: The risk of cancer recurrence after liver surgery mainly depends on tumour biology, but preclinical and clinical evidence suggests that the degree of perioperative liver injury plays a role in creating a favourable microenvironment for tumour cell engraftment or proliferation of dormant micro-metastases. Understanding the contribution of perioperative liver injury to tumour recurrence is imperative, as these pathways are potentially actionable. In this review, we examine the key mechanisms of perioperative liver injury, which comprise mechanical handling and surgical stress, ischaemia-reperfusion injury, and parenchymal loss leading to liver regeneration. We explore how these processes can trigger downstream cascades leading to the activation of the immune system and the pro-inflammatory response, cellular proliferation, angiogenesis, anti-apoptotic signals, and release of circulating tumour cells. Finally, we discuss the novel therapies under investigation to decrease ischaemia-reperfusion injury and increase regeneration after liver surgery, including pharmaceutical agents, inflow modulation, and machine perfusion.

The role of ischaemia-reperfusion injury and liver regeneration in hepatic tumour recurrence / M. Maspero, S. Yilmaz, B. Cazzaniga, R. Raj, K. Ali, V. Mazzaferro, A. Schlegel. - In: JHEP REPORTS. - ISSN 2589-5559. - 5:11(2023), pp. 100846.1-100846.19. [10.1016/j.jhepr.2023.100846]

The role of ischaemia-reperfusion injury and liver regeneration in hepatic tumour recurrence

M. Maspero
Primo
;
V. Mazzaferro
Penultimo
;
2023

Abstract

: The risk of cancer recurrence after liver surgery mainly depends on tumour biology, but preclinical and clinical evidence suggests that the degree of perioperative liver injury plays a role in creating a favourable microenvironment for tumour cell engraftment or proliferation of dormant micro-metastases. Understanding the contribution of perioperative liver injury to tumour recurrence is imperative, as these pathways are potentially actionable. In this review, we examine the key mechanisms of perioperative liver injury, which comprise mechanical handling and surgical stress, ischaemia-reperfusion injury, and parenchymal loss leading to liver regeneration. We explore how these processes can trigger downstream cascades leading to the activation of the immune system and the pro-inflammatory response, cellular proliferation, angiogenesis, anti-apoptotic signals, and release of circulating tumour cells. Finally, we discuss the novel therapies under investigation to decrease ischaemia-reperfusion injury and increase regeneration after liver surgery, including pharmaceutical agents, inflow modulation, and machine perfusion.
cholangiocarcinoma; colorectal liver metastasis; hepatocellular carcinoma; liver resection; liver transplantation; machine perfusion; organ preservation
Settore MED/18 - Chirurgia Generale
Settore MED/06 - Oncologia Medica
2023
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1018751
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