Hepatocellular Carcinoma

Key clinical point: The pediatric hepatocellular carcinoma (HCC) subtypes fibrolamellar carcinoma (FLC) and conventional HCC (cHCC) can be considered nonequivalent entities because they show different anatomic patterns and outcomes together with their known molecular differences.

Major finding: HCC subtypes were significantly different in presentation and behavior, with increased lymph node involvement in FLC and higher stage in cHCC. Multivariate analysis revealed increased mortality in cHCC compared with that in FLC (adjusted hazard ratio 2.2; P = .004).

Study details: These findings are from a multicenter, retrospective review study including 262 patients <20 years of age with hepatocellular neoplasms, including cHCC (n = 110), FLC (n = 119), and tumors with mixed features of HCC and hepatoblastoma (n = 33).

Disclosures: The study was supported by the University of Utah Population Health Research Foundation and National Center for Advancing Translational Sciences of the US National Institutes of Health. Some authors reported receiving research grants or travel support from various sources.

Source: Short SS et al. Histologic type predicts disparate outcomes in pediatric hepatocellular neoplasms: A Pediatric Surgical Oncology Research Collaborative study. Cancer. 2022 (May 13). Doi: 10.1002/cncr.34256

Key clinical point: The pediatric hepatocellular carcinoma (HCC) subtypes fibrolamellar carcinoma (FLC) and conventional HCC (cHCC) can be considered nonequivalent entities because they show different anatomic patterns and outcomes together with their known molecular differences.

Major finding: HCC subtypes were significantly different in presentation and behavior, with increased lymph node involvement in FLC and higher stage in cHCC. Multivariate analysis revealed increased mortality in cHCC compared with that in FLC (adjusted hazard ratio 2.2; P = .004).

Study details: These findings are from a multicenter, retrospective review study including 262 patients <20 years of age with hepatocellular neoplasms, including cHCC (n = 110), FLC (n = 119), and tumors with mixed features of HCC and hepatoblastoma (n = 33).

Disclosures: The study was supported by the University of Utah Population Health Research Foundation and National Center for Advancing Translational Sciences of the US National Institutes of Health. Some authors reported receiving research grants or travel support from various sources.

Source: Short SS et al. Histologic type predicts disparate outcomes in pediatric hepatocellular neoplasms: A Pediatric Surgical Oncology Research Collaborative study. Cancer. 2022 (May 13). Doi: 10.1002/cncr.34256

Key clinical point: The pediatric hepatocellular carcinoma (HCC) subtypes fibrolamellar carcinoma (FLC) and conventional HCC (cHCC) can be considered nonequivalent entities because they show different anatomic patterns and outcomes together with their known molecular differences.

Major finding: HCC subtypes were significantly different in presentation and behavior, with increased lymph node involvement in FLC and higher stage in cHCC. Multivariate analysis revealed increased mortality in cHCC compared with that in FLC (adjusted hazard ratio 2.2; P = .004).

Study details: These findings are from a multicenter, retrospective review study including 262 patients <20 years of age with hepatocellular neoplasms, including cHCC (n = 110), FLC (n = 119), and tumors with mixed features of HCC and hepatoblastoma (n = 33).

Disclosures: The study was supported by the University of Utah Population Health Research Foundation and National Center for Advancing Translational Sciences of the US National Institutes of Health. Some authors reported receiving research grants or travel support from various sources.

Source: Short SS et al. Histologic type predicts disparate outcomes in pediatric hepatocellular neoplasms: A Pediatric Surgical Oncology Research Collaborative study. Cancer. 2022 (May 13). Doi: 10.1002/cncr.34256

Key clinical point: Radiation segmentectomy shows high efficacy with a low high-grade adverse event rate in patients with unresectable very early- to early-stage hepatocellular carcinoma (HCC) at unfavorable locations for ablation.

Major finding: Initial target lesion complete and partial response rates were 83% and 17%, respectively, whereas the initial objective and sustained complete response rates were 100% and 90%, respectively. Grade 3 leukopenia and thrombocytopenia were observed in 14% and 7% of patients, respectively, whereas no grade 4 events were observed.

Study details: Findings are from a prospective, single-center study, RASER, that included 29 adult patients with unresectable, solitary, very early- to early-stage HCC (diameter ≤ 3 cm) at a location unsuitable for ablation and no metastasis or macrovascular invasion.

Disclosures: The study was sponsored by Boston Scientific. Some authors declared being on the medical advisory board of or receiving grant support or consulting fees from various sources, including Boston Scientific.

Source: Kim E et al. Radiation segmentectomy for curative intent of unresectable very early to early stage hepatocellular carcinoma (RASER): a single-centre, single-arm study. Lancet Gastroenterol Hepatol. 2022 (May 23). Doi: 10.1016/S2468-1253(22)00091-7

Key clinical point: Radiation segmentectomy shows high efficacy with a low high-grade adverse event rate in patients with unresectable very early- to early-stage hepatocellular carcinoma (HCC) at unfavorable locations for ablation.

Major finding: Initial target lesion complete and partial response rates were 83% and 17%, respectively, whereas the initial objective and sustained complete response rates were 100% and 90%, respectively. Grade 3 leukopenia and thrombocytopenia were observed in 14% and 7% of patients, respectively, whereas no grade 4 events were observed.

Study details: Findings are from a prospective, single-center study, RASER, that included 29 adult patients with unresectable, solitary, very early- to early-stage HCC (diameter ≤ 3 cm) at a location unsuitable for ablation and no metastasis or macrovascular invasion.

Disclosures: The study was sponsored by Boston Scientific. Some authors declared being on the medical advisory board of or receiving grant support or consulting fees from various sources, including Boston Scientific.

Source: Kim E et al. Radiation segmentectomy for curative intent of unresectable very early to early stage hepatocellular carcinoma (RASER): a single-centre, single-arm study. Lancet Gastroenterol Hepatol. 2022 (May 23). Doi: 10.1016/S2468-1253(22)00091-7

Key clinical point: Radiation segmentectomy shows high efficacy with a low high-grade adverse event rate in patients with unresectable very early- to early-stage hepatocellular carcinoma (HCC) at unfavorable locations for ablation.

Major finding: Initial target lesion complete and partial response rates were 83% and 17%, respectively, whereas the initial objective and sustained complete response rates were 100% and 90%, respectively. Grade 3 leukopenia and thrombocytopenia were observed in 14% and 7% of patients, respectively, whereas no grade 4 events were observed.

Study details: Findings are from a prospective, single-center study, RASER, that included 29 adult patients with unresectable, solitary, very early- to early-stage HCC (diameter ≤ 3 cm) at a location unsuitable for ablation and no metastasis or macrovascular invasion.

Disclosures: The study was sponsored by Boston Scientific. Some authors declared being on the medical advisory board of or receiving grant support or consulting fees from various sources, including Boston Scientific.

Source: Kim E et al. Radiation segmentectomy for curative intent of unresectable very early to early stage hepatocellular carcinoma (RASER): a single-centre, single-arm study. Lancet Gastroenterol Hepatol. 2022 (May 23). Doi: 10.1016/S2468-1253(22)00091-7

Key clinical point: Stereotactic body radiotherapy (SBRT) plus transcatheter arterial chemoembolization (TACE) may be safe and more effective than either of the procedures alone (monotherapy) for treating inoperable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

Major finding: SBRT plus TACE vs. monotherapy led to significantly higher overall survival (1-year: risk ratio [RR] 1.52; 95% CI 1.33-1.74; 2-year: RR 2.00; 95% CI 1.48-2.70) and objective response (RR 1.22; 95% CI 1.08-1.37) rates, a significantly lower disease progression rate (RR 0.45; 95% CI 0.26-0.79), and a similar adverse event incidence (RR 1.03; 95% CI 0.82-1.31).

Study details: This was a meta-analysis of nine studies involving 938 patients with inoperable HCC and PVTT who received SBRT plus TACE (n = 455) or monotherapy (n = 483).

Disclosures: The study was sponsored by Chinese Medical Hand in Hand Project Committee & Beijing Medical Award Foundation, among others. The authors declared no conflicts of interest.

Source: Zhang X-F et al. Stereotactic body radiotherapy plus transcatheter arterial chemoembolization for inoperable hepatocellular carcinoma patients with portal vein tumour thrombus: A meta-analysis. PLoS One. 2022;17(5): e0268779 (May 20). Doi: 10.1371/journal.pone.0268779

Key clinical point: Stereotactic body radiotherapy (SBRT) plus transcatheter arterial chemoembolization (TACE) may be safe and more effective than either of the procedures alone (monotherapy) for treating inoperable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

Major finding: SBRT plus TACE vs. monotherapy led to significantly higher overall survival (1-year: risk ratio [RR] 1.52; 95% CI 1.33-1.74; 2-year: RR 2.00; 95% CI 1.48-2.70) and objective response (RR 1.22; 95% CI 1.08-1.37) rates, a significantly lower disease progression rate (RR 0.45; 95% CI 0.26-0.79), and a similar adverse event incidence (RR 1.03; 95% CI 0.82-1.31).

Study details: This was a meta-analysis of nine studies involving 938 patients with inoperable HCC and PVTT who received SBRT plus TACE (n = 455) or monotherapy (n = 483).

Disclosures: The study was sponsored by Chinese Medical Hand in Hand Project Committee & Beijing Medical Award Foundation, among others. The authors declared no conflicts of interest.

Source: Zhang X-F et al. Stereotactic body radiotherapy plus transcatheter arterial chemoembolization for inoperable hepatocellular carcinoma patients with portal vein tumour thrombus: A meta-analysis. PLoS One. 2022;17(5): e0268779 (May 20). Doi: 10.1371/journal.pone.0268779

Key clinical point: Stereotactic body radiotherapy (SBRT) plus transcatheter arterial chemoembolization (TACE) may be safe and more effective than either of the procedures alone (monotherapy) for treating inoperable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

Major finding: SBRT plus TACE vs. monotherapy led to significantly higher overall survival (1-year: risk ratio [RR] 1.52; 95% CI 1.33-1.74; 2-year: RR 2.00; 95% CI 1.48-2.70) and objective response (RR 1.22; 95% CI 1.08-1.37) rates, a significantly lower disease progression rate (RR 0.45; 95% CI 0.26-0.79), and a similar adverse event incidence (RR 1.03; 95% CI 0.82-1.31).

Study details: This was a meta-analysis of nine studies involving 938 patients with inoperable HCC and PVTT who received SBRT plus TACE (n = 455) or monotherapy (n = 483).

Disclosures: The study was sponsored by Chinese Medical Hand in Hand Project Committee & Beijing Medical Award Foundation, among others. The authors declared no conflicts of interest.

Source: Zhang X-F et al. Stereotactic body radiotherapy plus transcatheter arterial chemoembolization for inoperable hepatocellular carcinoma patients with portal vein tumour thrombus: A meta-analysis. PLoS One. 2022;17(5): e0268779 (May 20). Doi: 10.1371/journal.pone.0268779

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) shows potent therapeutic efficacy against unresectable hepatocellular carcinoma (uHCC) in patients with a good hepatic function, classified as Child-Pugh A (CP-A), but has decreased efficacy in those with CP-B.

Major finding: Patients with CP-A vs. CP-B showed better 6-, 12-, and 18-month progression-free (58.2%, 36.1%, and 27.8% vs. 49.6%, 8.7%, and non-estimable, respectively; P < .001) and overall (89.9%, 71.7%, and 51.4% vs. 63.6%, 18.4%, and non-estimable, respectively; P < .001) survival rates.

Study details: This retrospective study included 457 patients with uHCC and CP-A (n = 427) or CP-B (n = 30) who received Atez/Bev.

Disclosures: This study received no financial support. Some authors declared serving as advisors for and receiving lecture fees or research funds from various sources. Two authors declared serving as editors/editorial board members of Liver Cancer.

Source: Tanaka T et al. Therapeutic efficacy of atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma in patients with Child-Pugh class A or B liver function in real-world clinical practice. Hepatol Res. 2022 (May 28). Doi: 10.1111/hepr.13797

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) shows potent therapeutic efficacy against unresectable hepatocellular carcinoma (uHCC) in patients with a good hepatic function, classified as Child-Pugh A (CP-A), but has decreased efficacy in those with CP-B.

Major finding: Patients with CP-A vs. CP-B showed better 6-, 12-, and 18-month progression-free (58.2%, 36.1%, and 27.8% vs. 49.6%, 8.7%, and non-estimable, respectively; P < .001) and overall (89.9%, 71.7%, and 51.4% vs. 63.6%, 18.4%, and non-estimable, respectively; P < .001) survival rates.

Study details: This retrospective study included 457 patients with uHCC and CP-A (n = 427) or CP-B (n = 30) who received Atez/Bev.

Disclosures: This study received no financial support. Some authors declared serving as advisors for and receiving lecture fees or research funds from various sources. Two authors declared serving as editors/editorial board members of Liver Cancer.

Source: Tanaka T et al. Therapeutic efficacy of atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma in patients with Child-Pugh class A or B liver function in real-world clinical practice. Hepatol Res. 2022 (May 28). Doi: 10.1111/hepr.13797

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) shows potent therapeutic efficacy against unresectable hepatocellular carcinoma (uHCC) in patients with a good hepatic function, classified as Child-Pugh A (CP-A), but has decreased efficacy in those with CP-B.

Major finding: Patients with CP-A vs. CP-B showed better 6-, 12-, and 18-month progression-free (58.2%, 36.1%, and 27.8% vs. 49.6%, 8.7%, and non-estimable, respectively; P < .001) and overall (89.9%, 71.7%, and 51.4% vs. 63.6%, 18.4%, and non-estimable, respectively; P < .001) survival rates.

Study details: This retrospective study included 457 patients with uHCC and CP-A (n = 427) or CP-B (n = 30) who received Atez/Bev.

Disclosures: This study received no financial support. Some authors declared serving as advisors for and receiving lecture fees or research funds from various sources. Two authors declared serving as editors/editorial board members of Liver Cancer.

Source: Tanaka T et al. Therapeutic efficacy of atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma in patients with Child-Pugh class A or B liver function in real-world clinical practice. Hepatol Res. 2022 (May 28). Doi: 10.1111/hepr.13797

Key clinical point: Therapy with atezolizumab plus bevacizumab (Atez/Bev) vs. lenvatinib in the first-line setting may confer a survival benefit in patients with unresectable hepatocellular carcinoma (uHCC).

Major finding: Patients receiving Atez/Bev vs. lenvatinib showed better overall survival (1 year: 67.2% vs. 66.2%; 1.5 years: 58.1% vs. 52.7%; P = .002) and progression-free survival (1 year: 31.6% vs. 20.4%; 1.5 years: non-estimable vs. 11.2%; P < .0001) rates.

Study details: This retrospective study included 251 systemic treatment-naive patients with uHCC who received standard-dose Atez/Bev (n = 194) or lenvatinib (n = 57).

Disclosures: The study did not receive any funding. Some authors declared serving as advisors or receiving lecture fees or research funding from various sources.

Source: Hiraoka A et al. Does first-line treatment have prognostic impact for unresectable HCC?—Atezolizumab plus bevacizumab versus lenvatinib .Cancer Med. 2022 (Jun 3). Doi: 10.1002/cam4.4854

Key clinical point: Therapy with atezolizumab plus bevacizumab (Atez/Bev) vs. lenvatinib in the first-line setting may confer a survival benefit in patients with unresectable hepatocellular carcinoma (uHCC).

Major finding: Patients receiving Atez/Bev vs. lenvatinib showed better overall survival (1 year: 67.2% vs. 66.2%; 1.5 years: 58.1% vs. 52.7%; P = .002) and progression-free survival (1 year: 31.6% vs. 20.4%; 1.5 years: non-estimable vs. 11.2%; P < .0001) rates.

Study details: This retrospective study included 251 systemic treatment-naive patients with uHCC who received standard-dose Atez/Bev (n = 194) or lenvatinib (n = 57).

Disclosures: The study did not receive any funding. Some authors declared serving as advisors or receiving lecture fees or research funding from various sources.

Source: Hiraoka A et al. Does first-line treatment have prognostic impact for unresectable HCC?—Atezolizumab plus bevacizumab versus lenvatinib .Cancer Med. 2022 (Jun 3). Doi: 10.1002/cam4.4854

Key clinical point: Therapy with atezolizumab plus bevacizumab (Atez/Bev) vs. lenvatinib in the first-line setting may confer a survival benefit in patients with unresectable hepatocellular carcinoma (uHCC).

Major finding: Patients receiving Atez/Bev vs. lenvatinib showed better overall survival (1 year: 67.2% vs. 66.2%; 1.5 years: 58.1% vs. 52.7%; P = .002) and progression-free survival (1 year: 31.6% vs. 20.4%; 1.5 years: non-estimable vs. 11.2%; P < .0001) rates.

Study details: This retrospective study included 251 systemic treatment-naive patients with uHCC who received standard-dose Atez/Bev (n = 194) or lenvatinib (n = 57).

Disclosures: The study did not receive any funding. Some authors declared serving as advisors or receiving lecture fees or research funding from various sources.

Source: Hiraoka A et al. Does first-line treatment have prognostic impact for unresectable HCC?—Atezolizumab plus bevacizumab versus lenvatinib .Cancer Med. 2022 (Jun 3). Doi: 10.1002/cam4.4854

Key clinical point: Nivolumab may serve as a first-line systemic treatment option in patients with hepatocellular carcinoma (HCC) and Child-Pugh B (CP-B) cirrhosis.

Major finding: Patients receiving nivolumab vs. sorafenib had a 31% reduced hazard of death (adjusted hazard ratio 0.69; P = .008) and were less likely to discontinue treatment due to toxicity (12% vs. 36%; P = .001).

Study details: The data come from a retrospective real-world cohort study that included patients with HCC and CP-B cirrhosis who received nivolumab (n = 79) or sorafenib (n = 431) as the first-line systemic treatment.

Disclosures: The study was funded by the US National Institutes of Health. Some authors declared serving on the advisory boards of or receiving honoraria or research grants from various sources.

Source: Chapin WJ et al. Comparison of nivolumab and sorafenib for first systemic therapy in patients with hepatocellular carcinoma and Child-Pugh B cirrhosis. Cancer Med. 2022 (Jun 2). Doi:   10.1002/cam4.4906

Key clinical point: Nivolumab may serve as a first-line systemic treatment option in patients with hepatocellular carcinoma (HCC) and Child-Pugh B (CP-B) cirrhosis.

Major finding: Patients receiving nivolumab vs. sorafenib had a 31% reduced hazard of death (adjusted hazard ratio 0.69; P = .008) and were less likely to discontinue treatment due to toxicity (12% vs. 36%; P = .001).

Study details: The data come from a retrospective real-world cohort study that included patients with HCC and CP-B cirrhosis who received nivolumab (n = 79) or sorafenib (n = 431) as the first-line systemic treatment.

Disclosures: The study was funded by the US National Institutes of Health. Some authors declared serving on the advisory boards of or receiving honoraria or research grants from various sources.

Source: Chapin WJ et al. Comparison of nivolumab and sorafenib for first systemic therapy in patients with hepatocellular carcinoma and Child-Pugh B cirrhosis. Cancer Med. 2022 (Jun 2). Doi:   10.1002/cam4.4906

Key clinical point: Nivolumab may serve as a first-line systemic treatment option in patients with hepatocellular carcinoma (HCC) and Child-Pugh B (CP-B) cirrhosis.

Major finding: Patients receiving nivolumab vs. sorafenib had a 31% reduced hazard of death (adjusted hazard ratio 0.69; P = .008) and were less likely to discontinue treatment due to toxicity (12% vs. 36%; P = .001).

Study details: The data come from a retrospective real-world cohort study that included patients with HCC and CP-B cirrhosis who received nivolumab (n = 79) or sorafenib (n = 431) as the first-line systemic treatment.

Disclosures: The study was funded by the US National Institutes of Health. Some authors declared serving on the advisory boards of or receiving honoraria or research grants from various sources.

Source: Chapin WJ et al. Comparison of nivolumab and sorafenib for first systemic therapy in patients with hepatocellular carcinoma and Child-Pugh B cirrhosis. Cancer Med. 2022 (Jun 2). Doi:   10.1002/cam4.4906

Key clinical point: The preoperative ratio of creatinine and cystatin C estimated glomerular filtration rates (eGFRcre/eGFRcys) can predict overall survival (OS) and recurrence-free survival (RFS) in patients with hepatocellular carcinoma (HCC) undergoing hepatic resection.

Major finding: High eGFRcre/eGFRcys (>1.0025) was significantly associated with worse OS (adjusted hazard ratio [aHR] 4.07; P = .03) and RFS (aHR 2.12; P = .04).

Study details: The data come from a retrospective study that included 157 patients with HCC who underwent curative hepatic resection.

Disclosures: The study was sponsored by Grants-in-Aid for Scientific Research, Japan Society for the Promotion of Science. The authors reported no conflicts of interest.

Source: Harimoto N et al. The ratio of creatinine and cystatin C estimated glomerular filtration rates as a surrogate marker in patients with hepatocellular carcinoma undergoing hepatic resection. J Hepatobiliary Pancreat Sci. 2022 (May 11). Doi: 10.1002/jhbp.1164

Key clinical point: The preoperative ratio of creatinine and cystatin C estimated glomerular filtration rates (eGFRcre/eGFRcys) can predict overall survival (OS) and recurrence-free survival (RFS) in patients with hepatocellular carcinoma (HCC) undergoing hepatic resection.

Major finding: High eGFRcre/eGFRcys (>1.0025) was significantly associated with worse OS (adjusted hazard ratio [aHR] 4.07; P = .03) and RFS (aHR 2.12; P = .04).

Study details: The data come from a retrospective study that included 157 patients with HCC who underwent curative hepatic resection.

Disclosures: The study was sponsored by Grants-in-Aid for Scientific Research, Japan Society for the Promotion of Science. The authors reported no conflicts of interest.

Source: Harimoto N et al. The ratio of creatinine and cystatin C estimated glomerular filtration rates as a surrogate marker in patients with hepatocellular carcinoma undergoing hepatic resection. J Hepatobiliary Pancreat Sci. 2022 (May 11). Doi: 10.1002/jhbp.1164

Key clinical point: The preoperative ratio of creatinine and cystatin C estimated glomerular filtration rates (eGFRcre/eGFRcys) can predict overall survival (OS) and recurrence-free survival (RFS) in patients with hepatocellular carcinoma (HCC) undergoing hepatic resection.

Major finding: High eGFRcre/eGFRcys (>1.0025) was significantly associated with worse OS (adjusted hazard ratio [aHR] 4.07; P = .03) and RFS (aHR 2.12; P = .04).

Study details: The data come from a retrospective study that included 157 patients with HCC who underwent curative hepatic resection.

Disclosures: The study was sponsored by Grants-in-Aid for Scientific Research, Japan Society for the Promotion of Science. The authors reported no conflicts of interest.

Source: Harimoto N et al. The ratio of creatinine and cystatin C estimated glomerular filtration rates as a surrogate marker in patients with hepatocellular carcinoma undergoing hepatic resection. J Hepatobiliary Pancreat Sci. 2022 (May 11). Doi: 10.1002/jhbp.1164

Key clinical point: C-reactive protein to albumin ratio (CAR) can predict overall survival (OS) and progression-free survival (PFS) in patients treated with lenvatinib for unresectable hepatocellular carcinoma (uHCC).

Major finding: High CAR (≥0.108) was independently associated with OS (adjusted hazard ratio [aHR] 1.915; P < .001) and PFS (aHR 1.644; P < .001). Patients with low vs. high CAR showed significantly better cumulative OS and PFS (both P < .001).

Study details: This retrospective, multicenter study included 522 patients with uHCC who were treated with lenvatinib for >2 weeks, followed-up for >4 weeks, and had CAR data available at the beginning of follow-up.

Disclosures: This study did not receive any funding. Some authors reported serving as advisors for or receiving research funds or lecture fees from various sources.

Source: Tada T et al. C-reactive protein to albumin ratio predicts survival in patients with unresectable hepatocellular carcinoma treated with Lenvatinib. Sci Rep. 2022;12:8421 (May 19). Doi: 10.1038/s41598-022-12058-y

Key clinical point: C-reactive protein to albumin ratio (CAR) can predict overall survival (OS) and progression-free survival (PFS) in patients treated with lenvatinib for unresectable hepatocellular carcinoma (uHCC).

Major finding: High CAR (≥0.108) was independently associated with OS (adjusted hazard ratio [aHR] 1.915; P < .001) and PFS (aHR 1.644; P < .001). Patients with low vs. high CAR showed significantly better cumulative OS and PFS (both P < .001).

Study details: This retrospective, multicenter study included 522 patients with uHCC who were treated with lenvatinib for >2 weeks, followed-up for >4 weeks, and had CAR data available at the beginning of follow-up.

Disclosures: This study did not receive any funding. Some authors reported serving as advisors for or receiving research funds or lecture fees from various sources.

Source: Tada T et al. C-reactive protein to albumin ratio predicts survival in patients with unresectable hepatocellular carcinoma treated with Lenvatinib. Sci Rep. 2022;12:8421 (May 19). Doi: 10.1038/s41598-022-12058-y

Key clinical point: C-reactive protein to albumin ratio (CAR) can predict overall survival (OS) and progression-free survival (PFS) in patients treated with lenvatinib for unresectable hepatocellular carcinoma (uHCC).

Major finding: High CAR (≥0.108) was independently associated with OS (adjusted hazard ratio [aHR] 1.915; P < .001) and PFS (aHR 1.644; P < .001). Patients with low vs. high CAR showed significantly better cumulative OS and PFS (both P < .001).

Study details: This retrospective, multicenter study included 522 patients with uHCC who were treated with lenvatinib for >2 weeks, followed-up for >4 weeks, and had CAR data available at the beginning of follow-up.

Disclosures: This study did not receive any funding. Some authors reported serving as advisors for or receiving research funds or lecture fees from various sources.

Source: Tada T et al. C-reactive protein to albumin ratio predicts survival in patients with unresectable hepatocellular carcinoma treated with Lenvatinib. Sci Rep. 2022;12:8421 (May 19). Doi: 10.1038/s41598-022-12058-y

Key clinical point: Nonalcoholic fatty liver disease (NAFLD) is independently associated with an increased risk for hepatocellular carcinoma (HCC).

Major finding: NAFLD significantly increased the risk for HCC (hazard ratio [HR] 1.88; P < .01) but not for recurrence (HR 0.97; P = .73), cancer mortality (HR 2.16; P = .1), or all-cause mortality (HR 1.02; P = .84).

Study details: Findings are from a meta-analysis of 103 observational studies that evaluated HCC risk and outcomes in 948,217 patients with NAFLD.

Disclosures: This study received no funding. The authors declared no conflicts of interest.

Source: Petrelli F et al. Hepatocellular carcinoma in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis: HCC and steatosis or steatohepatitis. Neoplasia. 2022;30:100809 (May 27). Doi: 10.1016/j.neo.2022.100809

Key clinical point: Nonalcoholic fatty liver disease (NAFLD) is independently associated with an increased risk for hepatocellular carcinoma (HCC).

Major finding: NAFLD significantly increased the risk for HCC (hazard ratio [HR] 1.88; P < .01) but not for recurrence (HR 0.97; P = .73), cancer mortality (HR 2.16; P = .1), or all-cause mortality (HR 1.02; P = .84).

Study details: Findings are from a meta-analysis of 103 observational studies that evaluated HCC risk and outcomes in 948,217 patients with NAFLD.

Disclosures: This study received no funding. The authors declared no conflicts of interest.

Source: Petrelli F et al. Hepatocellular carcinoma in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis: HCC and steatosis or steatohepatitis. Neoplasia. 2022;30:100809 (May 27). Doi: 10.1016/j.neo.2022.100809

Key clinical point: Nonalcoholic fatty liver disease (NAFLD) is independently associated with an increased risk for hepatocellular carcinoma (HCC).

Major finding: NAFLD significantly increased the risk for HCC (hazard ratio [HR] 1.88; P < .01) but not for recurrence (HR 0.97; P = .73), cancer mortality (HR 2.16; P = .1), or all-cause mortality (HR 1.02; P = .84).

Study details: Findings are from a meta-analysis of 103 observational studies that evaluated HCC risk and outcomes in 948,217 patients with NAFLD.

Disclosures: This study received no funding. The authors declared no conflicts of interest.

Source: Petrelli F et al. Hepatocellular carcinoma in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis: HCC and steatosis or steatohepatitis. Neoplasia. 2022;30:100809 (May 27). Doi: 10.1016/j.neo.2022.100809

Key clinical point: Microwave ablation may be a safe and effective first-line locoregional therapy (LRT) for bridging patients with hepatocellular carcinoma (HCC) to liver transplant (LT), with no cases of waitlist removal due to tumor seeding, procedural adverse events, or local tumor progression.

Major finding: In total, 71 (80.7%) of 88 patients eventually received LT. None of the patients died while on the waitlist, and only 4.5% of patients dropped out due to tumor growth outside of the Milan Criteria. The 5-year post-transplant overall survival rate was 76.7%, with the overall and major adverse event rates being 5.1% and 3.0%, respectively.

Study details: Findings are from a single-center, retrospective study including 88 patients with HCC on the waitlist for LT who received percutaneous microwave ablation as the first-line LRT.

Disclosures: The study did not receive any funding. Some authors declared consulting for, being on the board of directors or a shareholder of, or receiving research support from various sources.

Source: Couillard AB et al. Microwave ablation as bridging to liver transplant for patients with hepatocellular carcinoma: A single-center retrospective analysis. J Vasc Interv Radiol. 2022 (Jun 3). Doi: 10.1016/j.jvir.2022.05.019

Key clinical point: Microwave ablation may be a safe and effective first-line locoregional therapy (LRT) for bridging patients with hepatocellular carcinoma (HCC) to liver transplant (LT), with no cases of waitlist removal due to tumor seeding, procedural adverse events, or local tumor progression.

Major finding: In total, 71 (80.7%) of 88 patients eventually received LT. None of the patients died while on the waitlist, and only 4.5% of patients dropped out due to tumor growth outside of the Milan Criteria. The 5-year post-transplant overall survival rate was 76.7%, with the overall and major adverse event rates being 5.1% and 3.0%, respectively.

Study details: Findings are from a single-center, retrospective study including 88 patients with HCC on the waitlist for LT who received percutaneous microwave ablation as the first-line LRT.

Disclosures: The study did not receive any funding. Some authors declared consulting for, being on the board of directors or a shareholder of, or receiving research support from various sources.

Source: Couillard AB et al. Microwave ablation as bridging to liver transplant for patients with hepatocellular carcinoma: A single-center retrospective analysis. J Vasc Interv Radiol. 2022 (Jun 3). Doi: 10.1016/j.jvir.2022.05.019

Key clinical point: Microwave ablation may be a safe and effective first-line locoregional therapy (LRT) for bridging patients with hepatocellular carcinoma (HCC) to liver transplant (LT), with no cases of waitlist removal due to tumor seeding, procedural adverse events, or local tumor progression.

Major finding: In total, 71 (80.7%) of 88 patients eventually received LT. None of the patients died while on the waitlist, and only 4.5% of patients dropped out due to tumor growth outside of the Milan Criteria. The 5-year post-transplant overall survival rate was 76.7%, with the overall and major adverse event rates being 5.1% and 3.0%, respectively.

Study details: Findings are from a single-center, retrospective study including 88 patients with HCC on the waitlist for LT who received percutaneous microwave ablation as the first-line LRT.

Disclosures: The study did not receive any funding. Some authors declared consulting for, being on the board of directors or a shareholder of, or receiving research support from various sources.

Source: Couillard AB et al. Microwave ablation as bridging to liver transplant for patients with hepatocellular carcinoma: A single-center retrospective analysis. J Vasc Interv Radiol. 2022 (Jun 3). Doi: 10.1016/j.jvir.2022.05.019