Background: The dominant artery blood supply is a characteristic of hepatocellular carcinoma (HCC). However, it is not known whether the blood supply can predict the post-hepatectomy prognosis of patients with HCC. This retrospective study investigated the prognostic value of the portal venous and arterial blood supply estimated on triphasic liver CT (as a portal venous coefficient, PVC, and hepatic arterial coefficient, HAC, respectively) in patients with HCC following hepatectomy. Methods: HCC patients who were tested by triphasic liver CT 2 weeks before hepatectomy and received R0 hepatectomy at the Second Affiliated Hospital, Kunming Medical University between January 1, 2016 and December 31, 2020, were retrospectively screened. Their PVC and HAC, and other variables were analyzed for the prediction of overall survival (OS) and recurrence-free survival (RFS) using the least absolute shrinkage and selection operator and Cox proportional hazard regression models. Results: Four hundred and nineteen patients (53.2 ± 10.6 years of age and 370 men) were evaluated. A shorter OS was independently associated with higher blood albumin and total bilirubin grade [hazard ratio (HR) 2.020, 95% confidence interval (CI) 1.534– 2.660], higher Barcelona Clinic Liver Cancer (BCLC) stage (HR 1.514, 95% CI 1.290– 1.777), PVC ≤ 0.386 (HR 1.628, 95% CI 1.149– 2.305), and HAC > 0.029 (HR 1.969, 95% CI 1.380– 2.809). A shorter RFS was independently associated with male (HR 1.652, 95% CI 1.005– 2.716), higher serum α-fetoprotein ≥ 400 ng/mL (HR 1.672, 95% CI 1.236– 2.263), higher BCLC stage (HR 1.516, 95% CI 1.300– 1.768), tumor PVC ≤ 0.386 (HR 1.641, 95% CI 1.198– 2.249), and tumor HAC > 0.029 (HR 1.455, 95% CI 1.060– 1.997). Conclusion: Tumor PVC or HAC before hepatectomy is valuable for independently predicting postoperative survival of HCC patients.

Purpose: This study aimed to investigate whether tumor-associated lymphatic vessel density (LVD) could predict the survival of patients with hepato-biliary-pancreatic (HBP) cancers after radical resection.Methods: A systematic search was conducted using PubMed, Embase, and Cochrane Library from the inception to July 31, 2024 for literature that reported the role of LVD in overall survival (OS) and recurrence-free survival (RFS) of patients with HBP cancers after radical resection.Results: Ten studies with 761 patients were included for the meta-analysis. The results indicated that a higher level of LVD was associated with worse OS (hazard ratio, HR = 2.87, 95% CI 1.63 to 5.04) and worse RFS (HR = 3.18, 95% CI 1.41 to 7.17) in HBP cancers. Subgroup analysis based on pathological types revealed that a higher level of LVD was significantly related to worse OS in hepatocellular carcinoma (HCC) (HR = 2.35, 95% CI 1.16 to 4.78), cholangiocarcinoma (HR = 4.65, 95% CI 1.70 to 12.70), and gallbladder cancer patients (HR = 4.64, 95% CI 1.37 to 15.71). The levels of LVD were not significantly associated with OS in pancreatic adenocarcinoma patients after radical resection (HR = 1.08, 95% CI 0.61 to 1.89). Similarly, a higher level of LVD was significantly associated with worse RFS in HCC (HR = 1.92, 95% CI 1.01 to 3.65) and cholangiocarcinoma patients (HR = 4.54, 95% CI 2.10 to 9.83).Conclusions: A higher level of LVD was a biomarker for the prediction of worse OS and RFS in patients with hepatobiliary cancers after radical resection.Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024571167.

This review evaluates the efficacy and safety of therapies for hepatocellular carcinoma (HCC) with hepatic vein tumor thrombus (HVTT), inferior vena cava tumor thrombus (IVCTT), and/or right atrium tumor thrombus (RATT). A systematic review of PubMed, EMBASE, Cochrane Library, and Wanfang databases was conducted for literatures in this topic up to 22 August 2024, focusing on overall survival (OS), progression -free survival (PFS), and adverse reactions. Seven studies involving 453 patients were analyzed. The therapeutic strategies included surgery alone, local ± systemic therapy, and surgery with adjuvant therapy. The pooled 1-, 3-, and 5-year OS rates for all patients were 63.3% (95% CI 52.7%-73.9%), 21.6% (95% CI 4.9%-38.2%), and 8.3% (95% CI 2.9%-13.8%), respectively. Surgery with adjuvant therapy achieved the highest 1-year OS, while local ± systemic therapy led to the best 5-year OS. The pooled 1-, 3-, and 5-year PFS rates for all patients were 56.8% (95% CI 45.2%-68.4%), 9.4% (95% CI 0.0%-20.0%), and 1.6% (95% CI 0.0%-3.8%), respectively. Surgery alone frequently had adverse reactions of ascites and pleural effusion, the local ± systemic therapy frequently resulted in hepatic dysfunction and platelet abnormalities, and surgery and adjuvant therapy was frequently accompanied by peritoneal abscess. Local ± systemic therapy provided the best long-term OS and manageable complications among these three therapeutic strategies for HCC with HVTT, IVCTT, and/or RATT. PROSPERO, (CRD42024573152).

Purpose: This study aimed to evaluate the association of tumor compression in the hepatic or portal vein with the presence of microvascular invasion (MVI) and satellite nodules in patients with hepatocellular carcinoma (HCC). Patients and Methods: HCC patients at the Barcelona Clinic Liver Cancer (BCLC) stages 0-A who underwent a radical liver resection in our hospitals from January 2016 to December 2022 were collected. The tumor compression of the portal or hepatic vein in individual patients was analyzed by preoperative imaging and postoperative pathology. Their MVI, satellite nodules, overall survival (OS), and recurrence-free survival (RFS) were analyzed, and the potential risk factors for the MVI and satellite nodules of patients were analyzed by univariable and multivariable logistic analyses. Results: A total of 390 patients were included with 333 male and 263 patients < 60 years old. Of them, 51 (13.1%) HCC patients had tumor venous compression, which was not significantly associated with OS and RFS, but significantly related to higher positive rates of MVI and satellite nodules than those without tumor-venous compression (MVI, 51.0% vs 36.6%, P = 0.025; satellite nodules, 19.6% vs 9.1%, P = 0.023). Tumor venous compression was an independent risk factor for the development of MVI (OR = 1.902, 95% CI: 1.049– 3.447; P = 0.034) and satellite nodules (OR = 2.871, 95% CI: 1.277– 6.458; P = 0.011). Conclusion: Preoperative tumor venous compression is an independent predictor of MVI and satellite nodules in HCC patients at BCLC stages 0-A and may serve as an imaging biomarker for determining the resection margin and treatment planning.

Purpose: This study aimed to evaluate the impact of middle hepatic vein (MHV) resection during hemihepatectomy on short-term surgical outcomes and long-term prognosis in patients with hepatocellular carcinoma (HCC). Patients and Methods: Patients with HCC at Barcelona Clinic Liver Cancer (BCLC) stages 0-B who underwent hemihepatectomy between January 2016 and December 2022 were retrospectively screened. They were categorized into the MHV-preserved and MHV-resected groups. Intraoperative parameters, postoperative complications, liver function, overall survival (OS), and recurrence-free survival (RFS) were compared. Cox regression analyses were used to identified independent risk factors for OS and RFS. Results: A total of 137 patients were included, of whom 107 (78.1%) had MHV preserved and 30 (21.9%) had MHV resected. Compared with MHV preservation, MHV resection was associated with a longer operative time (329.9 ± 108.0 vs 291.4 ± 88.9 min, P = 0.048), greater intraoperative blood loss (1025.0 [400.0– 2075.0] vs 500.0 [300.0– 800.0] mL, P = 0.002), and a higher need for intraoperative blood transfusion (43.3% vs 24.3%, P = 0.041). Postoperative serum ALT and AST levels on days 3 and 5 were significantly higher in the MHV-resected group (all P < 0.05). However, postoperative hospital stay, complication rates, and other liver function parameters (ALB, TBIL, DBIL, PT, INR) did not differ significantly between the two groups. No significant differences were found in OS or RFS (all P > 0.05). Conclusion: MHV resection during hemihepatectomy increases operative time, blood loss, and postoperative liver enzyme levels, but does not significantly impact long-term survival in patients with HCC.

Hepatocellular carcinoma (HCC), a highly aggressive liver cancer, poses a large medical care burden worldwide. The prognosis of patients with HCC is poor, owing to recurrence and metastasis after common treatment methods. Therefore, identifying new targets to eliminate HCC cells is critical for treatment of HCC without recurrence. PANoptosis, a novel inflammatory cell death pathway, has become an intensively investigated area in recent years. The concept of PANoptosis has brought new hope for HCC therapy, given recent evidence implicating this form of programmed cell death in cancer progression, prognosis, and resistance to chemotherapy and immunotherapy. Despite increasing reviews describing the role of PANoptosis in various cancer types, to our knowledge, no systematic review has examined the implications of PANoptosis in HCC. Therefore, we sought to provide the first systematic review of the regulatory mechanisms and therapeutic potential of PANoptosis in HCC. We summarize recent progress in exploration of the role of PANoptosis in HCC, particularly regulation of the HCC tumor microenvironment by PANoptosis. Finally, we highlight the potential of PANoptosis-based diagnostic and therapeutic strategies for HCC.