Visual Universitätsmedizin Mainz

Hepatocellular Carcinoma

Hepatocellular carcinoma is treated by a multidisciplinary team. In 2014, 19 patients were transplanted for HCC and 30 liver resections were performed. The development of computerassisted intraoperative navigation allows the resection of predefined areas of the liver on a 3D-reconstructed computed tomography examination by preserving vascular structures. Further, 260 conventional and DC BEADS transarterial chemoembolization (TACE) procedures were done (Otto G. J Hepatol. 2013) and 384 cases were treated within the outpatient clinic of the UCTs HCC Program, which was certified as the first liver cancer center in Germany in 2015. Each year around 120 new HCC cases are diagnosed and treated at our center.

Clinical Research

Clinical research activities involve the participation in several international multi-center trials on liver cancer investigating systemic treatment strategies for HCC, including the pivotal phase III trial of sorafenib (SHARP trial; Llovet J.M. Engl J Med. 2008). Novel treatment strategies involve the analysis of oncolytic viruses (JX-594; TRAVERSE trial) in patients with therapy-refractory HCC.

Data Collection / Biobanking

The HCC Program has one of the world's largest collectives of HCC patients involving more than 1,800 patients with complete documentation of the clinical course, laboratory parameters and histological findings as well as an extensive collection of matched serum (>4500) and tissue (>800) samples (Weinmann A. J Clin Gastroenterol. 2014).
 
Within the HCC registry we analyzed I) safety and efficacy of sorafenib in patients with concomitant liver cirrhosis (Wörns M.A. J Clin Gastroenterol. 2009); II) the safety of sorafenib in recurrent HCC after liver transplantation (Weinmann A. Dig Liver Dis. 2012); or III) treatment and survival of NASH associated HCC (Weinmann A. BMC Cancer 2015).

Translational HCC-Projects

One core area within the translational HCC Program is focusing on immunological effects of small molecule inhibitors on the tumor microenverionment (Sprinzl M.F. Hepatology 2013; Sprinzl M.F. J Hepatol. 2015). Another strength of the HCC Program is the systematic application of cutting edge molecular technologies, i.e., microarray and Next Generation Sequencing (NGS), to classify and characterize liver tumors as well as chronic liver diseases (Marquardt J.U. J. Hepatol. 2014). Precision medicine approaches to identify predictive and prognostic molecular profiles are the major focus of a newly established Lichtenberg professorship awarded to J. Marquardt. Epigenetic modulators and related molecular mechanisms are investigated in the context of chronic liver diseases and hepatocellular carcinoma (Marquardt J.U. Hepatology 2013).

Most significant publications

  • Sprinzl M.F., A. Puschnik, A.M. Schlitter, A. Schad, K. Ackermann, I. Esposito, H. Lang, P.R. Galle, A. Weinmann, M. Heikenwälder, U. Protzer. 2015. Sorafenib inhibits macrophage-induced growth of hepatoma cells by interference with insulin-like growth factor-1 secretion. J Hepatol. 62(4):863-70.
     
  • Weinmann A., Y. Alt, S. Koch, C. Nelles, C. Düber, H. Lang, G. Otto, T. Zimmermann, J.U. Marquardt, P.R. Galle, M.A. Wörns, J.M. Schattenberg. 2015. Treatment and survival of non-alcoholic steatohepatitis associated hepatocellular carcinoma. BMC Cancer. 15:210.
     
  • Marquardt J.U., D. Seo, J.B. Andersen, M.C. Gillen, M.S. Kim, E.A. Conner, V.M. Factor., Y.N. Park, S.S. Thorgeirsson. 2014. Sequential analysis of hepatocarcinogenesis indicates late stage acquisition of malignant traits. J Hepatol. 60(2):346-53.
     
  • Weinmann A., S. Koch, I.M. Niederle, H. Schulze-Bergkamen, J. König, M. Hoppe-Lotichius, T. Hansen, M.B. Pitton, C. Düber, G. Otto, M. Schuchmann, P.R. Galle, M.A. Wörns. 2014. Trends in epidemiology, treatment, and survival of hepatocellular carcinoma patients between 1998 and 2009: an analysis of 1066 cases of a German HCC Registry. J Clin Gastroenterol. 48(3):279-89.
     
  • Marquardt J.U., K. Fischer, K. Baus, A. Kashyap, S. Ma, M. Krupp, M. Linke, A. Teufel, U. Zechner, D. Strand, S.S. Thorgeirsson, P.R. Galle, S. Strand. 2013. SIRT6 dependent Member of the FZI genetic and epigenetic alterations are associated with poor clinical outcome in HCC patients. Hepatology. 58(3):1054-64.
     
  • Otto G., M. Schuchmann, M. Hoppe-Lotichius, M. Heise, A. Weinmann, T. Hansen, M.P. Pitton. 2013. How to decide about liver transplantation in patients with hepatocellular carcinoma: size and number of lesions or response to TACE? J Hepatol. 59(2):279-84.
     
  • Sprinzl M.F., F. Reisinger, A. Puschnik, M. Ringelhan, K. Ackermann, D. Hartmann, M. Schiemann, A. Weinmann, P.R. Galle, M. Schuchmann, H. Friess, G. Otto, M. Heikenwalder, U. Protzer. 2013. Sorafenib perpetuates cellular anticancer effector functions by modulating the crosstalk between macrophages and natural killer cells. Hepatology. 57(6):2358-68.
     
  • Weinmann A., I.M. Niederle, S. Koch, M. Hoppe-Lotichius, M. Heise, C. Düber, M. Schuchmann, G. Otto, P.R. Galle, M.A. Wörns. 2012. Sorafenib for recurrence of hepatocellular carcinoma after liver transplantation. Dig Liver Dis. 44(5):432-7.
     
  • Wörns M.A., A. Weinmann, K. Pfingst, C. Schulte-Sasse, C.M. Messow, H. Schulze-Bergkamen, A. Teufel, M. Schuchmann, S. Kanzler, C. Düber, G. Otto, P.R. Galle. 2009. Safety and efficacy of sorafenib in patients with advanced hepatocellular carcinoma in consideration of concomitant stage of liver cirrhosis. J Clin Gastroenterol. 43(5):489-95.
     
  • Llovet J.M., S. Ricci, V. Mazzaferro, P. Hilgard, E. Gane, J.F. Blanc, A.C. de Oliveira, A. Santoro, J.L. Raoul, A. Forner, M. Schwartz, C. Porta, S. Zeuzem, L. Bolondi, T.F. Greten, P.R. Galle, J.F. Seitz, I. Borbath, D. Häussinger, T. Giannaris, M. Shan, M. Moscovici, D. Voliotis, J. Bruix; SHARP Investigators Study Group. 2008. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 359(4):378-90.