “no-touch” radiofrequency ablation for hepatocellular carcinoma improve local tumor control? Systematic review and meta-analysis. Eur Radiol. 2022 (Jul 30). Doi: 10.1007/s00330-022-08991-1

Key clinical point: Improved survival among children vs adults with hepatocellular carcinoma (HCC) despite greater fibrolamellar histology prevalence and positive lymph node number and similar metastasis rates is a likely result of a more aggressive surgical approach.

Major finding: Although children vs adults had a higher prevalence of fibrolamellar HCC (32% vs 9%) and number of positive lymph nodes (35% vs 17%; P  =  .02) and comparable metastasis rates (30% vs 28%; P  =  .47), they had significantly better 1-year (81% vs 70%) and 5-year (55% vs 48%) overall survival and surgical intervention (74% vs 62%) rates (all P < .001).

Study details: This study stratified the data of 1520 patients with grade ≥1 HCC from the National Cancer Database by age: <21 years (children; n = 244) and 21-40 years (young adults; n = 1276).

Disclosures: No source of funding was reported. SJ Commander declared receiving financial support from several sources.

Source: Commander SJ et al. Improved survival and higher rates of surgical resection associated with hepatocellular carcinoma in children as compared to young adults. Int J Cancer. 2022 (Jul 16). Doi:  10.1002/ijc.34215

Key clinical point: Improved survival among children vs adults with hepatocellular carcinoma (HCC) despite greater fibrolamellar histology prevalence and positive lymph node number and similar metastasis rates is a likely result of a more aggressive surgical approach.

Major finding: Although children vs adults had a higher prevalence of fibrolamellar HCC (32% vs 9%) and number of positive lymph nodes (35% vs 17%; P  =  .02) and comparable metastasis rates (30% vs 28%; P  =  .47), they had significantly better 1-year (81% vs 70%) and 5-year (55% vs 48%) overall survival and surgical intervention (74% vs 62%) rates (all P < .001).

Study details: This study stratified the data of 1520 patients with grade ≥1 HCC from the National Cancer Database by age: <21 years (children; n = 244) and 21-40 years (young adults; n = 1276).

Disclosures: No source of funding was reported. SJ Commander declared receiving financial support from several sources.

Source: Commander SJ et al. Improved survival and higher rates of surgical resection associated with hepatocellular carcinoma in children as compared to young adults. Int J Cancer. 2022 (Jul 16). Doi:  10.1002/ijc.34215

Key clinical point: Improved survival among children vs adults with hepatocellular carcinoma (HCC) despite greater fibrolamellar histology prevalence and positive lymph node number and similar metastasis rates is a likely result of a more aggressive surgical approach.

Major finding: Although children vs adults had a higher prevalence of fibrolamellar HCC (32% vs 9%) and number of positive lymph nodes (35% vs 17%; P  =  .02) and comparable metastasis rates (30% vs 28%; P  =  .47), they had significantly better 1-year (81% vs 70%) and 5-year (55% vs 48%) overall survival and surgical intervention (74% vs 62%) rates (all P < .001).

Study details: This study stratified the data of 1520 patients with grade ≥1 HCC from the National Cancer Database by age: <21 years (children; n = 244) and 21-40 years (young adults; n = 1276).

Disclosures: No source of funding was reported. SJ Commander declared receiving financial support from several sources.

Source: Commander SJ et al. Improved survival and higher rates of surgical resection associated with hepatocellular carcinoma in children as compared to young adults. Int J Cancer. 2022 (Jul 16). Doi:  10.1002/ijc.34215

Key clinical point: The combination of sorafenib adjuvant therapy and radiofrequency ablation (RFA) offers better survival outcomes than RFA alone in patients with recurrent hepatocellular carcinoma (RHCC) within Milan criteria after curative resection of primary HCC.

Major finding: Patients receiving RFA plus sorafenib vs RFA alone had significantly higher 1- and 3-year overall survival (97.7% vs 93.1%; P  =  .018 and 83.7% vs 61.3%; P < .001, respectively) and tumor-free survival (90.8% vs 67.8% and 49.0% vs 28.0%, respectively; both P < .001) rates.

Study details: This multicenter, retrospective study included 174 propensity score-matched pairs of adult patients with RHCC within Milan criteria who did or did not receive sorafenib after RFA.

Disclosures: This study was sponsored by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Zhou Q et al. Sorafenib as adjuvant therapy following radiofrequency ablation for recurrent hepatocellular carcinoma within Milan criteria: A multicenter analysis. J Gastroenterol. 2022 (Jul 11). Doi: 10.1007/s00535-022-01895-3

Key clinical point: The combination of sorafenib adjuvant therapy and radiofrequency ablation (RFA) offers better survival outcomes than RFA alone in patients with recurrent hepatocellular carcinoma (RHCC) within Milan criteria after curative resection of primary HCC.

Major finding: Patients receiving RFA plus sorafenib vs RFA alone had significantly higher 1- and 3-year overall survival (97.7% vs 93.1%; P  =  .018 and 83.7% vs 61.3%; P < .001, respectively) and tumor-free survival (90.8% vs 67.8% and 49.0% vs 28.0%, respectively; both P < .001) rates.

Study details: This multicenter, retrospective study included 174 propensity score-matched pairs of adult patients with RHCC within Milan criteria who did or did not receive sorafenib after RFA.

Disclosures: This study was sponsored by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Zhou Q et al. Sorafenib as adjuvant therapy following radiofrequency ablation for recurrent hepatocellular carcinoma within Milan criteria: A multicenter analysis. J Gastroenterol. 2022 (Jul 11). Doi: 10.1007/s00535-022-01895-3

Key clinical point: The combination of sorafenib adjuvant therapy and radiofrequency ablation (RFA) offers better survival outcomes than RFA alone in patients with recurrent hepatocellular carcinoma (RHCC) within Milan criteria after curative resection of primary HCC.

Major finding: Patients receiving RFA plus sorafenib vs RFA alone had significantly higher 1- and 3-year overall survival (97.7% vs 93.1%; P  =  .018 and 83.7% vs 61.3%; P < .001, respectively) and tumor-free survival (90.8% vs 67.8% and 49.0% vs 28.0%, respectively; both P < .001) rates.

Study details: This multicenter, retrospective study included 174 propensity score-matched pairs of adult patients with RHCC within Milan criteria who did or did not receive sorafenib after RFA.

Disclosures: This study was sponsored by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Zhou Q et al. Sorafenib as adjuvant therapy following radiofrequency ablation for recurrent hepatocellular carcinoma within Milan criteria: A multicenter analysis. J Gastroenterol. 2022 (Jul 11). Doi: 10.1007/s00535-022-01895-3

Key clinical point: Baseline hepatitis B virus (HBV) DNA levels are not associated with the clinical outcomes of patients with HBV-related hepatocellular carcinoma (HCC) treated with anti-programmed cell death protein 1 (anti-PD-1)-based immunotherapy.

Major finding: Baseline HBV DNA levels were not significantly associated with the overall survival (adjusted hazard ratio [aHR] 0.77; P  =  .59) or progression-free survival (aHR 0.68; P  =  .098).

Study details: This single-center retrospective observational study included 217 patients with advanced HBV-related HCC who received ≥1 dose of anti-PD-1 therapy.

Disclosures: This study was supported by the National Natural Science Foundation of China and Medical Science and Technology Research Project of Health Commission of Henan Province. The authors declared no conflicts of interest.

Source: An M et al. Association of hepatitis B virus DNA levels with overall survival for advanced hepatitis B virus-related hepatocellular carcinoma under immune checkpoint inhibitor therapy. Cancer Immunol Immunother. 2022 (Jul 30). Doi: 10.1007/s00262-022-03254-w

Key clinical point: Baseline hepatitis B virus (HBV) DNA levels are not associated with the clinical outcomes of patients with HBV-related hepatocellular carcinoma (HCC) treated with anti-programmed cell death protein 1 (anti-PD-1)-based immunotherapy.

Major finding: Baseline HBV DNA levels were not significantly associated with the overall survival (adjusted hazard ratio [aHR] 0.77; P  =  .59) or progression-free survival (aHR 0.68; P  =  .098).

Study details: This single-center retrospective observational study included 217 patients with advanced HBV-related HCC who received ≥1 dose of anti-PD-1 therapy.

Disclosures: This study was supported by the National Natural Science Foundation of China and Medical Science and Technology Research Project of Health Commission of Henan Province. The authors declared no conflicts of interest.

Source: An M et al. Association of hepatitis B virus DNA levels with overall survival for advanced hepatitis B virus-related hepatocellular carcinoma under immune checkpoint inhibitor therapy. Cancer Immunol Immunother. 2022 (Jul 30). Doi: 10.1007/s00262-022-03254-w

Key clinical point: Baseline hepatitis B virus (HBV) DNA levels are not associated with the clinical outcomes of patients with HBV-related hepatocellular carcinoma (HCC) treated with anti-programmed cell death protein 1 (anti-PD-1)-based immunotherapy.

Major finding: Baseline HBV DNA levels were not significantly associated with the overall survival (adjusted hazard ratio [aHR] 0.77; P  =  .59) or progression-free survival (aHR 0.68; P  =  .098).

Study details: This single-center retrospective observational study included 217 patients with advanced HBV-related HCC who received ≥1 dose of anti-PD-1 therapy.

Disclosures: This study was supported by the National Natural Science Foundation of China and Medical Science and Technology Research Project of Health Commission of Henan Province. The authors declared no conflicts of interest.

Source: An M et al. Association of hepatitis B virus DNA levels with overall survival for advanced hepatitis B virus-related hepatocellular carcinoma under immune checkpoint inhibitor therapy. Cancer Immunol Immunother. 2022 (Jul 30). Doi: 10.1007/s00262-022-03254-w

Key clinical point: Compared with transcatheter arterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC) offers better efficacy in patients with advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) without significantly compromising safety.

Major finding: Patients receiving HAIC vs TACE had a significantly longer median overall survival (11.2 vs 9.0 months; P  =  .010) and progression-free survival (5.6 vs 2.0 months; P  =  .006) and a higher objective response rate (56.8% vs 18.2%; P < .001). No treatment‐related grade 4/5 adverse events were reported.

Study details: This was a propensity score‐matched cohort study including 44 pairs of adult patients with advanced HCC and PVTT who underwent HAIC with oxaliplatin plus raltitrexed or TACE.

Disclosures: This study was supported by the Guiding Project of Science and Technology Program of Fujian Province, China.

Source: Chen S, Yuan B, et al. Hepatic arterial infusion oxaliplatin plus raltitrexed and chemoembolization in hepatocellular carcinoma with portal vein invasion: A propensity score-matching cohort study. J Surg Oncol. 2022 (Jul 20). Doi: 10.1002/jso.27023

Key clinical point: Compared with transcatheter arterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC) offers better efficacy in patients with advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) without significantly compromising safety.

Major finding: Patients receiving HAIC vs TACE had a significantly longer median overall survival (11.2 vs 9.0 months; P  =  .010) and progression-free survival (5.6 vs 2.0 months; P  =  .006) and a higher objective response rate (56.8% vs 18.2%; P < .001). No treatment‐related grade 4/5 adverse events were reported.

Study details: This was a propensity score‐matched cohort study including 44 pairs of adult patients with advanced HCC and PVTT who underwent HAIC with oxaliplatin plus raltitrexed or TACE.

Disclosures: This study was supported by the Guiding Project of Science and Technology Program of Fujian Province, China.

Source: Chen S, Yuan B, et al. Hepatic arterial infusion oxaliplatin plus raltitrexed and chemoembolization in hepatocellular carcinoma with portal vein invasion: A propensity score-matching cohort study. J Surg Oncol. 2022 (Jul 20). Doi: 10.1002/jso.27023

Key clinical point: Compared with transcatheter arterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC) offers better efficacy in patients with advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) without significantly compromising safety.

Major finding: Patients receiving HAIC vs TACE had a significantly longer median overall survival (11.2 vs 9.0 months; P  =  .010) and progression-free survival (5.6 vs 2.0 months; P  =  .006) and a higher objective response rate (56.8% vs 18.2%; P < .001). No treatment‐related grade 4/5 adverse events were reported.

Study details: This was a propensity score‐matched cohort study including 44 pairs of adult patients with advanced HCC and PVTT who underwent HAIC with oxaliplatin plus raltitrexed or TACE.

Disclosures: This study was supported by the Guiding Project of Science and Technology Program of Fujian Province, China.

Source: Chen S, Yuan B, et al. Hepatic arterial infusion oxaliplatin plus raltitrexed and chemoembolization in hepatocellular carcinoma with portal vein invasion: A propensity score-matching cohort study. J Surg Oncol. 2022 (Jul 20). Doi: 10.1002/jso.27023

Key clinical point: Heavy alcohol intake and ALDH2 rs671 polymorphism are associated with a significantly increased risk for hepatocellular carcinoma (HCC) development in patients with hepatitis B virus (HBV)-related cirrhosis.

Major finding: Alcohol intake amount (>160 vs 80-160 g/day: adjusted hazard ratio [aHR] 1.78; P  =  .04) and ALDH2 rs671 polymorphism (GA/AA vs GG genotype: aHR 5.61; P < .001) were significantly associated with an increased incidence of HCC.

Study details: This retrospective cohort study enrolled 1515 patients with cirrhosis due to heavy alcoholism or HBV infection.

Disclosures: This study was sponsored by the Ministry of Science and Technology, Taiwan, E-Da Hospital-National Taiwan University Hospital Joint Research Program, and others.

Source: Tsai MC et al. Association of heavy alcohol intake and ALDH2 rs671 polymorphism with hepatocellular carcinoma and mortality in patients with hepatitis B virus–related cirrhosis. JAMA Netw Open. 2022;5(7):e2223511 (Jul 25). Doi: 10.1001/jamanetworkopen.2022.23511

Key clinical point: Heavy alcohol intake and ALDH2 rs671 polymorphism are associated with a significantly increased risk for hepatocellular carcinoma (HCC) development in patients with hepatitis B virus (HBV)-related cirrhosis.

Major finding: Alcohol intake amount (>160 vs 80-160 g/day: adjusted hazard ratio [aHR] 1.78; P  =  .04) and ALDH2 rs671 polymorphism (GA/AA vs GG genotype: aHR 5.61; P < .001) were significantly associated with an increased incidence of HCC.

Study details: This retrospective cohort study enrolled 1515 patients with cirrhosis due to heavy alcoholism or HBV infection.

Disclosures: This study was sponsored by the Ministry of Science and Technology, Taiwan, E-Da Hospital-National Taiwan University Hospital Joint Research Program, and others.

Source: Tsai MC et al. Association of heavy alcohol intake and ALDH2 rs671 polymorphism with hepatocellular carcinoma and mortality in patients with hepatitis B virus–related cirrhosis. JAMA Netw Open. 2022;5(7):e2223511 (Jul 25). Doi: 10.1001/jamanetworkopen.2022.23511

Key clinical point: Heavy alcohol intake and ALDH2 rs671 polymorphism are associated with a significantly increased risk for hepatocellular carcinoma (HCC) development in patients with hepatitis B virus (HBV)-related cirrhosis.

Major finding: Alcohol intake amount (>160 vs 80-160 g/day: adjusted hazard ratio [aHR] 1.78; P  =  .04) and ALDH2 rs671 polymorphism (GA/AA vs GG genotype: aHR 5.61; P < .001) were significantly associated with an increased incidence of HCC.

Study details: This retrospective cohort study enrolled 1515 patients with cirrhosis due to heavy alcoholism or HBV infection.

Disclosures: This study was sponsored by the Ministry of Science and Technology, Taiwan, E-Da Hospital-National Taiwan University Hospital Joint Research Program, and others.

Source: Tsai MC et al. Association of heavy alcohol intake and ALDH2 rs671 polymorphism with hepatocellular carcinoma and mortality in patients with hepatitis B virus–related cirrhosis. JAMA Netw Open. 2022;5(7):e2223511 (Jul 25). Doi: 10.1001/jamanetworkopen.2022.23511