Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center

Nanning, China

Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center

Nanning, China
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Mo H.-Y.,Guangxi Medical University | Liao Y.-Y.,Guangxi Medical University | You X.-M.,Guangxi Medical University | You X.-M.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | And 7 more authors.
PLoS ONE | Year: 2017

Aims The role of adoptive immunotherapy (AIT) for patients with hepatocellular carcinoma (HCC) who have received curative therapy is still not well illustrated. This timely meta-analysis aims to update the current evidence on efficacy and safety of AIT for patients with HCC who have received curative therapy. Methods We searched PubMed, EMBASE, Scopus and the Cochrane Library Through January 2017 for relevant studies. Mortality and tumor recurrence were compared between patients with or without adjuvant AIT. The meta-analysis was performed using Review Manager 5.3.Results Eight studies involving 1861 patients met the eligibility criteria and were meta-analyzed. Adjuvant AIT was associated with significantly lower mortality at 1 year (RR 0.64, 95%CI 0.52-0.79), 3 years (RR 0.73, 95%CI 0.65-0.81) and 5 years (RR 0.86, 95%CI 0.79-0.94).Similarly, adjuvant AIT was associated with significantly lower recurrence rate than curative therapies alone at 1 year (RR 0.64, 95%CI 0.49-0.82), 3 years (RR 0.85, 95%CI 0.79-0.91) and 5 years (RR 0.90, 95%CI 0.85-0.95). Short-term outcomes were confirmed in sensitivity analyses based on randomized trials or choice of random- or fixed-effect meta-analysis model. None of the included patients experienced grade 4 adverse events. Conclusions This timely meta-analysis confirms the evidence that adjuvant AIT for patients with HCC after curative treatment lowers risk of mortality and tumor recurrence. © 2017 Mo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Gong W.-F.,Guangxi Medical University | Gong W.-F.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Zhong J.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | And 13 more authors.
Oncotarget | Year: 2017

The ability of antiviral therapy to reduce risk of post-hepatectomy hepatitis B virus (HBV) reactivation in patients negative for viral DNA is unclear. This prospective study involved 174 consecutive patients with hepatitis B virus related hepatocellular carcinoma who were negative for hepatitis B virus DNA in serum and who underwent hepatic resection. Hepatitis B virus reactivation occurred in 30 patients in the non-antiviral group (27.8%) but in only 2 patients in the antiviral group (3.0%, P < 0.001). Based on multivariate analysis, risk of hepatitis B virus reactivation was associated with minor hepatectomy and absence of antiviral therapy. Liver function indicators at one week after resection did not differ significantly between the two groups, or between patients who experienced hepatitis B virus reactivation or not. Nevertheless, alanine aminotransferase and albumin at 1 month after resection were significantly higher in the antiviral group than in the non-antiviral group, and they were significantly higher in patients who did not experience hepatitis B virus reactivation than in those who did. Therefore, patients with hepatitis B virus related hepatocellular carcinoma face substantial risk of hepatitis B virus reactivation after hepatectomy, even if they are negative for viral DNA at baseline. Antiviral therapy can reduce the risk of reactivation, helping improve liver function after surgery.


Zhong J.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Peng N.-F.,Guangxi Medical University | Peng N.-F.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | And 14 more authors.
Oncotarget | Year: 2017

The current clinical reality of tumor stages and primary treatments of hepatocellular carcinoma (HCC) is poorly understood. This study reviewed the distribution of tumor stages and primary treatment modalities among a large population of patients with primary HCC. Medical records of patients treated between January 2003 and October 2013 for primary HCC at our tertiary hospital in China were retrospectively reviewed. A total of 6241 patients were analyzed. The distribution of Barcelona Clinic Liver Cancer (BCLC) stages was as follows: stage 0/A, 28.9%; stage B, 16.2%; stage C, 53.6%; stage D, 1.3%. The distribution of Hong Kong Liver Cancer (HKLC) stages was as follows: stage I, 8.4%; stage IIa, 1.5%; stage IIb, 29.0%; stage IIIa, 10.0%; stage IIIb, 33.6%; stage IVa, 3.4%; stage IVb, 2.5%; stage Va, 0.2%; stage Vb, 11.4%. The most frequent therapy was hepatic resection for patients with BCLC-0/A/B disease, and transarterial chemoembolization for patients with BCLC-C disease. Both these treatments were the most frequent for patients with HKLC I to IIIb disease, while systemic chemotherapy was the most frequent first-line therapy for patients with HKLC IVa or IVb disease. The most frequent treatment for patients with HKLC Va/Vb disease was traditional Chinese medicine. In conclusion, Prevalences of BCLC-B and -C disease, and of HKLC I to IIIb disease, were relatively high in our patient population. Hepatic resection and transarterial chemoembolization were frequent first-line therapies.


Xiang X.,Guangxi Medical University | Zhong J.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Wang Y.-Y.,Guangxi Medical University | And 8 more authors.
Clinical and Translational Oncology | Year: 2017

Objective: This study reviewed the distribution of each tumor stage and each type of initial treatment modality among patients with primary hepatocellular carcinoma (HCC) treated at a tertiary tumor hospital between January 2003 and October 2013. Methods: Baseline data of patients with primary hepatocellular carcinoma treated between January 2003 and October 2013 were retrospectively collected. Tumor stage was determined according to the Barcelona Clinic Liver Cancer (BCLC) staging system and Hong Kong Clinic Liver Cancer (HKLC) staging system. Results: A total of 6241 patients with primary hepatocellular carcinoma were included in the analysis. In accordance with the BCLC, 28.9% of patients were in stage 0/A, 16.2% in stage B, 53.6% in stage C, and 1.3% in stage D. According to the HKLC stage system, 8.4% patients were in stage I, 1.5% in stage IIa, 29.0% in stage IIb, 10.0% in stage IIIa, 33.6% in stage IIIb, 3.4% in stage IVa, 2.5% in stage IVb, 0.2% in stage Va, and 11.4% in stage Vb. Treatment modalities applied to this patient group were as follows: 33.3% of patients underwent hepatic resection, 36.7% underwent transarterial chemoembolization (TACE), 2.2% underwent radiotherapy, 0.9% underwent local ablated therapy, 8.8% underwent systemic chemotherapy, 4.2% underwent traditional herbal medicine therapy, 0.1% underwent targeted drug therapy, and 13.8% received no treatment. Hepatic resection was the most frequent therapy for patients with BCLC 0/A/B disease, and TACE was the initial therapy for patients with BCLC C disease. In the Hong Kong Clinic Liver Cancer staging system, the main treatments for HKLC I to IIIb disease is hepatic resection and TACE. Systemic chemotherapy was the initial therapy for patients with HKLC IVa/IVb disease. Most HKLC Va/Vb patients received traditional Chinese medicine treatment. Conclusion: Prevalence of stage BCLC B and C disease was high among our hepatocellular carcinoma patients. In Hong Kong Clinic Liver Cancer staging system, HKLC I to IIIb disease was high among our HCC patients. Hepatic resection and TACE are initial therapies. © 2017 Federación de Sociedades Españolas de Oncología (FESEO)


Zhong J.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | You X.-M.,Guangxi Medical University | You X.-M.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | And 15 more authors.
Medicine (United States) | Year: 2015

The present study compared the efficacy of hepatic resection (HR) in patients with large hepatocellular carcinoma (HCC) and those with multinodular tumor and examined how that efficacy has changed over time in a large medical center. The intermediate stage of HCC comprises a highly heterogeneous patient population. Moreover, official guidelines have different views on the suitability of HR to treat such patients. A consecutive sample of 927 patients with preserved liver function and large and/or multinodular HCC who were treated by initial HR were divided into 3 groups: those with a single tumor ≥5cm in diameter (n=588), 2 to 3 tumors with a maximum diameter >3 cm (n=225), or >3 tumors of any diameter (n=114). Hospital mortality and overall survival (OS) in each group were compared for the years 2000 to 2007 and 2008 to 2013. Patients with >3 tumors showed the highest incidence of hospital mortality of all groups (P<0.05). Kaplan-Meier survival analysis showed that OS varied across the 3 groups as follows: single tumor > 2 to 3 tumors > 3+ tumors (all P<0.05). OS at 5 years ranged from 24% to 41% in all 3 groups for the period 2000 to 2007, and from 35% to 46% for the period 2008 to 2013. OS was significantly higher during the more recent 6-year period in the entire patient population, those with single tumor, and those with 3+ tumors (all P<0.05). However, in patients with 2 to 3 tumors, OS was only slightly higher during the more recent 6-year period (P=0.084). Prognosis can vary substantially for these 3 types of HCC. Patients with >3 tumors show the highest hospital mortality and lowest OS after HR. OS has been improving for all 3 types of HCC at our medical center as a consequence of improvements in surgical technique and perioperative management. © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Xie Z.-B.,Guangxi Medical University | Xie Z.-B.,Fudan University | Wang X.-B.,Guangxi Medical University | Fu D.-L.,Fudan University | And 5 more authors.
OncoTargets and Therapy | Year: 2016

Background: Patients with hepatocellular carcinoma have the risk of postoperative hepatitis B virus (HBV) reactivation (PHR). Antiviral therapy was given to patients with detectable HBV DNA levels but not to patients with undetectable HBV DNA levels. Methods: In this retrospective study, 258 patients were enrolled (HBV DNA levels <00 copies/mL group, n=159, and HBV DNA levels <500 copies/mL group, n=99). Results: A total of 50 patients (19.4%) had PHR. The following significant factors related to PHR were found: without antiviral therapy (hazard ratio [HR] =0.17, 95% confidence interval [CI] 0.031-0.911), hepatitis B e antigen positivity (HR =5.20, 95% CI 1.931-14.007), hepatitis B core antigen S1 positivity (HR =2.54, 95% CI 1.116-5.762), preoperative HBV DNA levels ≥500 copies/mL (HR =1.28, 95% CI 1.085-2.884), hepatic inflow occlusion (HR =3.60, 95% CI 1.402-9.277), moderate liver cirrhosis or more (HR =2.26, 95% CI 1.001-5.121), and blood transfusion (HR =2.89, 95% CI 0.836-10.041). Recurrence-free survival time was significantly shorter in patients with PHR (23.06±2.46 months) than in patients without PHR (29.30±1.27 months). Conclusion: Antiviral therapy could efficiently decrease the incidence of PHR. Patients with HBV DNA levels <500 copies/mL still have the risk of PHR. PHR remained as a prognostic risk factor for hepatocellular carcinoma recurrence and recurrence-free survival. © 2016 Xie et al.


Wang Y.-Y.,Guangxi Medical University | Zhong J.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Su Z.-Y.,Guangxi Medical University | And 11 more authors.
British Journal of Surgery | Year: 2016

Background The Child-Pugh (CP) score is used widely to assess liver function and predict postoperative outcomes in patients with hepatocellular carcinoma (HCC). Recently, the albumin-bilirubin (ALBI) score has been validated as a predictor of overall survival in these patients. This study aimed to compare the ability of the ALBI and CP scores to predict outcomes in patients with HCC after liver resection with curative intent. Methods Consecutive patients who underwent liver resection with curative intent for HCC between January 2007 and July 2013 were included in this retrospective study. The performance of the ALBI score in predicting postoperative liver failure (PHLF) and long-term survival was compared with that of the CP score. Results A total of 1242 patients were enrolled. Of these, 166 (13·4 per cent) experienced PHLF. The area under the receiver operating characteristic (ROC) curve of the ALBI score for predicting PHLF was greater than that of the CP score (0·723 versus 0·607; P < 0·001). Similar to findings for CP grade, the incidence and severity of PHLF increased with increasing ALBI grade. The ALBI grade stratified patients into at least two distinct overall survival cohorts (P < 0·001), whereas the CP grade did not. The ALBI grade also classified patients with CP grade A disease into two distinct overall survival cohorts (P < 0·001), and overall survival rates in the group with poorer survival were similar to those in the majority of patients with CP grade B disease. Both CP and ALBI scores had low power in predicting disease-free survival. Conclusion The ALBI grade predicted PHLF and overall survival in patients with HCC undergoing liver resection with curative intent more accurately than the CP grade. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.


Chen J.,Guangxi Medical University | Chen J.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Bai T.,Guangxi Medical University | Bai T.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | And 10 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Background: Compared with open hepatectomy (OH), laparoscopic hepatectomy (LH) had better shortterm outcomes in normal hepatocellular carcinoma (HCC) patients. Since liver cirrhosis is the major risk of HCC, serve postoperative complications can be observed after LH in HCC patients with cirrhosis. We conducted this systematic review to analysis the safety and the efficiency of LH in HCC patients with liver cirrhosis. Methods: MEDLINE, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure database, and clinical trial registries were searched through March 2015. Risk ratios (RRs), weigh mean difference (WMD) and 95% confidence intervals (CIs) were calculated. Results: The analysis included 7 retrospective trials, altogether involving 828 patients. Patients in LH group had wider tumor margin (WMD = 0.12, 95% CI 0.04 to 0.21, P = 0.003), less blood loss (WMD = -157.25, 95% CI -295.05 to -19.45, P = 0.03), less blood transfusion (RR = 0.41, 95% CI 0.22 to 0.74, P = 0.004), less postoperative mobility (RR = 0.48, 95% CI 0.35 to 0.66, P<0.001) and less hospital stay (WMD = -4.11, 95% CI -6.23 to -1.98, P<0.001). Overall survival (OS) and disease free survival (DFS) were similar between 2 groups, except LH had a better 5-year survival rate (RR = 1.28, 95% CI 1.01 to 1.62, P = 0.04). Conclusion: In HCC patients with liver cirrhosis, LH have short-term outcomes advantages of tumor margin, blood loss, blood transfusion, postoperative mobility, and hospital stay. OS and DFS were similar between LH and OH. LH is safe in HCC patients with liver cirrhosis. © 2015 E-Century Publishing Corporation. All rights reserved.


Pang Y.-B.,Guangxi Medical University | Zhong J.-H.,Guangxi Medical University | Zhong J.-H.,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center | Luo X.-L.,Guangxi Medical University | And 8 more authors.
Tumor Biology | Year: 2015

The aim of this study was to analyze the clinicopathological characteristics and expression of liver stem cell markers of hepatocellular carcinoma (HCC) involving bile duct tumor thrombi (BDTT). A total of 35 patients with HCC and BDTT in a consecutive series of HCC patients who underwent surgical treatment were studied retrospectively and compared with 916 patients without BDTT from the same series. Clinicopathological characteristics, overall survival (OS), and tumor expression of liver stem cell markers CD133, CD90, EpCAM, CK19, VEGF, and C-kit were compared between the two patient groups. Analysis was performed for the entire patient groups as well as for 35 pairs of patients with or without BDTT matched by propensity score. HCC patients with BDTT tended to have smaller tumors than those without BDTT, as well as a higher probability of having poorly differentiated tumor, Child-Pugh class B, liver cirrhosis, and microvascular invasion. Tumor tissue in patients with BDTT showed significantly higher expression rates of all liver stem cell markers examined. OS was significantly lower for patients with BDTT at 1 year (69 vs 84 %), 3 years (37 vs 64 %), and 5 years (20 vs 55 %) (P < 0.001). Patients with HCC and BDTT show lower OS than patients without BDTT. The higher frequency of liver stem cell marker expression in the presence of BDTT suggests that such stem cells may play a role in the pathogenesis of this form of HCC. © 2015 International Society of Oncology and BioMarkers (ISOBM)

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