Browsing by Author "Contreras-Mancilla, J"

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A preoperative risk score based on early recurrence for estimating outcomes after resection of hepatocellular carcinoma in the non-cirrhotic liver
(Elsevier B.V., 2024) Ruiz, E; Honles, J; Fernández, R; Uribe, K; Cerapio, JP; Cancino, K; Contreras-Mancilla, J; Casavilca-Zambrano, S; Berrospi, F; Pineau, P; Bertani, S
Background: Liver resection is the mainstay treatment option for patients with hepatocellular carcinoma in the non-cirrhotic liver (NCL-HCC), but almost half of these patients will experience a recurrence within five years of surgery. Therefore, we aimed to develop a rationale-based risk evaluation tool to assist surgeons in recurrence-related treatment planning for NCL-HCC. Methods: We analyzed single-center data from 263 patients who underwent liver resection for NCL-HCC. Using machine learning modeling, we first determined an optimal cut-off point to discriminate early versus late relapses based on time to recurrence. We then constructed a risk score based on preoperative variables to forecast outcomes according to recurrence-free survival. Results: We computed an optimal cut-off point for early recurrence at 12 months post-surgery. We identified macroscopic vascular invasion, multifocal tumor, and spontaneous tumor rupture as predictor variables of outcomes associated with early recurrence and integrated them into a scoring system. We thus stratified, with high concordance, three groups of patients on a graduated scale of recurrence-related survival. Conclusion: We constructed a preoperative risk score to estimate outcomes after liver resection in NCL-HCC patients. Hence, this score makes it possible to rationally stratify patients based on recurrence risk assessment for better treatment planning.
Carcinoma hepatocelular en Perú: una descripción molecular de un cuadro clínico atípico
(Asociacion Mexicana de Gastroenterologia, 2024) Contreras-Mancilla, J; Cerapio, JP; Ruiz, E; Fernández, R; Casavilca-Zambrano, S; Machicado, C; Fournié, JJ; Pineau, P; Bertani, S
Introduction: Hepatocellular carcinoma (HCC) is the third most frequent cancer of digestive tract tumors in Peru, with a high mortality rate of 17.7 per 100,000 inhabitants. A significant number of HCC cases in Peru do not follow the classic clinical epidemiology of the disease described in other parts of the world. Those patients present with a distinct transcriptome profile and a singular tumor process, suggesting a particular type of hepatocarcinogenesis in a portion of the Peruvian population. Aim: Our aim was to understand the clinical and biologic involvement of the epigenetic profile (methylation) and gene expression (transcriptome) of HCC in Peruvian patients. Methods: HCC and liver transcriptome and DNA methylation profiles were evaluated in 74 Peruvian patients. Results: When grouped by age, there was greater DNA methylation in younger patients with HCC but no differences with respect to the transcriptomic profile. A high prevalence of the hepatitis B virus (HBV) (> 90%) was also observed in the younger patients with HCC. Enrichment analyses in both molecular profiles pinpointed PRC2 as an important molecular effector of that liver tumor process in Peruvian patients. Conclusion: HCC in Peruvian patients has a unique molecular profile, associated with the presence of HBV, as well as overall DNA hypermethylation related to undifferentiated liver cells or cellular reprogramming.
On the risk of further excluding outcast patient populations in South America
(Elsevier Espana S.L.U, 2023) Ruiz, E; Fernández, R; Berrospi, F; Casavilca-Zambrano, S; Contreras-Mancilla, J; Cerapio, JP; Pineau, P; Bertani, S
It is with great interest that we read the article by Farah and colleagues on the epidemiological transition at work regarding risk factors for hepatocellular carcinoma (HCC) in South America [1]. In this study, the authors compiled data from 339 patients seen between 2019 and 2021 in six countries of the region, with Peruvian patients accounting for the most significant proportion, i.e., 125 HCC cases (37%) collected at one general services hospital.