Liver resection for intermediate hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is one of the most common malignant tumors in China. The Barcelona Clinic Liver Cancer(BCLC) staging system is regarded as the gold standard staging system for HCC, classifying HCC as early, intermediate, or advanced. For intermediate HCC, trans-catheter arterial chemoembolization(TACE) is recommended as the optimal strategy by the BCLC guideline. This review investigates whether liver resection is better than TACE for intermediate HCC. Based on published studies, we compare the survival benefits and complications of liver resection and TACE for intermediate HCC. We also compare the survival benefits of liver resection in early and intermediate HCC. We find that liver resection can achieve better or at least comparable survival outcomes compared with TACE for intermediate HCC; however, we do not observe a significant difference between liver resection and TACE in terms of safety and morbidity. We conclude that liver resection may improve the short- and long-term survival of carefully selected intermediate HCC patients, and the procedure may be safely performed in the management of intermediate HCC.

Role of microRNA in liver regeneration

BACKGROUND： Liver regeneration is a complex process. micro RNAs（mi RNAs） are short, single-stranded RNAs that modify gene expression at the post-transcriptional level. Recent investigations have revealed that mi RNAs are closely linked to liver regeneration.DATA SOURCES： All included studies were obtained from Pub Med, Embase, the Science Direct databases and Web of Science, with no limitation on publication year. Only studies published in English were considered.RESULTS： We grouped studies that involved mi RNA and liver regeneration into two groups： mi RNAs as promoters and as inhibitors of liver regeneration. We summarized the relevant mi RNAs separately from the related pathways.CONCLUSIONS： Blocking or stimulating the pathways of mi RNAs in liver regeneration may be novel therapeutic strategies in future regeneration-related liver managements. We may discover additional chemotherapy targets of mi RNA.

Clinical value of artificial intelligence in hepatocellular carcinoma: Current status and prospect

Hepatocellular carcinoma(HCC)is the most commonly diagnosed type of liver cancer and the fourth leading cause of cancer-related mortality worldwide.The early identification of HCC and effective treatments for it have been challenging.Due to the sufficient compensatory ability of early patients and its nonspecific symptoms,HCC is more likely to escape diagnosis in the incipient stage,during which patients can achieve a more satisfying overall survival if they undergo resection or liver transplantation.Patients at advanced stages can profit from radical therapies in a limited way.In order to improve the unfavorable prognosis of HCC,diagnostic ability and treatment efficiency must be improved.The past decade has seen rapid advancements in artificial intelligence,underlying its unique usefulness in almost every field,including that of medicine.Herein,we sought and reviewed studies that put emphasis on artificial intelligence and HCC.

Evolution and current status of the subclassification of intermediate hepatocellular carcinoma

The staging and treatment of intermediate hepatocellular carcinoma(HCC)remains controversial.According to the recommendations of Barcelona Clinic Liver Cancer staging system,patients with intermediate HCC are candidates for transcatheter arterial chemoembolization.However,not all patients with intermediate HCC benefit from transcatheter arterial chemoembolization.Therefore,it is meaningful to propose a novel staging system of intermediate HCC in order to allocate different treatments for different subgroups.Bolondi et al proposed the first subclassification system of intermediate HCC.Subsequently,investigators performed studies to validate the feasibility of Bolondi’s criteria and proposed several novel staging systems.The present study reviewed the literatures and provided a general overview of the evolution and current status of the subclassification of intermediate HCC.We propose to expand the indication of liver resection and add radical treatments as the first option of the treatment for patients with intermediate HCC.