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Prognosis cirrhosis

Katharine Margaret Irvine, Isanka Ratnasekera, Elizabeth E Powell, David Arthur Hume
Liver cirrhosis is an increasing health burden and public health concern. Regardless of etiology, patients with cirrhosis are at risk of a range of life-threatening complications, including the development of infections, which are associated with high morbidity and mortality and frequent hospital admissions. The term Cirrhosis-Associated Immune Dysfunction (CAID) refers to a dynamic spectrum of immunological perturbations that develop in patients with cirrhosis, which are intimately linked to the underlying liver disease, and negatively correlated with prognosis...
2019: Frontiers in Immunology
Katiuscha Merath, Rittal Mehta, J Madison Hyer, Fabio Bagante, Kota Sahara, Sorin Alexandrescu, Hugo P Marques, Luca Aldrighetti, Shishir K Maithel, Carlo Pulitano, Matthew J Weiss, Todd W Bauer, Feng Shen, George A Poultsides, Olivier Soubrane, Guillaume Martel, B Groot Koerkamp, Alfredo Guglielmi, Endo Itaru, Aslam Ejaz, Timothy M Pawlik
BACKGROUND: The association between body mass index (BMI) and long-term outcomes of patients with ICC has not been well defined. We sought to define the presentation and oncologic outcomes of patients with ICC undergoing curative-intent resection, according to their BMI category. METHODS: Patients who underwent resection of ICC were identified in a multi-institutional database. Patients were categorized as normal weight (BMI 18.5-24.9 kg/m2 ), overweight (BMI 25...
March 7, 2019: European Journal of Surgical Oncology
Naomi Lange, Jean-François Dufour
The prognosis of patients with hepatocellular carcinoma is dependent on the stage of tumor at diagnosis. The earlier the tumor is found, the higher the chances to offer a curative treatment. In order to diagnose hepatocellular carcinoma early, patients at risk should be enrolled in a surveillance program. The population at risk is usually defined as patients with cirrhosis. These patients should have twice a year a ultrasonographic examination of the liver. However, more and more patients will develop hepatocellular carcinoma in the context of nonalcoholic fatty liver disease which is tightly linked to obesity and diabetes...
March 12, 2019: Digestive Diseases and Sciences
Yingzhen N Zhang, Kathryn J Fowler, Arinc Ozturk, Chetan K Potu, Ashley L Louie, Vivian Montes, Walter C Henderson, Kang Wang, Michael P Andre, Anthony E Samir, Claude B Sirlin
Liver fibrosis is a histological hallmark of most chronic liver diseases, which can progress to cirrhosis and liver failure, and predisposes to hepatocellular carcinoma. Accurate diagnosis of liver fibrosis is necessary for prognosis, risk stratification, and treatment decision-making. Liver biopsy, the reference standard for assessing liver fibrosis, is invasive, costly, and impractical for surveillance and treatment response monitoring. Elastography offers a noninvasive, objective, and quantitative alternative to liver biopsy...
March 12, 2019: Journal of Magnetic Resonance Imaging: JMRI
Feifei Lei, Xu Lei, Rugui Li, Huabing Tan
Prognostic significance of serum microcystin in hepatocellular carcinoma has not been well investigated. The aim of the study was to reveal the relationship between serum microcystin-LR and prognosis in these patients. There were 650 early-stage hepatitis B-induced hepatocellular carcinoma patients, who were not affected by hepatitis C, cirrhosis, heavy drinking or excessive aflatoxin exposure. All of them underwent hepatectomy and were followed up for 5 years. Tumor relapse and overall death were recorded...
March 12, 2019: Clinical and Experimental Medicine
Carlos Noronha Ferreira, Daniela Reis, Helena Cortez-Pinto, Rui Tato Marinho, Afonso Gonçalves, Sónia Palma, Inês Leite, Tiago Rodrigues, Ana Júlia Pedro, Paula Alexandrino, Fátima Serejo, Margarida Sobral Dias, Paula Ferreira, Mariana Vasconcelos, Filipe Damião, Leonor Xavier Brito, Cilenia Baldaia, Narcisa Fatela, Fernando Ramalho, José Velosa
BACKGROUND: The role of portal vein thrombosis (PVT) in the natural history of cirrhosis is controversial. AIMS: We analyzed the safety and effect of anticoagulant therapy (AT) on PVT recanalization and orthotopic liver transplant (OLT)-free survival. METHODS: Eighty consecutive patients from a prospective registry of cirrhosis and non-tumoral PVT at a tertiary center were analyzed. AT effect on PVT recanalization and OLT-free survival was determined by time-dependent Cox regression analysis...
March 9, 2019: Digestive Diseases and Sciences
Gerda Elisabeth Villadsen, Kira Simonsen, Peter Ott, Hendrik Vilstrup, Henning Grønbæk
BACKGROUND AND AIMS: In 2009, the Danish Government instituted "Fast Track Clinical Pathways" (FTCP) to accelerate diagnosis and treatment of cancers including hepatocellular carcinoma (HCC). We examined how the implementation of FTCP affected the time from referral to diagnosis and treatment as well as the patient survival. METHODS: 309 consecutive patients with suspected HCC were included, 79 referred during the period 2007-2008 (before FTCP) and 230 during 2009-2011...
March 2019: Journal of Gastrointestinal and Liver Diseases: JGLD
Ke-Lei Zhu, Xiu-Jun Cai
BACKGROUND: Primary hepatic leiomyosarcoma is rare and reported sporadically, with less than 40 such cases have been reported in the English-language literature. Although it is reported to be associated with acquired immune deficiency syndrome, Epstein-Barr virus infection, Hodgkin's lymphoma, immunosuppression after organ transplantation, and hepatitis C virus-related liver cirrhosis, the precise steps leading to leiomyosarcoma have not been fully identified. Therapeutic strategies include liver wedge resection or lobectomy, chemotherapy, radiotherapy and liver transplantation; however, the prognosis of primary hepatic leiomyosarcoma is dismal...
February 26, 2019: World Journal of Clinical Cases
Jonggi Choi, Gwang Hyeon Choi, Danbi Lee, Ju Hyun Shim, Young-Suk Lim, Han Chu Lee, Young-Hwa Chung, Yung-Sang Lee, Kang Mo Kim
BACKGROUND & AIMS: As surrogate markers for autoimmune hepatitis (AIH), serum alanine aminotransferase (ALT) and immunoglobulin G (IgG) are convenient to measure under immunosuppression. However, the long-term prognosis of patients who achieve complete biochemical remission (CBR) in comparison with patients who achieve only biochemical remission (BR) is uncertain. METHODS: A total of 291 patients (89.7% female) diagnosed with AIH were retrospectively reviewed...
February 28, 2019: Liver International: Official Journal of the International Association for the Study of the Liver
Xiufeng Liu, Shukui Qin
Hepatocellular carcinoma (HCC) is the most common malignancy worldwide, and is especially common in China. A total of 70%-80% of patients are diagnosed at an advanced stage and can receive only palliative care. Sorafenib has been the standard of care for a decade, and promising results for regorafenib as a second-line and lenvatinib as a first-line treatment were reported only 1 or 2 years ago. FOLFOX4 was recently recommended as a clinical practice guideline by the China Food and Drug Administration. All approved systemic therapies remain unsatisfactory, with limited objective response rates and poor overall survival...
February 2019: Oncologist
Takahiko Sakaue, Hironori Koga, Hideki Iwamoto, Toru Nakamura, Yu Ikezono, Mitsuhiko Abe, Fumitaka Wada, Atsutaka Masuda, Toshimitsu Tanaka, Masaru Fukahori, Tomoyuki Ushijima, Yuutarou Mihara, Yoshiki Naitou, Yoshinobu Okabe, Tatsuyuki Kakuma, Keisuke Ohta, Kei-Ichiro Nakamura, Takuji Torimura
Cancer cells surviving in ascites exhibit cancer stem cell (CSC)-like features. This study analyzed the expression of the CSC marker CD133 in the ascites-derived exosomes obtained from patients with unresectable pancreatic cancer. In addition, inverse correlation of CD133 expression with prognosis was examined. Of the 133 consecutive patients, 19 patients were enrolled in the study. Exosomes derived from the malignant ascites demonstrated higher density and wider variation in size than those from non-malignant ascites...
February 25, 2019: Medical Molecular Morphology
Camila Alvarez-Silva, Robert Schierwagen, Alessandra Pohlmann, Fernando Magdaleno, Frank E Uschner, Patrick Ryan, Maria J G T Vehreschild, Joan Claria, Eicke Latz, Benjamin Lelouvier, Manimozhiyan Arumugam, Jonel Trebicka
Background: Acquired dysfunctional immunity in cirrhosis predisposes patients to frequent bacterial infections, especially spontaneous bacterial peritonitis (SBP), leading to systemic inflammation that is associated with poor outcome. But systemic inflammation can also be found in the absence of a confirmed infection. Detection of bacterial DNA has been investigated as a marker of SBP and as a predictor of prognosis. Data is, however, contradictory. Here we investigated whether levels of IL-6 and IL-8 putatively produced by myeloid cells in ascites are associated with systemic inflammation and whether inflammation depends on the presence of specific bacterial DNA...
2019: Frontiers in Immunology
Hong Zhao, Ruihong Zhao, Jianhua Hu, Xuan Zhang, Jianke Ma, Yemin Shi, Weihang Ma, Jifang Sheng, Lanjuan Li
BACKGROUND: Upper gastrointestinal hemorrhage (UGH) is a life-threatening complication in patients with cirrhosis; however, data regarding the role of UGH in acute-on-chronic liver failure (ACLF) are limited. METHODS: A prospective, observational cohort study was performed from February 2014 to Mach 2015. RESULTS: UGH was identified in 170 of 492 cirrhotic patients with acute decompensation (AD) at the time of admission. Logistic regression analysis showed that fecal occult blood test positivity was an independent risk factor for UGH in patients with or without ACLF [OR(95%CI): 8...
March 2019: Expert Review of Gastroenterology & Hepatology
Leon A Adams
Non-alcoholic steatohepatitis (NASH) is an increasingly common cause of cirrhosis, hepatocellular carcinoma, and liver-related death (LRD). Consequently, there is a critical need for effective drug therapy that improves clinically relevant end-points. Hepatic steatosis assessed by magnetic resonance imaging-proton density fat fraction is increasingly used in the early phase trials examining drugs with anti-steatotic effects. However, the prognostic significance of a reduction in steatosis is unknown, and thus, phase 3 trials require a histological end-point of NASH resolution without fibrosis progression...
February 19, 2019: Hepatology International
Jing Jing, Rui-Lin Wang, Xin-Yan Zhao, Yun Zhu, Ming Niu, Li-Fu Wang, Xue-Ai Song, Ting-Ting He, Yong-Qiang Sun, Wen-Tao Xu, Si-Miao Yu, Li-Ping Wang, Yu-Ming Guo, Zhao-Fang Bai, Xiao-He Xiao, Jia-Bo Wang
OBJECTIVES: The present study aimed to evaluate the association between the concurrence of pre-existing chronic liver diseases (CLD) and worse prognosis in patients with HILI. DESIGN: A case-control study. SETTING: Tertiary hospital specialising in liver diseases in China. PARTICIPANTS: 145 hospitalised HILI patients were assessed with respect to prognosis by comparing HILI with or without pre-existing CLD from February 2007 to January 2017...
January 15, 2019: BMJ Open
Lamia H Ali, Aliaa M Higazi, Hend M Moness, Naglaa M Farag, Zienab M Saad, Hamdy A Moukareb, Wael Soliman, Ghada El Sagheer, Sahar R Abd El Hamid, Haytham Abdl Hamid
Background: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. It has been widely established that the early detection of HCC enables more treatment options with improvements in prognosis and survival. Objectives: The aim of this study was to assess the diagnostic accuracy of both circulating miR-215 and squamous cell carcinoma antigen-IgM (SCCA-IgM) as serum biomarkers for HCC by examining their diagnostic sensitivity, specificity, accuracy, and predictive values in hepatitis C virus (HCV)-induced HCC patients...
2019: Clinical and Experimental Gastroenterology
Dong Kyun Kim, Bo Ra Kim, Jin Sook Jeong, Yang Hyun Baek
BACKGROUND: Intrahepatic sarcomatoid chonalgiocarcinoma (s-CCC) is an extremely rare disease, accounting for less than 1% of hepatobiliary system malignancies, and its pathophysiology is not well known. On the hypothesis that its clinical, serologic, or radiologic diagnosis are not fully understood and its prognosis is poor, we investigated the distinguishing features of s-CCC compared with those of intrahepatic bile duct adenocarcinoma [cholangiocellular carcinoma (CCC)] in patients from a single center...
February 7, 2019: World Journal of Gastroenterology: WJG
Charlotte Alexandra Woodhouse, Vishal C Patel, Simon Goldenberg, Alberto Sanchez-Fueyo, Louise China, Alastair O'Brien, Clare Flach, Abdel Douiri, Debbie Shawcross
INTRODUCTION: Patients with advanced cirrhosis have enteric bacterial dysbiosis and translocation of bacteria and their products across the gut epithelial barrier. This culminates in systemic inflammation and endotoxaemia, inducing innate immune dysfunction which predisposes to infection, and development of complications such as bleeding, sepsis and hepatic encephalopathy. This feasibility study aims to assess the safety of administering faecal microbiota transplantion to patients with cirrhosis and explore the effect of the intervention on their prognosis by achieving restoration of a healthy gut microbiome...
February 15, 2019: BMJ Open
Mariana Ferreira Cardoso, Gonçalo Alexandrino, Joana Carvalho E Branco, Vera Anapaz, Rita Carvalho, David Horta, Alexandra Martins
INTRODUCTION: Acute-on-chronic liver failure (ACLF) is a dynamic syndrome that should be assessed repeatedly. An algorithm for risk stratification in decompensated cirrhosis was recently proposed by the EASL-CLIF (European Association for the Study of the Liver-Chronic Liver Failure) Consortium. AIM: To validate the EASL-CLIF Consortium scores in patients with and without ACLF. MATERIALS AND METHODS: Retrospective single-center cohort study including patients admitted for acute decompensation of cirrhosis between January 2014 and December 2015, and followed-up until December 2016...
February 13, 2019: Gastroenterología y Hepatología
Jian Wang, Zhaoping Zhang, Xiaomin Yan, Ming Li, Juan Xia, Yong Liu, Yuxin Chen, Bei Jia, Li Zhu, Chuanwu Zhu, Rui Huang, Chao Wu
BACKGROUND: The Albumin-Bilirubin (ALBI) score was developed to predict the long-term prognosis of hepatocellular carcinoma patients. We aimed to investigate the performance of ALBI for predicting severity and long-term prognosis of chronic hepatitis B-related liver cirrhosis (CHB-LC). METHODS: CHB-LC patients were enrolled from two medical centers between 2011 and 2017. The prognostic performance of ALBI was evaluated and compared with Child-Turcotte-Pugh (CTP), model of end-stage liver disease (MELD) and MELD integrating sodium (MELD-Na) scores...
January 26, 2019: Digestive and Liver Disease
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