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Pathophysiology of recurrent hepatocellular carcinoma after radiofrequency ablation
Author(s) -
Ikemoto Tetsuya,
Shimada Mitsuo,
Yamada Shinichiro
Publication year - 2017
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12705
Subject(s) - hepatocellular carcinoma , radiofrequency ablation , medicine , pathological , hypoxia (environmental) , ablation , microrna , pathophysiology , cancer , downregulation and upregulation , cancer research , oncology , pathology , biology , gene , biochemistry , chemistry , organic chemistry , oxygen
Radiofrequency ablation (RFA) is effective for the local control of hepatocellular carcinoma (HCC), particularly when a patient's liver functional reserve does not allow radical resection. There is controversy regarding the superiority of surgical resection compared with RFA for such patients, particularly those with three or fewer tumors with diameters ≤3 cm. Moreover, HCC often recurs after RFA, and the tumor cells show distinct phenotypic changes. Incomplete ablation accounts for tumor recurrence, and recent studies provide new insights into the biological mechanisms responsible for the pathological changes of HCC after RFA. This review focuses on the roles of epithelial–mesenchymal transition and cancer stemness that are driven by a mechanism that involves microRNA‐mediated upregulation of hypoxia‐inducible factor‐1. The studies reviewed here provide compelling evidence that complete ablation of HCC is required to prevent recurrence and indicate that further research is urgently required to develop a new systematic strategy to prevent tumor recurrence by targeting hypoxia‐inducible factor‐1.