scholarly journals Long-Term Zinc Supplementation Improves Liver Function and Decreases the Risk of Developing Hepatocellular Carcinoma

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1955 ◽  
Author(s):  
Atsushi Hosui ◽  
Eiji Kimura ◽  
Sumiko Abe ◽  
Takashi Tanimoto ◽  
Kousaku Onishi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Group ◽  
Liver Function ◽  
Cumulative Incidence ◽  
Zinc Supplementation ◽  
Incidence Rates ◽  
Zinc Enzymes ◽  
Zn Concentration ◽  
Serum Zn

Zinc plays a pivotal role in various zinc enzymes, which are crucial in the maintenance of liver function. Patients with chronic liver diseases (CLDs) usually have lower concentrations of zinc, which decrease further as liver fibrosis progresses. Whether long-term zinc supplementation improves liver function and reduces the risk of hepatocellular carcinoma (HCC) development remains unknown. Two hundred and sixty-seven patients with CLDs who received a zinc preparation (Zn-group; 196 patients), or who did not receive zinc (no Zn-treatment group; 71 patients), were retrospectively analyzed in this study. The Zn-group was divided into 4 groups according to their serum Zn concentrations at 6 months after the start of Zn treatment. Liver function significantly deteriorated in the no Zn-treatment group, while no notable change was observed in the Zn-group. The cumulative incidence rates of events and HCC at 3 years were observed to be lower in the Zn-group (9.5%, 7.6%) than in the no Zn-treatment group (24.9%, 19.2%) (p < 0.001). According to serum Zn concentrations, the cumulative incidence rates of events and HCC were significantly decreased in patients with Zn concentrations ≥ 70 µg/dL (p < 0.001). Zinc supplementation appears to be effective at maintaining liver function and suppressing events and HCC development, especially among patients whose Zn concentration is greater than 70 µg/dL.

scholarly journals Long-Term Zinc Supplementation Improves Liver Function and Decreases the Risk of Developing Hepatocellular Carcinoma

2018 ◽  
Author(s):  
Atsushi Hosui ◽  
Eiji Kimura ◽  
Sumiko Abe ◽  
Takashi Tanimoto ◽  
Kousaku Onishi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Group ◽  
Liver Function ◽  
Cumulative Incidence ◽  
Zinc Supplementation ◽  
Incidence Rates ◽  
Zinc Enzymes ◽  
Zn Concentration ◽  
Serum Zn

Background and Aim: Zinc plays a pivotal role in various zinc enzymes, resulting in the maintenance of liver function. Patients with chronic liver diseases (CLDs) usually have lower concentrations of zinc, which decrease further as liver fibrosis progresses. It remains unknown whether long-term zinc supplementation improves liver function and reduces the risk of hepatocellular carcinoma (HCC) development. Patients and Methods: Two hundred sixty-seven patients with CLDs who received a zinc preparation (Zn-group; 196 patients), or who did not receive zinc (no Zn-treatment group; 71 patients) were retrospectively analyzed in this study. The Zn-group was divided into 4 groups according to their serum Zn concentrations at 6 months after the start of Zn treatment. Results: Liver function significantly deteriorated in the no Zn-treatment group, while no notable change was observed in the Zn-group. The cumulative incidence rates of events and HCC at 3 years were lower in the Zn-group (9.5%, 7.6%) than in the no Zn-treatment group (24.9%, 19.2%) (p&lt;0.001). According to the serum Zn concentrations, the cumulative incidence rates of events and HCC were significantly decreased in patients with Zn concentrations &ge; 70 &micro;g/dl (p&lt;0.001). Conclusion: Zinc supplementation appears to be effective at maintaining liver function and suppressing events and HCC development, especially among patients whose Zn concentration is greater than 70 &micro;g/dl.

scholarly journals Renal Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with Liver Cirrhosis: A Nationwide Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Wei-Fan Hsu ◽  
Shi-Hang Yu ◽  
Jaw-Town Lin ◽  
Jaw-Ching Wu ◽  
Ming-Chih Hou ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Enzyme Inhibitors ◽  
Multivariate Analyses ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Incidence Rates ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers ◽  
Cirrhotic Patients

Background. The use of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) carries a risk of renal function deterioration in cirrhotic patients with ascites. However, whether the long-term use of ACEis/ARBs is safe in cirrhotic patients without ascites remains unknown. Methods. In this nationwide cohort study, we identified 311,361 newly diagnosed cirrhotic patients between January 1997 and December 2013. To avoid indication and immortal time biases, patients receiving regular ACEi/ARB therapy, defined as the ACEi/ARB cohort, were matched to patients receiving regular calcium channel blockers (CCBs), defined as the CCB cohort, at a ratio of 1 : 1 by age, sex, and propensity scores for comorbidities and medications (2,188 patients in each cohort). Cumulative incidence rates and multivariate analyses of end-stage renal disease (ESRD) risk were adjusted for competing mortality. Results. The 10-year cumulative incidence rates of ESRD were 2.32% (95% confidence interval [CI]: 1.45–3.20) in the ACEi/ARB cohort and 1.70% (95% CI: 1.03–2.36) in the CCB cohort (P=0.610). In multivariate analyses, ACEi/ARB use was not associated with a higher risk of ESRD in cirrhotic patients (hazard ratio HR=1.15; 95% CI: 0.69–1.94, P=0.591). In the sensitivity test, the 10-year cumulative incidence rates of ESRD in cirrhotic patients with ascites were 6.50% (95% CI: 0.54–12.46) and 1.24% (95% CI: 0.00–2.71) in ACEi/ARB and CCB cohorts, respectively (P=0.090). Conclusions. Long-term ACEi/ARB use was not associated with a higher risk of ESRD in cirrhotic patients. However, the risk of ESRD tended to increase in cirrhotic patients with ascites.

Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

2012 ◽  
pp. 261-264 ◽  
Author(s):  
Laura A. Dawson ◽  
Sameh Hashem ◽  
Alexis Bujold
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Liver Function ◽  
Randomized Trials ◽  
Stereotactic Body Radiation Therapy ◽  
Great Majority ◽  
High Dose ◽  
Dose Volume ◽  
Systemic Therapies

Overview: Stereotactic body radiotherapy (SBRT), in which highly conformal potent radiation doses are delivered in fewer fractions than traditional radiation therapy (RT), is an increasingly popular treatment for hepatocellular carcinoma (HCC). The great majority of HCCs smaller than 6 cm and with Child-Pugh A liver function are controlled with SBRT with limited toxicity. Long-term local control is reduced in larger tumors, and toxicity is increased in patients with Child-Pugh B or C liver function. SBRT is an effective treatment for tumor vascular thrombi and can lead to sustained vascular recanalization. The first site of recurrence following SBRT is most often within the liver, away from the high dose volume, providing rationale for combining SBRT with regional or systemic therapies. Randomized trials of SBRT are warranted.

Long-Term Update of Stereotactic Radiosurgery for Benign Spinal Tumors

Neurosurgery ◽  
2018 ◽  
Vol 85 (5) ◽  
pp. 708-716 ◽  
Author(s):  
Alexander L Chin ◽  
Dylann Fujimoto ◽  
Kiran A Kumar ◽  
Laurie Tupper ◽  
Salma Mansour ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cumulative Incidence ◽  
Standard Of Care ◽  
Incidence Rates ◽  
Spinal Tumors ◽  
Secondary Malignancy ◽  
Intracranial Tumors ◽  
Symptom Response

Abstract BACKGROUND Stereotactic radiosurgery (SRS) for benign intracranial tumors is an established standard of care. The widespread implementation of SRS for benign spinal tumors has been limited by lack of long-term data. OBJECTIVE To update our institutional experience of safety and efficacy outcomes after SRS for benign spinal tumors. METHODS We performed a retrospective cohort study of 120 patients with 149 benign spinal tumors (39 meningiomas, 26 neurofibromas, and 84 schwannomas) treated with SRS between 1999 and 2016, with follow-up magnetic resonance imaging available for review. The primary endpoint was the cumulative incidence of local failure (LF), with death as a competing risk. Secondary endpoints included tumor shrinkage, symptom response, toxicity, and secondary malignancy. RESULTS Median follow-up was 49 mo (interquartile range: 25-103 mo, range: 3-216 mo), including 61 courses with >5 yr and 24 courses with >10 yr of follow-up. We observed 9 LF for a cumulative incidence of LF of 2%, 5%, and 12% at 3, 5, and 10 yr, respectively. Excluding 10 tumors that were previously irradiated or that arose within a previously irradiated field, the 3-, 5-, and 10-yr cumulative incidence rates of LF were 1%, 2%, and 8%, respectively. At last follow-up, 35% of all lesions had decreased in size. With a total of 776 patient-years of follow-up, no SRS-related secondary malignancies were observed. CONCLUSION Comparable to SRS for benign intracranial tumors, SRS provides longer term local control of benign spinal tumors and is a standard-of-care alternative to surgical resection.

scholarly journals Effect of Severity of Liver Cirrhosis on Surgical Outcomes of Hepatocellular Carcinoma After Liver Resection and Microwave Coagulation

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiang Li ◽  
Hai-su Tao ◽  
Jian Li ◽  
Wen-qiang Wang ◽  
Wei-wei Sheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Liver Resection ◽  
Liver Function ◽  
Subgroup Analysis ◽  
Surgical Outcomes ◽  
Long Term Outcomes ◽  
Microwave Coagulation ◽  
Small Hcc

BackgroundLiver resection (LR) and percutaneous microwave coagulation therapy (PMCT) are both considered as radical treatments for small hepatocellular carcinoma (HCC). However, it is still unclear whether to select LR or PMCT in HCC patients with different degrees of liver cirrhosis. The purpose of this study was to compare the efficacy of LR and PMCT in the treatment of solitary and small HCC accompanied with different degrees of liver cirrhosis.MethodsIn this study, 230 patients with solitary HCC lesions ≤ 3 cm and Child-Pugh A liver function were retrospectively reviewed. Among these patients, 122 patients underwent LR, and 108 received PMCT. The short- and long-term outcomes were compared between these two procedures. Severity of liver cirrhosis was evaluated by using clinical scoring system (CSS) as previously published. Subgroup analysis based on CSS was performed to evaluate the effect of severity of liver cirrhosis on surgical outcomes after LR and PMCT.ResultsThere was no mortality within 90 days in both groups. Major complications were significantly more frequent in the LR group than in the PMCT group (18.8% vs. 4.6%, p&lt;0.001). However, LR provided better surgical outcomes than PMCT. The 5-year overall survival (OS) rates for the LR and PMCT groups were 65.2% and 42%, respectively (p=0.006), and the corresponding disease-free survival (DFS) rates were 51.7% and 31.5%, respectively (p=0.004). Nevertheless, subgroup analysis showed that PMCT provided long-term outcomes that were similar to LR and lower surgical complications in HCC patients with CSS score≥4.ConclusionsLR may provide better OS and DFS rates than PMCT for patients with solitary HCC lesions ≤ 3 cm and Child-Pugh A liver function irrespective of liver cirrhosis. PMCT should be viewed as the optimal treatment for solitary and small HCC with severe cirrhosis.

Can we expect long-term survival in patients with extrahepatic metastasis of hepatocellular carcinoma?

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 251-251
Author(s):  
Kangpyo Kim ◽  
Jinsil Seong
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Local Treatment ◽  
Extrahepatic Metastasis ◽  
Term Survival ◽  
Advanced Hcc ◽  
Metastatic Lesions ◽  
Long Term Survivors ◽  
Single Organ

251 Background: Hepatocellular carcinoma presenting metastases has been considered detrimental situation. However, it is not infrequent observing long term survivors following active therapeutic intervention in selected patients. In this study, we investigated whether long term survival could be real as well as its common clinical features. Methods: From november 2005 to december 2014, among 1020 HCC patients with extrahepatic metastasis, 75 patients survived over 2 years. The patient and tumor characteristics were examined involving the site, number of metastatic lesions, liver function, and other factors. Treatment methods for liver and metastatic lesions were also reviewed with subgroup survival analysis according to the treatment strategies. Results: We observed survival over 2 years in 7.3 % with median survival of 41 months. The most common sites of extrahepatic metastasis were lung, bone, adrenal gland and lymph nodes in order of frequency. Of 75 survivors, 72 (96%) had single organ metastasis, and 46 (64%) had four or less countable metastatic lesions. Child-Pugh score was within 5 to 7 points for 71 patients when extrahepatic metastasis first occurred. More than two-thirds of patients (52 patients, 69.3%) received local treatments such as surgery or radiotherapy showing significantly higher survival than systemic treatment only (23 patients, 30.7 %) group; 3 year survival 65.7 % versus 21.7 % for the group with and without local treatment respectively (p = 0.001). For patients with a viable tumor in the liver, the application of local treatments such as transarterial treatment or radiotherapy showed a significant survival benefit (3-year survival 46.6 % versus 31.3%, p = 0.045). Conclusions: The long-term survivors presented limited number of extrahepatic metastasis (oligometastasis) and received local treatment for their metastatic lesions. Local treatments to metastatic lesions will increase the survival of advanced HCC patients who have proper liver function and a small number of metastases in a single organ. This study suggests the application of individually tailored therapeutic strategies for advanced HCC patients with extrahepatic metastasis.

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