Journal of Liver Cancer

Dong-Sik Kim

5 Articles

Clinical outcome of surgical resection for multifocal T2-T3 hepatocellular carcinoma up to 3 nodules: a comparative analysis with a single nodule: Sehyeon Yu, Hye-Sung Jo, Young-Dong Yu, Yoo jin Choi, Dong-Sik Kim; J Liver Cancer. 2023;23(2):377-388. Published online September 15, 2023; DOI: https://doi.org/10.17998/jlc.2023.08.24

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Abstract PDF Supplementary Material: Background/Aim
s: Although the Barcelona Clinic Liver Cancer staging system seems to underestimate the impact of curative-intent surgical resection for multifocal hepatocellular carcinoma (HCC), recent studies have indicated favorable results for the surgical resection of multiple HCC. This study aimed to assess clinical outcomes and feasibility of surgical resection for multifocal HCC with up to three nodules compared with single tumor cases.
Methods
Patients who underwent surgical resection for HCC with up to three nodules between 2009 and 2020 were included, and those with the American Joint Committee on Cancer (AJCC) 8th edition, T1 and T4 stages were excluded to reduce differences in disease distribution and severity. Finally, 81 and 52 patients were included in the single and multiple treatment groups, respectively. Short- and long-term outcomes including recurrence-free survival (RFS) and overall survival (OS), were evaluated.
Results
All patients were classified as Child-Pugh class A. RFS and OS were not significantly different between the two groups (P=0.176 and P=0.966, respectively). Multivariate analysis revealed that transfusion and intrahepatic metastasis were significantly associated with recurrence (P=0.046 and P=0.005, respectively). Additionally, intrahepatic metastasis was significantly associated with OS (hazard ratio, 1.989; 95% confidence interval, 1.040-3.802; P=0.038).
Conclusions
Since there was no significant difference in survival between the single and multiple groups among patients with AJCC 8th stage T2 and T3, surgical resection with curative intent could be considered with acceptable long-term survival for selected patients with multiple HCC of up to three nodules.

A Case of Simultaneous Resection of Recurrent Combined Hepatocellular Cholangiocarcinoma and Hypovascular Hepatocellular Carcinoma: Tae Hyung Kim, Soon Ho Um, Sang Jung Park, Seung Woon Park, Han Ah Lee, Yeon Seok Seo, Young Dong Yu, Dong-Sik Kim, Joo Young Kim; J Liver Cancer. 2017;17(1):94-99. Published online March 31, 2017; DOI: https://doi.org/10.17998/jlc.17.1.94

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Abstract PDF: Liver cancer is more complex to treat compared to cancers in other organs, since liver function should be considered. In addition, only a few patients can be applied curative treatment due to advanced stage at diagnosis. Therefore, early stage detection is important and has been increased through screening and surveillance programs using image modalities recently. However, it is still difficult to diagnose small or hypovascular hepatocellular carcinoma (HCC) even using advanced image modalties. In particular, hypovascular HCCs do not show arterial contrast enhancement which is a typical finding of HCC on computed tomography (CT) and magnetic resonance imaging (MRI). Those also account for a considerable portion of early HCC. We present 54 yearsold man who had recurrent hypervascular and hypovascular nodules on three phase CT and gadoxetic acid-enhanced MRI. The nodules were removed by surgical resection and confirmed as combined hepatocellular-cholangiocarcinoma and well differentiated HCC respectively.

A Case of Management for Hepatocellular Carcinoma with Lung Metastasis: Han Jo Jeon, Tae Hyung Kim, Soon Ho Um, Yeon Seok Seo, Hyun Seo Kim, Ki Joon Lim, Seung Woon Park, Han Ah Lee, Dong-Sik Kim; J Liver Cancer. 2016;16(2):129-133. Published online September 30, 2016; DOI: https://doi.org/10.17998/jlc.16.2.129

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Abstract PDF: Liver cancer is the 2nd most common cause of cancer related death in Korea. Especially, patients who present extrahepatic spread of hepatocellular carcinoma (HCC) have a shorter life expectancy (50% survival at 1 year and less than 4 months of median overall survival). Molecular target agent like sorafenib was usually mentioned as a treatment for them, but that was still not firmly established. We present a 75 year-old who had expanding nodular type of HCC. The mass was removed by resection and radiofrequency ablation. However, lung metastasis were revealed shortly after surgery. That lesions were treated with lenvatinib and systemic chemotherapy.

Beyond BCLC in the management of patients with HCC 수술적 치료의 적응증: Dong-Sik Kim; J Liver Cancer. 2015;15(1):1-3. Published online March 31, 2015; DOI: https://doi.org/10.17998/jlc.15.1.1

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Abstract PDF: Although surgical resection can provide best treatment outcome with curative intent, patients with relatively early stage of hepatocellular carcinoma (HCC) can get benefit of this treatment. Barcelona Clinic Liver Cancer (BCLC) staging system limits surgical resection to patients with single HCC with well-preserved liver function, which is often challenged in real practice, especially from Asian countries. During last two decades, surgical outcomes have made remarkable progress approaching zero mortality in many reports. In this review, areas that surgical indications can be expanded beyond BCLC staging system will be discussed, especially in Asian population. (Journal of Liver Cancer 2015;15:1-3)

Directions for Future Hepatocellular Carcinoma Treatment Guidelines; Surgeon’s Perspective: Extension of Surgical Indication: Dong-Sik Kim; Journal of the Korean Liver Cancer Study Group. 2013;13(1):14-17. Published online February 28, 2013; DOI: https://doi.org/10.17998/jlc.13.1.14

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Abstract PDF: Since the second edition of practice guidelines for management of hepatocellular carcinoma in 2009, several other organizations have added newer versions of guidelines. It must be a good opportunity to review trends in changes of recent guidelines focusing on surgical filed. At the same time, issues that have been suggested or discussed so far regarding Korean guidelines will be discussed.