Ricerc@Sapienza

Despite gaining wide consensus in the management of hepatocellular carcinoma (HCC), minimally invasive liver surgery (MILS) has been poorly investigated for its role in the setting of salvage liver transplantation (SLT). A multicenter retrospective analysis was carried out in 6 Italian centers on 211 patients with HCC who were initially resected with open (n = 167) versus MILS (n = 44) and eventually wait-listed for SLT. The secondary endpoint was identification of risk factors for posttransplant death and tumor recurrence.

Although studies suggest decreased incident hepatocellular carcinoma (HCC) after treatment with direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infection, data are conflicting regarding risk and aggressiveness of recurrence in patients who have a history of treated HCC. This review analyses data available in literature in order to elucidate the impact of DAAs on the risk of HCC recurrence after successful treatment of the tumor. Overall 24 papers were identified.

Introduction: Concerns were raised about a high occurrence of hepatocellular carcinoma (HCC) after successful treatment of chronic hepatitis C (CHC) by direct-acting antivirals (DAAs). Areas covered: The authors summarize the clinical studies reporting the occurrence rate and risk factors of HCC after DAAs in CHC. Expert opinion: The recent introduction of all-oral DAAs has substantially changed the scenario of CHC, achieving a sustained virological response (SVR) in >90% of cases.

BACKGROUND/AIM:
Focal nodular hyperplasia (FNH) is the second most common benign tumor of the liver. As of 2017, many clinical, radiological and surgical features have been largely documented. On the other hand, little is still known about the correlation of FNH with hepatocellular carcinoma, nor the preferable modality of treatment. Our aim was to elucidate the latter topic.

Background Laparoscopic liver resection (LLR) appears to be safe and effective as open liver resection (OLR) for hepatocellular carcinoma (HCC). However, studies comparing LLR with ORL in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of LLR versus OLR for HCC in elderly patients. Methods A retrospective analysis was made comparing laparoscopic (n = 11) and open (n = 18) liver resections in elderly patients performed at the University of Naples "Federico II'' between January 2010 and December 2014.

Hepatocellular carcinoma (HCC) is a major healthcare problem worldwide, representing one of the leading causes of cancer mortality. Since there are currently no predictive biomarkers for early stage diagnosis, HCC is detected only in advanced stages and most patients die within one year, as radical tumour resection is generally performed late during the disease. The development of alternative therapeutic approaches to HCC remains one of the most challenging areas of cancer.

In this chapter we aim at presenting status of art in Liver Surgery. After a brief introduction about natural evolution of HCC either in cirrhotic and non-cirrhotic patients, this manuscript will focus on planning and timing surgery: CT evaluation of remnant liver, biopsy and US evaluation of liver disease, intra-operative US, surgical techniques, such as major and limited hepatectomies, two-stage hepatectomies, each of them in open or mini-invasive approach, and their possible complications. Follow-up and further interventions during expected recurrences will be highlighted.