Hepatocellular Carcinoma

Key clinical point: No difference in overall survival occurred between HCC patients treated with Lipiodol

Major finding: The average overall tumor reduction was 21.45%; 19.95% in the Lipiodol-only group and 22.95% in the combination group (P = 0.653). However, patients in the combination group showed significant improvement in various degrees of tumor response compared to the Lipiodol-only group (P = 0.010).

Study details: The data come from a prospective, randomized trial of 44 men and 17 women, aged 44-85 years, with hepatocellular carcinoma who underwent transarterial chemoembolization (cTACE) using Lipiodol only or with additional use of degradable starch microspheres (DSM).

Disclosures: The study was supported by PharmaCept GmbH, Berlin, Germany. The researchers had no financial conflicts to disclose.  

Source: Vogl TJ et al. Hepatol Int. 2021 May 27. doi: 10.1007/s12072-021-10193-8.

Key clinical point: No difference in overall survival occurred between HCC patients treated with Lipiodol

Major finding: The average overall tumor reduction was 21.45%; 19.95% in the Lipiodol-only group and 22.95% in the combination group (P = 0.653). However, patients in the combination group showed significant improvement in various degrees of tumor response compared to the Lipiodol-only group (P = 0.010).

Study details: The data come from a prospective, randomized trial of 44 men and 17 women, aged 44-85 years, with hepatocellular carcinoma who underwent transarterial chemoembolization (cTACE) using Lipiodol only or with additional use of degradable starch microspheres (DSM).

Disclosures: The study was supported by PharmaCept GmbH, Berlin, Germany. The researchers had no financial conflicts to disclose.  

Source: Vogl TJ et al. Hepatol Int. 2021 May 27. doi: 10.1007/s12072-021-10193-8.

Key clinical point: No difference in overall survival occurred between HCC patients treated with Lipiodol

Major finding: The average overall tumor reduction was 21.45%; 19.95% in the Lipiodol-only group and 22.95% in the combination group (P = 0.653). However, patients in the combination group showed significant improvement in various degrees of tumor response compared to the Lipiodol-only group (P = 0.010).

Study details: The data come from a prospective, randomized trial of 44 men and 17 women, aged 44-85 years, with hepatocellular carcinoma who underwent transarterial chemoembolization (cTACE) using Lipiodol only or with additional use of degradable starch microspheres (DSM).

Disclosures: The study was supported by PharmaCept GmbH, Berlin, Germany. The researchers had no financial conflicts to disclose.  

Source: Vogl TJ et al. Hepatol Int. 2021 May 27. doi: 10.1007/s12072-021-10193-8.

Key clinical point: Specific predictors for postoperative 90-day mortality for hepatocellular carcinoma patients after hepatic resection include Child-Pugh score, intraoperative blood loss, post-hepatectomy liver failure (PHLF), and peak serum bilirubin.

Major finding: The overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. 

Study details: The data come from a retrospective study of 244 adults with HCC who underwent elective hepatic resection between January 1, 2007, and December 31, 2017. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Lei GY et al. Visc Med. 2020 Oct 27. doi: 10.1159/000510811.

Key clinical point: Specific predictors for postoperative 90-day mortality for hepatocellular carcinoma patients after hepatic resection include Child-Pugh score, intraoperative blood loss, post-hepatectomy liver failure (PHLF), and peak serum bilirubin.

Major finding: The overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. 

Study details: The data come from a retrospective study of 244 adults with HCC who underwent elective hepatic resection between January 1, 2007, and December 31, 2017. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Lei GY et al. Visc Med. 2020 Oct 27. doi: 10.1159/000510811.

Key clinical point: Specific predictors for postoperative 90-day mortality for hepatocellular carcinoma patients after hepatic resection include Child-Pugh score, intraoperative blood loss, post-hepatectomy liver failure (PHLF), and peak serum bilirubin.

Major finding: The overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. 

Study details: The data come from a retrospective study of 244 adults with HCC who underwent elective hepatic resection between January 1, 2007, and December 31, 2017. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Lei GY et al. Visc Med. 2020 Oct 27. doi: 10.1159/000510811.

Key clinical point: The DEPDC1B gene restrained growth of tumors associated with HCC progression both in vitro and in vivo.

Major finding: Knockdown of DEPDC1B inhibited the progression of HCC by inhibiting cell proliferation, migration, and colony formation, also by promoting cell apoptosis in vitro.

Study details: The data come from an in vitro and in vivo analysis of DEPDC1B using immunohistochemical staining to detect expression in tumor tissues and normal tissues, and a  xenograft model was used to show the functions of DEPC1B on tumor growth in vivo.

Disclosures: The study was supported by the National Natural Science Foundation of China (No. 81602100) and Natural Science Foundation of Shanghai. The researchers had no financial conflicts to disclose.  

Source: Dang X-W et al. Aging. 2021 May 25. doi: 10.18632/aging.203016.

Key clinical point: The DEPDC1B gene restrained growth of tumors associated with HCC progression both in vitro and in vivo.

Major finding: Knockdown of DEPDC1B inhibited the progression of HCC by inhibiting cell proliferation, migration, and colony formation, also by promoting cell apoptosis in vitro.

Study details: The data come from an in vitro and in vivo analysis of DEPDC1B using immunohistochemical staining to detect expression in tumor tissues and normal tissues, and a  xenograft model was used to show the functions of DEPC1B on tumor growth in vivo.

Disclosures: The study was supported by the National Natural Science Foundation of China (No. 81602100) and Natural Science Foundation of Shanghai. The researchers had no financial conflicts to disclose.  

Source: Dang X-W et al. Aging. 2021 May 25. doi: 10.18632/aging.203016.

Key clinical point: The DEPDC1B gene restrained growth of tumors associated with HCC progression both in vitro and in vivo.

Major finding: Knockdown of DEPDC1B inhibited the progression of HCC by inhibiting cell proliferation, migration, and colony formation, also by promoting cell apoptosis in vitro.

Study details: The data come from an in vitro and in vivo analysis of DEPDC1B using immunohistochemical staining to detect expression in tumor tissues and normal tissues, and a  xenograft model was used to show the functions of DEPC1B on tumor growth in vivo.

Disclosures: The study was supported by the National Natural Science Foundation of China (No. 81602100) and Natural Science Foundation of Shanghai. The researchers had no financial conflicts to disclose.  

Source: Dang X-W et al. Aging. 2021 May 25. doi: 10.18632/aging.203016.

Key clinical point: No single first-line treatment for advanced hepatocellular carcinoma demonstrated superior outcomes across all measures, therefore treatment should be based on individual goals.

Major finding: Lenvatinib ranked highest for overall response rate for patients with advanced/unresectable HCC, followed by atezolizumab plus bevacizumab and nivolumab. For progression-free survival, the top-ranked treatments was atezolizumab + bevacizumab, followed by lenvatinib.

Study details: The data come from a meta-analysis of 27 randomized, controlled trials of first-line therapies for hepatocellular carcinoma. The treatments compared in the studies were Treatments compared were atezolizumab plus bevacizumab, brivanib, donafenib, dovitinib, FOLFOX4, lenvatinib, linifanib, nintedanib, nivolumab, sorafenib, sunitinib, vandetanib, 11 sorafenib combination therapies, and 3 other combination therapies. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Han Y et al. World J. Gastroenterol. 2021 May 21. doi: 10.3748/wjg.v27.i19.2415.

Key clinical point: No single first-line treatment for advanced hepatocellular carcinoma demonstrated superior outcomes across all measures, therefore treatment should be based on individual goals.

Major finding: Lenvatinib ranked highest for overall response rate for patients with advanced/unresectable HCC, followed by atezolizumab plus bevacizumab and nivolumab. For progression-free survival, the top-ranked treatments was atezolizumab + bevacizumab, followed by lenvatinib.

Study details: The data come from a meta-analysis of 27 randomized, controlled trials of first-line therapies for hepatocellular carcinoma. The treatments compared in the studies were Treatments compared were atezolizumab plus bevacizumab, brivanib, donafenib, dovitinib, FOLFOX4, lenvatinib, linifanib, nintedanib, nivolumab, sorafenib, sunitinib, vandetanib, 11 sorafenib combination therapies, and 3 other combination therapies. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Han Y et al. World J. Gastroenterol. 2021 May 21. doi: 10.3748/wjg.v27.i19.2415.

Key clinical point: No single first-line treatment for advanced hepatocellular carcinoma demonstrated superior outcomes across all measures, therefore treatment should be based on individual goals.

Major finding: Lenvatinib ranked highest for overall response rate for patients with advanced/unresectable HCC, followed by atezolizumab plus bevacizumab and nivolumab. For progression-free survival, the top-ranked treatments was atezolizumab + bevacizumab, followed by lenvatinib.

Study details: The data come from a meta-analysis of 27 randomized, controlled trials of first-line therapies for hepatocellular carcinoma. The treatments compared in the studies were Treatments compared were atezolizumab plus bevacizumab, brivanib, donafenib, dovitinib, FOLFOX4, lenvatinib, linifanib, nintedanib, nivolumab, sorafenib, sunitinib, vandetanib, 11 sorafenib combination therapies, and 3 other combination therapies. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Han Y et al. World J. Gastroenterol. 2021 May 21. doi: 10.3748/wjg.v27.i19.2415.

Key clinical point: The EZ albumin-bilirubin (ALBI) score was significantly correlated with the original and more complex ALBI score as a biomarker of liver injury.

Major finding: The correlation coefficient of the EZ-ALBI score with the standard ALBI score was 0.965 (P < 0.001). In multivariate analysis, factors including EZ-ALBI grade 2 and 3 were independently associated with increased mortality.

Study details: The data come from 3,794 patients newly diagnosed with HCC who were prospectively enrolled in the study and later analyzed.

Disclosures: The study was supported by the Taipei Veterans General Hospital. The researchers had no financial conflicts to disclose.  

Source: Ho S-Y et al. Hepatol Res. 2021 May 26. doi:10.1111/hepr.13671.

Key clinical point: The EZ albumin-bilirubin (ALBI) score was significantly correlated with the original and more complex ALBI score as a biomarker of liver injury.

Major finding: The correlation coefficient of the EZ-ALBI score with the standard ALBI score was 0.965 (P < 0.001). In multivariate analysis, factors including EZ-ALBI grade 2 and 3 were independently associated with increased mortality.

Study details: The data come from 3,794 patients newly diagnosed with HCC who were prospectively enrolled in the study and later analyzed.

Disclosures: The study was supported by the Taipei Veterans General Hospital. The researchers had no financial conflicts to disclose.  

Source: Ho S-Y et al. Hepatol Res. 2021 May 26. doi:10.1111/hepr.13671.

Key clinical point: The EZ albumin-bilirubin (ALBI) score was significantly correlated with the original and more complex ALBI score as a biomarker of liver injury.

Major finding: The correlation coefficient of the EZ-ALBI score with the standard ALBI score was 0.965 (P < 0.001). In multivariate analysis, factors including EZ-ALBI grade 2 and 3 were independently associated with increased mortality.

Study details: The data come from 3,794 patients newly diagnosed with HCC who were prospectively enrolled in the study and later analyzed.

Disclosures: The study was supported by the Taipei Veterans General Hospital. The researchers had no financial conflicts to disclose.  

Source: Ho S-Y et al. Hepatol Res. 2021 May 26. doi:10.1111/hepr.13671.

Key clinical point: Over a median follow-up of 36.7 months, safety and efficacy based on complications and rates of overall survival were not significantly different between hepatocellular carcinoma patients treated with radiofrequency ablation (RFA) and those treated with microwave ablation (MWA).

Major finding: Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%).

Study details: The data come from a retrospective study of 201 consecutive adult patients with hepatocellular carcinoma who underwent either radiofrequency ablation (150 patients) or microwave ablation (51 patients) at a single center between January 2012 and December 2016.

Disclosures: The study was supported by the Guangzhou Science and Technology Program and the Innovative Research Group Project of the National Natural Science Foundation of China.  The researchers had no financial conflicts to disclose.  

Source: Han X et al. Abdom Radiol. 2021 May 25. doi: 10.1007/s00261-021-03105-9.

Key clinical point: Over a median follow-up of 36.7 months, safety and efficacy based on complications and rates of overall survival were not significantly different between hepatocellular carcinoma patients treated with radiofrequency ablation (RFA) and those treated with microwave ablation (MWA).

Major finding: Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%).

Study details: The data come from a retrospective study of 201 consecutive adult patients with hepatocellular carcinoma who underwent either radiofrequency ablation (150 patients) or microwave ablation (51 patients) at a single center between January 2012 and December 2016.

Disclosures: The study was supported by the Guangzhou Science and Technology Program and the Innovative Research Group Project of the National Natural Science Foundation of China.  The researchers had no financial conflicts to disclose.  

Source: Han X et al. Abdom Radiol. 2021 May 25. doi: 10.1007/s00261-021-03105-9.

Key clinical point: Over a median follow-up of 36.7 months, safety and efficacy based on complications and rates of overall survival were not significantly different between hepatocellular carcinoma patients treated with radiofrequency ablation (RFA) and those treated with microwave ablation (MWA).

Major finding: Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%).

Study details: The data come from a retrospective study of 201 consecutive adult patients with hepatocellular carcinoma who underwent either radiofrequency ablation (150 patients) or microwave ablation (51 patients) at a single center between January 2012 and December 2016.

Disclosures: The study was supported by the Guangzhou Science and Technology Program and the Innovative Research Group Project of the National Natural Science Foundation of China.  The researchers had no financial conflicts to disclose.  

Source: Han X et al. Abdom Radiol. 2021 May 25. doi: 10.1007/s00261-021-03105-9.

First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).

Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.

Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.

Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016.  Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.

First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).

Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.

Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.

Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016.  Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.

First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).

Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.

Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.

Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016.  Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.

Key clinical point: Increased levels of prothrombin induced by vitamin K deficiency or antagonist- II (PIVKA-II) identified patients with hepatocellular carcinoma (HCC).

Major finding: Median PIVKA-II serum levels were significantly higher in patients with hepatocellular carcinoma (181.50 mAU/mL) vs patients with benign (noncancerous) liver disease (28.60 mAU/mL) or healthy controls (21.82 mAU/mL; both P less than .0001). When comparing HCC patients and healthy controls, PIVKA-II was markedly more sensitive than AFP (83.9% vs 64.3%, respectively), and somewhat more specific (91.5% vs 84.7%). Compared with measuring AFP alone, measuring both PIVKA-II and AFP demonstrated much greater sensitivity (81.95%) and slightly greater specificity (89.3%).

Study details: The researchers used enzyme-linked immunosorbent assays (ELISA) to measure serum PIVKA-II levels in 168 patients with HCC, 150 patients with benign liver disease, and 153 healthy controls.

Disclosures: Funding sources were described as inapplicable. The researchers reported having no conflicts of interest.

Source: Feng H et al. BMC Cancer. 2021 Apr 13. doi: 10.1186/s12885-021-08138-3

Key clinical point: Increased levels of prothrombin induced by vitamin K deficiency or antagonist- II (PIVKA-II) identified patients with hepatocellular carcinoma (HCC).

Major finding: Median PIVKA-II serum levels were significantly higher in patients with hepatocellular carcinoma (181.50 mAU/mL) vs patients with benign (noncancerous) liver disease (28.60 mAU/mL) or healthy controls (21.82 mAU/mL; both P less than .0001). When comparing HCC patients and healthy controls, PIVKA-II was markedly more sensitive than AFP (83.9% vs 64.3%, respectively), and somewhat more specific (91.5% vs 84.7%). Compared with measuring AFP alone, measuring both PIVKA-II and AFP demonstrated much greater sensitivity (81.95%) and slightly greater specificity (89.3%).

Study details: The researchers used enzyme-linked immunosorbent assays (ELISA) to measure serum PIVKA-II levels in 168 patients with HCC, 150 patients with benign liver disease, and 153 healthy controls.

Disclosures: Funding sources were described as inapplicable. The researchers reported having no conflicts of interest.

Source: Feng H et al. BMC Cancer. 2021 Apr 13. doi: 10.1186/s12885-021-08138-3

Key clinical point: Increased levels of prothrombin induced by vitamin K deficiency or antagonist- II (PIVKA-II) identified patients with hepatocellular carcinoma (HCC).

Major finding: Median PIVKA-II serum levels were significantly higher in patients with hepatocellular carcinoma (181.50 mAU/mL) vs patients with benign (noncancerous) liver disease (28.60 mAU/mL) or healthy controls (21.82 mAU/mL; both P less than .0001). When comparing HCC patients and healthy controls, PIVKA-II was markedly more sensitive than AFP (83.9% vs 64.3%, respectively), and somewhat more specific (91.5% vs 84.7%). Compared with measuring AFP alone, measuring both PIVKA-II and AFP demonstrated much greater sensitivity (81.95%) and slightly greater specificity (89.3%).

Study details: The researchers used enzyme-linked immunosorbent assays (ELISA) to measure serum PIVKA-II levels in 168 patients with HCC, 150 patients with benign liver disease, and 153 healthy controls.

Disclosures: Funding sources were described as inapplicable. The researchers reported having no conflicts of interest.

Source: Feng H et al. BMC Cancer. 2021 Apr 13. doi: 10.1186/s12885-021-08138-3

Key clinical point: Spleen stiffness, a measure of portal hypertension, was a risk factor for hepatocellular carcinoma (HCC) among patients with advanced liver disease whose chronic hepatitis C virus infection (HCV) was successfully treated with direct-acting antivirals (DAA).

Major finding: The incidence of HCC was 14% over a median of 41.5 months of follow-up. Six months after successful DAA treatment, spleen stiffness greater than 42 kPa was associated with a small but statistically significant increase in risk for HCC (hazard ratio, 1.025). Among patients whose liver stiffness exceeded 10 kPa, increased spleen stiffness was a risk factor for HCC, but any additional increase in liver stiffness (10-20 kPa vs >20 kPa) was not.

Study details: This was a single-center retrospective study of 140 patients with advanced chronic liver disease whose HCV was successfully treated with DAA. Liver and spleen stiffness were measured at baseline and 6 months after end of treatment.

Disclosures: The researchers reported receiving no funding for the study and stated that they had no conflicts of interest.

Source: Dajti E et al. JHEP Rep. 2021 Apr 14. doi: 10.1016/j.jhepr.2021.100289

Key clinical point: Spleen stiffness, a measure of portal hypertension, was a risk factor for hepatocellular carcinoma (HCC) among patients with advanced liver disease whose chronic hepatitis C virus infection (HCV) was successfully treated with direct-acting antivirals (DAA).

Major finding: The incidence of HCC was 14% over a median of 41.5 months of follow-up. Six months after successful DAA treatment, spleen stiffness greater than 42 kPa was associated with a small but statistically significant increase in risk for HCC (hazard ratio, 1.025). Among patients whose liver stiffness exceeded 10 kPa, increased spleen stiffness was a risk factor for HCC, but any additional increase in liver stiffness (10-20 kPa vs >20 kPa) was not.

Study details: This was a single-center retrospective study of 140 patients with advanced chronic liver disease whose HCV was successfully treated with DAA. Liver and spleen stiffness were measured at baseline and 6 months after end of treatment.

Disclosures: The researchers reported receiving no funding for the study and stated that they had no conflicts of interest.

Source: Dajti E et al. JHEP Rep. 2021 Apr 14. doi: 10.1016/j.jhepr.2021.100289

Key clinical point: Spleen stiffness, a measure of portal hypertension, was a risk factor for hepatocellular carcinoma (HCC) among patients with advanced liver disease whose chronic hepatitis C virus infection (HCV) was successfully treated with direct-acting antivirals (DAA).

Major finding: The incidence of HCC was 14% over a median of 41.5 months of follow-up. Six months after successful DAA treatment, spleen stiffness greater than 42 kPa was associated with a small but statistically significant increase in risk for HCC (hazard ratio, 1.025). Among patients whose liver stiffness exceeded 10 kPa, increased spleen stiffness was a risk factor for HCC, but any additional increase in liver stiffness (10-20 kPa vs >20 kPa) was not.

Study details: This was a single-center retrospective study of 140 patients with advanced chronic liver disease whose HCV was successfully treated with DAA. Liver and spleen stiffness were measured at baseline and 6 months after end of treatment.

Disclosures: The researchers reported receiving no funding for the study and stated that they had no conflicts of interest.

Source: Dajti E et al. JHEP Rep. 2021 Apr 14. doi: 10.1016/j.jhepr.2021.100289

Key clinical point: Consider testing for hepatitis D virus in patients receiving nucleoside/nucleotide analogues (NA) for chronic hepatitis B virus infection (HBV).

Major finding: Prevalences of anti-HDV and HDV RNA positivity were 2.3% and 1.0%, respectively. Five-year cumulative rates of hepatocellular carcinoma (HCC) were 22.2% among patients with detectable HDV RNA vs 7.3% among patients with undetectable HDV RNA (P = .01).

Study details: This was a single-center retrospective study of 1,349 patients receiving NA for chronic HBV.

Disclosures: The Center for Liquid Biopsy, Center for Cancer Research, Cohort Research Center, Kaohsiung Medical University, and Kaohsiung Medical University Hospital provided funding. Two coinvestigators disclosed ties to Abbott, BMS, Gilead, Merck, AbbVie, Roche, and IPSEN. The other investigators reported having no conflicts of interest.

Source: Jang T-Y et al. Sci Rep. 2021 Apr 14. doi: 10.1038/s41598-021-87679-w

Key clinical point: Consider testing for hepatitis D virus in patients receiving nucleoside/nucleotide analogues (NA) for chronic hepatitis B virus infection (HBV).

Major finding: Prevalences of anti-HDV and HDV RNA positivity were 2.3% and 1.0%, respectively. Five-year cumulative rates of hepatocellular carcinoma (HCC) were 22.2% among patients with detectable HDV RNA vs 7.3% among patients with undetectable HDV RNA (P = .01).

Study details: This was a single-center retrospective study of 1,349 patients receiving NA for chronic HBV.

Disclosures: The Center for Liquid Biopsy, Center for Cancer Research, Cohort Research Center, Kaohsiung Medical University, and Kaohsiung Medical University Hospital provided funding. Two coinvestigators disclosed ties to Abbott, BMS, Gilead, Merck, AbbVie, Roche, and IPSEN. The other investigators reported having no conflicts of interest.

Source: Jang T-Y et al. Sci Rep. 2021 Apr 14. doi: 10.1038/s41598-021-87679-w

Key clinical point: Consider testing for hepatitis D virus in patients receiving nucleoside/nucleotide analogues (NA) for chronic hepatitis B virus infection (HBV).

Major finding: Prevalences of anti-HDV and HDV RNA positivity were 2.3% and 1.0%, respectively. Five-year cumulative rates of hepatocellular carcinoma (HCC) were 22.2% among patients with detectable HDV RNA vs 7.3% among patients with undetectable HDV RNA (P = .01).

Study details: This was a single-center retrospective study of 1,349 patients receiving NA for chronic HBV.

Disclosures: The Center for Liquid Biopsy, Center for Cancer Research, Cohort Research Center, Kaohsiung Medical University, and Kaohsiung Medical University Hospital provided funding. Two coinvestigators disclosed ties to Abbott, BMS, Gilead, Merck, AbbVie, Roche, and IPSEN. The other investigators reported having no conflicts of interest.

Source: Jang T-Y et al. Sci Rep. 2021 Apr 14. doi: 10.1038/s41598-021-87679-w