- Current status of ultrasonography in national cancer surveillance program for hepatocellular carcinoma in South Korea: a large-scale multicenter study
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Sun Hong Yoo, Soon Sun Kim, Sang Gyune Kim, Jung Hyun Kwon, Han-Ah Lee, Yeon Seok Seo, Young Kul Jung, Hyung Joon Yim, Do Seon Song, Seong Hee Kang, Moon Young Kim, Young-Hwan Ahn, Jieun Han, Young Seok Kim, Young Chang, Soung Won Jeong, Jae Young Jang, Jeong-Ju Yoo
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J Liver Cancer. 2023;23(1):189-201. Published online March 24, 2023
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DOI: https://doi.org/10.17998/jlc.2023.03.11
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1,606
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 Abstract
 PDF Supplementary Material
- Background/Aim
Abdominal ultrasonography (USG) is recommended as a surveillance test for high-risk groups for hepatocellular carcinoma (HCC). This study aimed to analyze the current status of the national cancer surveillance program for HCC in South Korea and investigate the effects of patient-, physician-, and machine-related factors on HCC detection sensitivity.
Methods
This multicenter retrospective cohort study collected surveillance USG data from the high-risk group for HCC (liver cirrhosis or chronic hepatitis B or C >40 years of age) at eight South Korean tertiary hospitals in 2017.
Results
In 2017, 45 experienced hepatologists or radiologists performed 8,512 USG examinations. The physicians had a mean 15.0±8.3 years of experience; more hepatologists (61.4%) than radiologists (38.6%) participated. Each USG scan took a mean 12.2±3.4 minutes. The HCC detection rate by surveillance USG was 0.3% (n=23). Over 27 months of follow-up, an additional 135 patients (0.7%) developed new HCC. The patients were classified into three groups based on timing of HCC diagnosis since the 1st surveillance USG, and no significant intergroup difference in HCC characteristics was noted. HCC detection was significantly associated with patient-related factors, such as old age and advanced fibrosis, but not with physician- or machine-related factors.
Conclusions
This is the first study of the current status of USG as a surveillance method for HCC at tertiary hospitals in South Korea. It is necessary to develop quality indicators and quality assessment procedures for USG to improve the detection rate of HCC.
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Citations
Citations to this article as recorded by  - The Epidemiology of Hepatitis B Virus Infection in Korea: 15-Year Analysis
Log Young Kim, Jeong-Ju Yoo, Young Chang, Hoongil Jo, Young Youn Cho, Sangheun Lee, Dong Hyeon Lee, Jae Young Jang
Journal of Korean Medical Science.2024;[Epub] CrossRef - Long-Term HBsAg Titer Kinetics with Entecavir/Tenofovir: Implications for Predicting Functional Cure and Low Levels
Soon Kyu Lee, Soon Woo Nam, Jeong Won Jang, Jung Hyun Kwon
Diagnostics.2024; 14(5): 495. CrossRef
- The diagnostic value of circulating tumor DNA in hepatitis B virus induced hepatocellular carcinoma: a systematic review and meta-analysis
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Young Chang, Soung Won Jeong, Jae Young Jang, Hyuksoo Eun, Young‑Sun Lee, Do Seon Song, Su Jong Yu, Sae Hwan Lee, Won Kim, Hyun Woong Lee, Sang Gyune Kim, Seongho Ryu, Suyeon Park
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J Liver Cancer. 2022;22(2):167-177. Published online September 29, 2022
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DOI: https://doi.org/10.17998/jlc.2022.09.19
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2,603
Views
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73
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1
Citation
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Abstract
PDFSupplementary Material
- Background/Aim
New biomarkers are urgently needed to aid in the diagnosis of early stage hepatocellular carcinoma (HCC). We performed a meta-analysis on the diagnostic utility of circulating tumor DNA (ctDNA) levels in patients with hepatitis B virus-induced HCC.
Methods
We retrieved relevant articles from PubMed, Embase, and the Cochrane Library up to February 8, 2022. Two subgroups were defined; one subset of studies analyzed the ctDNA methylation status, and the other subset combined tumor markers and ctDNA assays. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC) were analyzed.
Results
Nine articles including 2,161 participants were included. The overall SEN and SPE were 0.705 (95% confidence interval [CI], 0.629-0.771) and 0.833 (95% CI, 0.769-0.882), respectively. The DOR, PLR, and NLR were 11.759 (95% CI, 7.982-17.322), 4.285 (95% CI, 3.098- 5.925), and 0.336 (0.301-0.366), respectively. The ctDNA assay subset exhibited an AUC of 0.835. The AUC of the combined tumor marker and ctDNA assay was 0.848, with an SEN of 0.761 (95% CI, 0.659-0.839) and an SPE of 0.828 (95% CI, 0.692-0.911).
Conclusions
Circulating tumor DNA has promising diagnostic potential for HCC. It can serve as an auxiliary tool for HCC screening and detection, especially when combined with tumor markers.
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Citations
Citations to this article as recorded by - 16S rRNA Next-Generation Sequencing May Not Be Useful for Examining Suspected Cases of Spontaneous Bacterial Peritonitis
Chan Jin Yang, Ju Sun Song, Jeong-Ju Yoo, Keun Woo Park, Jina Yun, Sang Gyune Kim, Young Seok Kim
Medicina.2024; 60(2): 289. CrossRef
- The General Rules for the Study of Primary Liver Cancer
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Jae Young Jang, June Sung Lee, Hyung-Joon Kim, Jae-Jun Shim, Ji Hoon Kim, Bo Hyun Kim, Choon Hyuck Kwon, Seung Duk Lee, Hae Won Lee, Jung Hoon Kim, Woo Kyoung Jeong, Jin-Young Choi, Heung Kyu Ko, Dong Ho Lee, Haeryoung Kim, Baek-hui Kim, Sang Min Yoon, Soon Ho Um
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J Liver Cancer. 2017;17(1):19-44. Published online March 31, 2017
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DOI: https://doi.org/10.17998/jlc.17.1.19
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2,445
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186
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28
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Abstract
PDF
- The General Rules for the Study of Primary Liver Cancer was published in June 2001 as the first
edition. Since then, the 5th edition of the General Rules for the Study of Primary Liver Cancer
was published by the 17th Committee of the Korean Liver Cancer Association based on the
most recent data. The 5th edition of the General Rules for the Study of Primary Liver Cancer
ranged over numerous topics such as anatomy, medical assessment of the patients, staging
of hepatocellular carcinoma, description of the image findings, summary of hepatic resection,
description of the surgical specimens, liver transplantation, reporting the pathological findings,
pathological examinations of liver specimen, non-surgical treatment, radiotherapy, and
assessment of tumor response after non-surgical treatment of hepatocellular carcinoma. The 5th
General Rules for the Study of Primary Liver Cancer will not only become the basis of academic
development for liver cancer studies in Korea, but also serve as the primary form of national
liver cancer data accumulation based on standardized rules.
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Citations
Citations to this article as recorded by - Preoperative Prediction of Microvascular Invasion with Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients with Single Hepatocellular Carcinoma: The Implication of Surgical Decision on the Extent of Liver Resection
Na Reum Kim, Heejin Bae, Hyeo Seong Hwang, Dai Hoon Han, Kyung Sik Kim, Jin Sub Choi, Mi-Suk Park, Gi Hong Choi
Liver Cancer.2024; 13(2): 181. CrossRef - Radiologic Patterns Determine the Outcomes of Initial and Subsequent Transarterial Chemoembolization in Intermediate-Stage Hepatocellular Carcinoma
Ya-Wen Hung, I-Cheng Lee, Chen-Ta Chi, Rheun-Chuan Lee, Chien-An Liu, Nai-Chi Chiu, Hsuen-En Hwang, Yee Chao, Ming-Chih Hou, Yi-Hsiang Huang
Liver Cancer.2024; 13(1): 29. CrossRef - National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma
Faisal Saud Dar, Zaigham Abbas, Irfan Ahmed, Muhammad Atique, Usman Iqbal Aujla, Muhammad Azeemuddin, Zeba Aziz, Abu Bakar Hafeez Bhatti, Tariq Ali Bangash, Amna Subhan Butt, Osama Tariq Butt, Abdul Wahab Dogar, Javed Iqbal Farooqi, Faisal Hanif, Jahanzai
World Journal of Gastroenterology.2024; 30(9): 1018. CrossRef - Macroscopic Characterization of Hepatocellular Carcinoma: An Underexploited Source of Prognostic Factors
Stéphanie Gonvers, Sebastiao Martins-Filho, André Hirayama, Julien Calderaro, Rebecca Phillips, Emilie Uldry, Nicolas Demartines, Emmanuel Melloul, Young Nyun Park, Valérie Paradis, Swan Thung, Venancio Alves, Christine Sempoux, Ismail Labgaa
Journal of Hepatocellular Carcinoma.2024; Volume 11: 707. CrossRef - Non-Invasive Imaging Biomarkers to Predict the Hepatopulmonary Shunt Fraction Before Transarterial Radioembolization in Patients with Hepatocellular Carcinoma
Charlie Alexander Hamm, Felix Busch, Anna Pöhlmann, Annabella Shewarega, Yubei He, Robin Schmidt, Han Xu, Gero Wieners, Bernhard Gebauer, Lynn Jeanette Savic
Journal of Hepatocellular Carcinoma.2023; Volume 10: 27. CrossRef - Histological subtypes of hepatocellular carcinoma: Their clinical and prognostic significance
So Hyun Shin, Joon Young Park, Chungsu Hwang, Hyun Jung Lee, Dong Hoon Shin, Jee Yeon Kim, Je Ho Ryu, Kwang Ho Yang, Tae Beom Lee, Jung Hee Lee
Annals of Diagnostic Pathology.2023; 64: 152134. CrossRef - Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging
Yoon Jung Hwang, Jae Seok Bae, Youngeun Lee, Bo Yun Hur, Dong Ho Lee, Haeryoung Kim
Clinical and Molecular Hepatology.2023; 29(3): 733. CrossRef - Microvascular Invasion in Hepatocellular Carcinoma: A Review of Its Definition, Clinical Significance, and Comprehensive Management
Zehao Zheng, Renguo Guan, Wang Jianxi, Zhen Zhao, Tianyi Peng, Chunsheng Liu, Ye Lin, Zhixiang Jian, Yuan Seng Wu
Journal of Oncology.2022; 2022: 1. CrossRef - A clinical and pathological update on hepatocellular carcinoma
Salvatore Lorenzo Renne, Luca Di Tommaso
Journal of Liver Cancer.2022; 22(1): 14. CrossRef - Comparing efficacies of different treatment regimens in patients with hepatocellular carcinoma accompanied by portal vein tumor thrombus using network meta-analysis
Seungji Lee, Sung Kyu Song, Byungje Bae, Yongkeun Park
Annals of Surgical Treatment and Research.2022; 103(5): 280. CrossRef - Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up
Mohammadreza Shaghaghi, Mounes Aliyari Ghasabeh, Sanaz Ameli, Maryam Ghadimi, Bita Hazhirkarzar, Roya Rezvani Habibabadi, Pegah Khoshpouri, Ankur Pandey, Pallavi Pandey, Ihab R. Kamel
European Radiology.2021; 31(3): 1378. CrossRef - Risk Factors for Beyond Milan Recurrence After Hepatic Resection for Single Hepatocellular Carcinoma No Larger Than 5 Centimeters
Mina Kim, Taegyu Kim, Hyun Young Lee, Sung Yeon Hong, Hee‐Jung Wang, Bong‐Wan Kim
Liver Transplantation.2021; 27(8): 1116. CrossRef - Hepatocellular carcinoma: a clinical and pathological overview
Salvatore Lorenzo Renne, Samantha Sarcognato, Diana Sacchi, Maria Guido, Massimo Roncalli, Luigi Terracciano, Luca Di Tommaso
Pathologica.2021; 113(3): 203. CrossRef - Prognostic significance of viable tumor size measurement in hepatocellular carcinomas after preoperative locoregional treatment
Yoon Jung Hwang, Youngeun Lee, Hyunjin Park, Yangkyu Lee, Kyoungbun Lee, Haeryoung Kim
Journal of Pathology and Translational Medicine.2021; 55(5): 338. CrossRef - Response to Comment on “Subclassification of Microscopic Vascular Invasion in Hepatocellular Carcinoma”
Gi Hong Choi, Incheon Kang, Young Nyun Park
Annals of Surgery.2021; 274(6): e748. CrossRef - Subclassification of Microscopic Vascular Invasion in Hepatocellular Carcinoma
Incheon Kang, Mi Jang, Jae Geun Lee, Dai Hoon Han, Dong Jin Joo, Kyung Sik Kim, Myoung Soo Kim, Jin Sub Choi, Soon Il Kim, Young Nyun Park, Gi Hong Choi
Annals of Surgery.2021; 274(6): e1170. CrossRef - Up-to-date Knowledge on the Pathological Diagnosis of Hepatocellular Carcinoma
Ji Hae Nahm, Young Nyun Park
The Korean Journal of Gastroenterology.2021; 78(5): 268. CrossRef - Survival according to recurrence patterns after resection for transplantable hepatocellular carcinoma in HBV endemic area: Appraisal of liver transplantation strategy
Chung Gyo Seo, Sun Young Yim, Soon Ho Um, Yoo Ra Lee, Yoo Jin Lee, Tae Hyung Kim, Hyun Gil Goh, Young Sun Lee, Sang Jun Suh, Na Yeon Han, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Hyung Joon Yim, Ji Hoon Kim, Dong Sik Kim, Yoon Tae Jeen, Hoon
Clinics and Research in Hepatology and Gastroenterology.2020; 44(4): 532. CrossRef - Risk of Liver Cirrhosis and Hepatocellular Carcinoma after Fontan Operation: A Need for Surveillance
Jun Sik Yoon, Dong Ho Lee, Eun Ju Cho, Mi Kyoung Song, Young Hun Choi, Gi Beom Kim, Yun Bin Lee, Jeong-Hoon Lee, Su Jong Yu, Haeryoung Kim, Yoon Jun Kim, Jung-Hwan Yoon, Eun Jung Bae
Cancers.2020; 12(7): 1805. CrossRef - Update on Hepatocellular Carcinoma: a Brief Review from Pathologist Standpoint
Nese Karadag Soylu
Journal of Gastrointestinal Cancer.2020; 51(4): 1176. CrossRef - How Should We Assign Large Infiltrative Hepatocellular Carcinomas for Staging?
Yoo Jin Lee, Yoo Ra Lee, Chung Gyo Seo, Hyun Gil Goh, Tae Hyung Kim, Sun Young Yim, Na Yeon Han, Jae Min Lee, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Hyonggin An, Beomjin Park, Yeon Seok Seo, Hyung Joon Yim, Ji Hoon Kim, Young Dong Yu, Dong Sik Kim, Yoon
Cancers.2020; 12(9): 2589. CrossRef - Substantial risk of recurrence even after 5 recurrence-free years in early-stage hepatocellular carcinoma patients
Jihye Kim, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik
Clinical and Molecular Hepatology.2020; 26(4): 516. CrossRef - Role of tumor margin and ADC change in defining the need for additional treatments after the first TACE in patients with unresectable HCC
Mohammadreza Shaghaghi, Mounes AliyariG hasabeh, Sanaz Ameli, Maryam Ghadimi, Bita Hazhirkarzar, Roya Rezvani Habibabadi, Hao Tang, Pegah Khoshpouri, Qingxia Wu, Ankur Pandey, Pallavi Pandey, Azarakhsh Baghdadi, Ihab R. Kamel
European Journal of Radiology.2020; 133: 109389. CrossRef - The 7th/8th American Joint Committee on Cancer and the Modified Union for International Cancer Control Staging System for Hepatocellular Carcinoma
In-Gyu Kim, Xu-Guang Hu, Hee-Jung Wang, Bong-Wan Kim, Sung Yeon Hong, Xue-Yin Shen
Yonsei Medical Journal.2019; 60(2): 140. CrossRef - Hepatocellular carcinoma with extrahepatic metastasis: Are there still candidates for transarterial chemoembolization as an initial treatment?
Jihye Kim, Dong-Hyun Sinn, Moon Seok Choi, Wonseok Kang, Geum-Youn Gwak, Yong-Han Paik, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Enzo Tagliazucchi
PLOS ONE.2019; 14(3): e0213547. CrossRef - Evaluation of early treatment response to radiotherapy for HCC using pre- and post-treatment MRI
So Hee Song, Woo Kyoung Jeong, Dongil Choi, Young Kon Kim, Hee Chul Park, Jeong Il Yu
Acta Radiologica.2019; 60(7): 826. CrossRef - The Clinicopathological and Prognostic Significance of the Gross Classification of Hepatocellular Carcinoma
Yangkyu Lee, Hyunjin Park, Hyejung Lee, Jai Young Cho, Yoo-Seok Yoon, Young-Rok Choi, Ho-Seong Han, Eun Sun Jang, Jin-Wook Kim, Sook-Hyang Jeong, Soomin Ahn, Haeryoung Kim
Journal of Pathology and Translational Medicine.2018; 52(2): 85. CrossRef - Hepatobiliary MRI as novel selection criteria in liver transplantation for hepatocellular carcinoma
Ah Yeong Kim, Dong Hyun Sinn, Woo Kyoung Jeong, Young Kon Kim, Tae Wook Kang, Sang Yun Ha, Chul Keun Park, Gyu Seong Choi, Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Min-Ji Kim, Insuk Sohn, Sin-Ho Jung, Seung Woon Paik, Won Jae Lee
Journal of Hepatology.2018; 68(6): 1144. CrossRef
- A Case of Hepatocellular Carcinoma with Pulmonary Metastasis Who Showed Complete Response by Cytotoxic Chemotherapy after Sorafenib Failure
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Hwa-Sun Park, Jae Young Jang, Min Young Baek, Yong Kwon Kim, Hyun Jin Youn, Su Young Back, Soung Won Jeong, Sae Hwan Lee, Sang Gyune Kim, Sang Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
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J Liver Cancer. 2017;17(1):72-76. Published online March 31, 2017
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DOI: https://doi.org/10.17998/jlc.17.1.72
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Abstract
PDF
- Hepatocellular carcinoma (HCC) is the 2nd most common cause of cancer related death
in Korea and well-known malignancy with poor prognosis. Sorafenib is the first-line
molecular targeted agent in patients with extra-hepatic spread of HCC. However, complete
response is extremely rare in patients treated with sorafenib and the disease control rate
is only 43%. We report a 53-year-old man with advanced HCC with pulmonary metastasis
who showed complete response by cytotoxic chemotherapy with doxorubicin and
cisplatin with relatively tolerable adverse effects after failure of treatment with sorafenib.
- A Case of Surgical Resection in Hepatocellular Carcinoma with Pulmonary Metastasis
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Woo Jin Jung, Jae Young Jang, Jun Seok Park, Hee Jeong Lee, Young Kyu Cho, Soung Won Jeong, Sae Hwan Lee, Snag Gyune Kim, Sang Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
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J Liver Cancer. 2016;16(2):145-150. Published online September 30, 2016
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DOI: https://doi.org/10.17998/jlc.16.2.145
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Abstract
PDF
- Hepatocellular carcinoma (HCC) is well known malignancy with poor prognosis, even after
resection of the primary tumor. Sorafenib is the first-line treatment in advanced HCC, but the
disease control rate of sorafenib is only 43%. Pulmonary metastasectomy in patients with
pulmonary metastasis from HCC has been reported to increase long-term survival compared
with systemic chemotherapy. Video-assisted thoracic surgery is considered a reliable
approach to the diagnosis and treatment of pulmonary diseases with low complication
rate. Pulmonary metastasectomy is not universally accepted because of frequent local
recurrence, an uncontrollable primary tumor, and frequent multiple pulmonary metastases
in HCC, but outcome of pulmonary metastasectomy and adjuvant sorafenib therapy has
not been studied. We experienced a patient who had advanced HCC with pulmonary
oligometastasis and received surgical resection of the metastatic pulmonary nodule and
sorafenib chemotherapy. In advanced HCC with pulmonary oligometastasis, surgical
resection of pulmonary metastasis and sorafenib chemotherapy should be considered.
- A Case of Management for Early Recurrence after Hepatic Resection for the Treatment of Small Hepatocellular Carcinoma
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Kyung Woo Park, Young Seok Kim, Sang Gyune Kim, Soung Won Jeong, Jae Young Jang, Hong Soo Kim, Sae Hwan Lee, Boo Sung Kim, Jun Cheol Jeong, Min Hee Lee, Jae Myeong Lee, Hee Kyung Kim
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J Liver Cancer. 2015;15(2):122-125. Published online September 30, 2015
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DOI: https://doi.org/10.17998/jlc.15.2.122
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Abstract
PDF
- For a small hepatocellular carcinoma (HCC), liver resection shows most favorable outcome in
case
which liver transplantation is not available, although it has also substantial recurrence
rate. Here, we report a case of recurred HCC with multiple intrahepatic metastasis at 5 months
after surgical resection for small HCC was done. A 55-year-old man with chronic HBV infection
received subsegmentectomy for HCC less than 2 cm. A follow-up computed tomography (CT)
at 5 months from operation revealed that there were multiple enhancing nodules in entire
remnant liver. Intra-arterial injections of adriamycin mixed lipiodol and gelfoam particles were
instituted through hepatic artery. We assume that poorly differentiated cellular feature would
be attributable to this kind of very early and aggressive recurrence of HCC. (J Liver Cancer
2015;15:122-125)
- Follow-up of Hepatocellular Carcinoma After Transarterial Chemoembolization; The Concordance of Contrast Enhanced Ultrasonography and Lipiodol CT
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Gene Hyun Bok, Soung Won Jeong, Jae Young Jang, Sae Hwan Lee, Sang Gyune Kim, Sang-Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
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J Liver Cancer. 2014;14(2):115-119. Published online September 30, 2014
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DOI: https://doi.org/10.17998/jlc.14.2.115
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Abstract
PDF
- Background/Aim
s: The aim of this study is to evaluate the concordance of contrast-enhanced
ultrasonography (CEUS) and lipiodol computed tomography (L-CT) for the assessment of
viable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE).
Methods
We retrospectively reviewed the post-TACE CEUS and L-CT images of 65
consecutive HCCs in 41 patients to assess the presence of viable tumor tissue. Forty-seven
HCCs in 31 patients that underwent post-TACE L-CT within 4 weeks of the CEUS examination
were included. The degree of concordance between CEUS and L-CT and factors related to
concordance were analyzed.
Results
The overall concordance of CEUS and LDCT was 78.7% (37/47). The concordance with
L-CT for viable tumor and non-viable tumor tissue on CEUS was 95.2%, and 65.4% respectively
(P<0.013). Diffuse tumors had a tendency for non-concordance (P=0.066). Although 3 of 4
lesions located in the hepatic dome were non-concordant, the sample size was too small to
establish significance. The mean tumor size for concordant and non-concordant tumors was
2.9 and 3.0 cm, with no significant difference.
Conclusions
Although the concordance of CEUS and L-CT for viable tumor tissue was
high, the concordance for non-viable tumor tissue was relatively low. Prospective studies
using angiography as a gold standard should be performed in the future. (J Liver Cancer
2014;14:115-119)
- Occurrence Rates of Hepatocellular Carcinoma in Patients with Adefovir-rescue Therapy for Lamivudine-Resistant Chronic Hepatitis B
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Jihyun Kim, Sae Hwan Lee, Kanghyug Choi, Yun Nah Lee, Soung won Jeong, Sang Gyune Kim, Jae Young Jang, Young Seok Kim, Hong Soo Kim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2013;13(2):130-135. Published online September 30, 2013
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DOI: https://doi.org/10.17998/jlc.13.2.130
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Abstract
PDF
- Background/Aim
s: Suboptimal virological response to adefovir (ADV) rescue therapy was commonly experienced in patient with lamivudine-resistant chronic hepatitis B. The aim of this study is to compare occurrence of hepatocellular carcinoma (HCC) of patients with adefovir rescue therapy to naïve patients with entecavir.
Methods
Electronic medical records of 156 patients with lamivudine-resistant chronic hepatitis B who treated with ADV and of 186 naïve-patients who received entecavir 0.5 mg, as control group, were reviewed retrospectively. Study subjects were matched using estimated propensity score and 107 matched subjects in each group were analyzed. Cumulative occurrence of HCC was evaluated during antiviral therapy and the association between clinical variables and development of HCC were analyzed using Kaplan-Meyer curve and risk factor for HCC was evaluated with Cox-proportional hazard model.
Results
Age, gender, Child-Pugh score, underlying cirrhosis, HBeAg, and HBV DNA level were not different in both groups, except treatment duration with ADV or entecavir (mean 52.6±17.5 vs 46.7±11.4 months, P=0.004). Cumulative virological response rates were 16% and 42% in patient with ADV rescue therapy and 68% and 85% in naïve-patients received entecavir at 1 and 3 years (P<0.001), respectively. HCC were diagnosed in 6 of 107 patients with lamivudine-resistance and 9 of 107 naïve-patients during follow-period and cumulative occurrence rates of HCC was not different between both group (P=0.308). Cumulative occurrence rates of HCC in total 214 subjects were 2.3%, 4.8%, and 9.6% at 1, 3, and 5 years, respectively. Age, underlying cirrhosis, and baseline HBV DNA level were associated with the occurrence of HCC, however gender, HBeAg status, ADV rescue therapy, and cumulative virological response were not correlated in univariate analysis. In multivariate analysis, age (P=0.008) and underlying cirrhosis (P=0.002) were independent risk factors for occurrence of HCC.
Conclusions
Long-term ADV rescue therapy in patients with lamivudine-resistant chronic hepatitis B did not increase the occurrence rates of HCC.
- The Comparison of Overall Survival between Child C with Early Stage HCC and Child A with Advanced Stage HCC
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Eui Ju Park, Jae Young Jang, Soung Won Jeong, Jin Woo Choo, Jin Nyoung Kim, Soon Ha Kwon, Byoung Moo Lee, Sae Hwan Lee, Sang Gyune Kim, Sang-Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2013;13(2):136-144. Published online September 30, 2013
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DOI: https://doi.org/10.17998/jlc.13.2.136
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Abstract
PDF
- Background/Aim
s: The prognosis of hepatocellular carcinoma (HCC) is affected by stage as well as liver function. We analyzed the survival outcome of early stage HCC in Child class C patients and advanced HCC in Child class A patients.
Methods
Among 453 HCC patients with good performance status, Group A included 33 consecutive Child class C patients with early stage (I, II) HCC, and Group B included 45 consecutive Child class A patients with advanced stage (III, IV) HCC. We investigated the clinical characteristics, cirrhotic complications, and prognostic factors related with survival in each group, and compared overall survival between two groups.
Results
Age, prothrombin time, total bilirubin and Model for End-Stage Liver Disease (MELD) scores were significantly higher in Group A. Male sex, platelet count, albumin, sodium (Na), hepatitis B virus, alpha fetoprotein (AFP) and portal vein thrombosis were significantly higher in Group B. Complications of cirrhosis such as variceal bleeding, ascites, and hepatic encephalopathy were increased in Group A (P<0.05). Patients with an elevated AFP (>400 ng/mL) tended to exhibit poor survival as it increased in Group A (P=0.084). MELD scores>15 (Hazard ratio[HR] 17.84, 95% confidence interval [CI] 3.70-85.93, P<0.001), stage IV (HR:3.27, 95% CI 1.10-9.75, P=0.033), and absence of HCC treatment (HR: 3.70, 95% CI 1.06-12.50, P=0.040) were independent poor prognostic factors in Group B. Median overall survival was 24.6 months (95% CI 10.6-38.4) for Group A and 13.5 months (95% CI 4.6-22.3) for Group B (P=0.278). In the HCC treatment group, there were no significant differences of median overall survival between Group A and Group B, respectively (27.1 vs. 15.7 months, P=0.338). In patients with conservative treatment, Group A and Group B had a significantly different median overall survival of 13.6 and 2.5 months, respectively (P=0.012). In patients of Group B, median overall survival was significantly higher in patients who received treatment of HCC compared to those who did not, respectively (15.7 vs. 2.5 months, P<0.001).
Conclusions
Overall median survival was not different between both groups. However, in Child class A patients with advanced stage HCCs, the cumulative median survival was higher in patients who received treatment of HCC compared to those who did not. Therefore, advanced stage HCC patients with good liver function should be considered for HCC treatments.
- A Case of Unresectable Hepatocellular Carcinoma Treated by Repeated Transcatheter Arterial Chemoembolization Using DC beads® Followed with Resection
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Jeong-Yeop Song, Young Seok Kim, Jae Myeong Lee, Soo Ji Jin, Kyu Sung Choi, Yun Nah Lee, Sang Hyune Kim, Sung Won Jeong, Jae Young Jang, Sae Hwan Lee, Hong Soo Kim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2013;13(1):65-69. Published online February 28, 2013
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DOI: https://doi.org/10.17998/jlc.13.1.65
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Abstract
PDF
- In patients with unresectable hepatocellular carcinoma (HCC) and no anti-cancer treatment, the prognosis is quite poor. But in
some cases, repeated sessions of transcatheter arterial chemoembolization (TACE) reduce the tumor size even to resectable, and
post-TACE resection may prolong the survival time. We present a case of 50-year-old HBV carrier woman with abdominal
distension. The diagnosis was huge HCC with intrahepatic metastasis. Repeated intra-arterial injections of adriamycin mixed
lipiodol or DC beads® (100-300/300-500/500-700 μm, ©BIOCOMPATIBLES UK LTD) were instituted through ten sessions for
13 months. The tumor size became reduced with a partial response after 10th TACE and post-TACE resection was performed. No
visible HCCs and decreased tumor markers were noted on the examinations 3 months after the resection.
- A Case of Good Responsed Bile Duct Invasion of Hepatocellular Carcinoma on Cyberknife Therapy
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Dae Han Choi, Jae Young Jang, Soung Won Jeong, Sae Hwan Lee, Sang Gyune Kim, Young Seok Kim, Hong Soo Kim, Boo Sung Kim, A ram Jang
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Journal of the Korean Liver Cancer Study Group. 2013;13(1):70-73. Published online February 28, 2013
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DOI: https://doi.org/10.17998/jlc.13.1.70
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Abstract
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- Hepatocellular carcinoma (HCC) is one of the common tumor worldwide and recorded as third most common cause of
cancer-related deaths. Invasion of the portal and hepatic veins by HCC is common. But intrabiliary invasion is rare. Radiotherapy
(RT) is considered appropriate for unresectable, locally advanced HCC without extrahepatic metastasis. With the conventional
RT, it is not possible to deliver a high radiation dose to a treatment volume in a short time and narrow lesion. Recent technological
developments in radiation therapy, such as stereotactic body radiation therapy (SBRT), make it possible to deliver a substantial
dose of radiation to the tumor and avoid radiosensitive normal liver in the vincinity. We report a patient who were treated by
cyberknife therapy for bile duct invasion of progressing HCC despite of treatment.
- A Case of Refractory Hepatocellular Carcinoma Presented with Brain Metastasis
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Eui Bae Kim, Soung Won Jeong, Jae Young Jang, Sae Hwan Lee, Sang Gyune Kim, Young Seok Kim, Hong Soo Kim, Boo Sung Kim, A ram Jang
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):151-154. Published online September 30, 2012
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Abstract
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- Hepatocellular carcinoma (HCC) is the sixth most common tumor worldwide and the third leading cause of tumor mortality.
The majority of tumors are diagnosed when advanced and then a 5-year survival rate of HCC is below 5%. However, recent
progress in the diagnosis and treatment of HCC has made it possible for the patient to survive longer, and as a result, distant
metastasis from HCC has increased and attracted more attention than before. HCC can be metastasized to all organs through
blood and lymphatic channel. Of the various metastatic sites, the most common site is the lungs, followed by the lymph nodes,
musculoskeletal, adrenal and omentum. Also, spleen, small bowel, large bowel and esophagus can be invloved. Brain metastasis
can be occurred rarely, and then it is regarded to oncologic emergency. We report a patient who present with brain metastasis of
progressing HCC despite of treatment.
- A One cm Sized Intrahepatic Cholangiocarcinoma in a Patient with Chronic Hepatiits B Misdiagnosed as Hepatocellular Carcinoma
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Gene Hyun Bok, Soung Won Jeong, Jae Young Jang, Kwang Yeun Shim, Sae Hwan Lee, Sang Gyune Kim, Young Seok Kim, Hong Soo Kim, Boo Sung Kim, So Young Jin, Sung Sook Hong, Yong Jae Kim
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Journal of the Korean Liver Cancer Study Group. 2012;12(1):23-27. Published online February 28, 2012
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Abstract
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- Morphologically, intrahepatic cholangiocarcinoma (ICC) presents as a parenchymal mass, and it is occasionally resectable and
potentially curable. In some cases, differentiation from other hepatic neoplasms such as metastatic lesions and hepatocellular
carcinoma (HCC) can be extremely difficult, both clinically and histologically, and definitive diagnosis often needs correlation
with clinical and radiologic finding.Contrasted computed tomography (CT) is useful in the diagnosis of ICC and in determining
the extent of tumor involvement. Although the majority of liver tumors can be diagnosed by modern imaging modalities such as
contrast CT, some cases of ICC show tumor enhancement in the arterial phase the same as that in HCC, or a biliary dilatation
without stenosis by intraductal tumor growth. Differences in these patterns of tumor enhancement and status of the bile ducts in
ICC may also reflect differences in cellular characteristics, clinical features, and prognosis after treatment. We present a case of a
small ICC showing similar clinical and radiologic characteristics to HCC.
- A Case of Mechanical Obstruction after Radiofrequency Ablation of Hepatocellular Carcinoma
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Ji Eun Lee, Jae Young Jang, Soung Won Jeong, Sae Hwan Lee, Sang Gyune Kim, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2011;11(2):195-198. Published online September 30, 2011
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Abstract
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- Radiofrequency ablation (RFA) inducing of coagulation necrosis by using thermal energy via electrodes placed within the
tissue effectively controls hepatocellular carcinoma (HCC). RFA has been commonly applied as an alternative curative therapy
to surgical resection for small HCC due to effective local tumor control. Although the technique is considered relatively safe,
several major complications requiring hospitalization for treatment have been reported such as vascular thrombosis,
pneumothorax, pleural effusion, skin burn, hematoma, liver abscess and colon perforation. Most complications occur due to
thermal injuries to adjacent structures by RFA. The risk of bowel perforation has been observed only when the target lesion is
adjacent to a gastrointestinal lumen, but, mechanical obstruction is extremely rare. Therefore, we report a case of mechanical
obstruction after transaction of ileum secondary to RFA of HCC.
- Thrombotic Occlusion of Right Femoral Artery Developed during Intra-Arterial Chemotherapy Through Chemoport
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Jae Pil Han, Young Seok Kim, Sae Hwan Lee, Soung Won Jeong, Sang Gyune Kim, Jae Young Jang, Hong Soo Kim, Jae Myeong Lee, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2011;11(2):199-202. Published online September 30, 2011
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- Although chemotherapy may not play a central role in the treatment of hepatocellular carcinoma (HCC), it must be one of the
important possibilities of multimodal treatment for advanced HCC. Intra-arterial (IA) chemotherapy which can deliver high
concentration of drug to the tumor has been widely used in unresectable or intractable HCC. It seems to reduce the incidence of
systemic side effects and improve drug efficacy. For this therapy, catheter implantation is required to infuse anti-tumor drug.
Here, we report a case of patient with complication developed during IA chemotherapy for advanced HCC with portal vein
thrombosis.
- A Patient of Hepatocellular Carcinoma Performed Hepatectomy after Tumor Downing Sizing with Transcatheter Arterial Chemoembolization
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Seul Ki Min, Sang Gyune Kim, Young Seok Kim, Sae Whan Lee, Soung Won Jeong, Jae Young Jang, Hong Soo Kim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2011;11(1):40-45. Published online February 28, 2011
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- Hepatocellular carcinoma (HCC) is the third most common cancer in korean population. Surgical management is the mainstay
of HCC. Surgical resection and liver transplantation shows the best outcomes in well-selected patients. But few patients are
possible to benefit from surgical resection or liver transplantation. The majority of cases of HCC are unresectable, but there are
no proven treatment modalities for these cases. In small number of articles showed the favorable result of adjuvant chemotherapy,
and transcatheter arterial chemoembolization (TACE) for unresectable HCCs. But there are some drawbacks, such as small
number of sample size and variablity of study design at each studies. Hereby we report a patients of HCC, who was performed
hepatectomy after tumor down sizing with TACE.
- A Case of Hepatocellular Carcinoma Presenting Early Intrahepatic Recurrence Following Hepatic Resection
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Jaejun Shim, Byung-Ho Kim, Young Hwangbo, Sang Wook Lee, Young Ju Lee, Seung Hyung Ha, Jae Young Jang, Seok Ho Dong, Hyo Jong Kim, Young Woon Chang, Rin Chang, Sang Mok Lee
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Journal of the Korean Liver Cancer Study Group. 2009;9(1):33-36. Published online June 30, 2009
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Abstract
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- Long term results of hepatic resection for hepatocellular carcinoma (HCC) are not satisfactory due to a high incidence of
postoperative recurrence. To improve the prognosis in patients who underwent hepatic resection, identification of risk factors
for recurrence and development of effective preventive strategies are required. A single nodular mass was found in the right
hepatic lobe of 53-year old male with B viral cirrhosis by surveillance ultrasonography. Dynamic abdominal CT showed a
3 cm-sized hypervascular mass in the right posteroinferior segment (S6). AFP was 359 ng/mL. Child-Pugh classification was
A, and ICG R15 was 18.8%. After preoperative transarterial chemoembolization (TACE), right hepatic wedge resection was
performed. Resection margin was free of tumor. Microinvasions in the surrounding vessels, lymphatics, bile ducts were not
found and microsatellite nodules were absent in the resected specimen. Although there were no risk factors that associated
with high postoperative recurrence, multifocal intrahepatic recurrence in the right lobe and left medial lobe occurred at 7
months after hepatic resection. He underwent two sessions of TACE.
- A Case of Icteric Hepatocellular Carcinoma Developed in Young Age
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Jong Kyu Park, Young Seok Kim, Sang Gyune Kim, Seung Won Jeong, Jae Young Jang, Hyun Jong Choi, Jong Ho Moon, Hong Soo Kim, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2009;9(1):90-93. Published online June 30, 2009
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Abstract
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- Jaundice presents in 19% to 40% of patients with hepatocellular carcinoma (HCC) at the time of diagnosis and usually
occurs in later stages. In most situations, it is due to diffuse tumor infiltration of liver parenchyma, hilar invasion, or
progressive terminal liver failure (advanced underlying cirrhosis). Obstructive jaundice as the main presenting clinical feature
is uncommon. Only 1~12% of HCC patients manifest obstructive jaundice as the initial complaint. Such cases are clinically
classified as “icteric type hepatoma”, or “cholestatic type of HCC”. Identification of this group of patients is clinically
important, because surgical treatment may be beneficial. We report a case of icteric HCC developed in young age.
- A Case of Advanced Hepatocellular Carcinoma Successfully Treated by Repeated Transcatheter Arterial Chemoembolization, Percutaneous Ethanol Injection and Surgical Resection
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Jaejun Shim, Byung-Ho Kim, Jae Young Jang, Seok Ho Dong, Hyo Jong Kim, Young Woon Chang, Rin Chang, Sung Hwa Hong, Joo Hyeong Oh
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Journal of the Korean Liver Cancer Study Group. 2008;8(1):120-123. Published online June 30, 2008
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Abstract
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- Here we report a case of multifocal advanced hapatocellular carcinoma successfully treated by repeated transc
atheter arterial chemoembolization (TACE), percutaneous ethanol injection (PEI) and surgical resection. Previously
healthy 54-year old man was admitted for the evaluation of incidental hepatic masses. Abdominal CT revealed
multifocal hepatic masses in right lobe including segment 5, 6 and 8, which showed early wash-out pattern in
portal phase and increased serum alpha fetoprotein (>840 ng/mL) was compatible with advanced hepatocelluar
carcinoma (stage III). Underlying cirrhosis was noted and Child-Pugh classification was A (5 points). After 4
cycles of TACE, nodular masses in segment 6 and 8 were completely lipiodolized. Viable mass in the remained
huge mass in right anterior lobe was treated by surgical resection. After 4 month operation, abdominal CT
revealed new hepatoma lesion at right anterior lobe, serum AFP was increased to 61 ng/mL. The lesion was
treated by one session of TACE. Underlying chonic hepatitis C was also treated with interferon and ribavirin. The
patient has been followed for 9 years without evidence of regional tumor recurrence or distant metastasis.
- A Case of Advanced Hepatocellular Carcinoma with Portal Vein Thrombosis Treated by Intra-arterial Chemotherapy and Radiotherapy
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Sang Gyune Kim, Young Seok Kim, Jae Young Jang, Su Jin Hong, Bong Min Ko, Chang Beom Ryu, Jong Ho Moon, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2007;7(1):94-97. Published online June 30, 2007
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Abstract
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- Advanced hepatocelluar carcinoma (HCC) with portal vein thrombosis has a poor prognosis due to inadequate
tumor response. 1 year survival rate and median surviral of stage IVa is less than 20%, 3 months respectively.
Transarterial chemoembolization (TACE) was known to prolong the overall survival rate in patients with
moderately advanced HCC. But, only small number of patients with stage IVa can receive the TACE. Other
treatment modalities to manage for advanced HCC are systemic chemotherapy, hepatic arterial infusion
chemotherapy or radiotherapy. Especially concurrent chemo-radiotherapy would be a better treatment option. We
report a case of good response after repeated hepatic arterial infusion chemotherapy and radiotherapy for patient
in advanced HCC with portal vein thrombosis.
- A Case of Complete Regression of Hepatocellular Carcinoma during COX-2 Inhibitor Administration
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Hae Jung Song, Yun Soo Kim, Chang Hee Han, Jae Young Jang, Jung Hoon Kim, Young Koog Cheon, Young Seok Kim, Jong Ho Moon, Young Deok Cho, Chan Sup Shim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2006;6(1):65-69. Published online June 30, 2006
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Abstract
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- Overexpression of cyclooxygenase-2 (COX-2) has been associated with hepatocarcinogenesis. Inhibitors of
COX-2 have proapoptotic and antiproliferative effects on malignant tumors and inhibit their invasion to
surrounding tissues. We report a case of complete regression of advanced HCC during COX-2 inhibitor
administration. An eighty-year-old female was diagnosed as advanced hepatocellular carcinoma (HCC) which was
associated with HCV infection. She received COX-2 inhibitor for 3 months due to degenerative arthritis of both
knees. Tumor enhancement on arterial phase was completely disappeared without specific treatment for the HCC,
and the size of mass markedly decreased on follow-up CT scan.
- A Case of Early Hepatocellular Carcinoma with High Grade Dysplastic Nodule
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Jae Young Jang , Yun Soo Kim, Young Kuk Cheon, Young Seok Kim, Jong Ho Moon, Young Deok Cho, So Young Jin, Chan Sup Shim, Boo Seong Kim
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Journal of the Korean Liver Cancer Study Group. 2002;2(1):105-108. Published online July 31, 2002
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- A 47-year-old male was referred for evaluation of a hepatic nodular lesion incidentally found on routine check up. He had no history of previous liver disease. Physical examination revealed no abonormality. Laboratory findings showed that HBsAG and anti-HCV were negative. Serum AST was minimally elevated and serum AFP was within normal range. Abdominal ultrasonogram showed a 1.3 cm-sized, hypoechoic nodule with peripheral halo in segment 5 of liver. Spiral CT revealed a well enhancing nodule in arterial phase, which could not be detected in portal and delayed phase. Liver biopsy showed well-differenciated hepatocellular carcinoma on the background of high grade dysplastic nodule. Surgical resection was recommended, however he refused and discharged.
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THE KOREAN LIVER CANCER ASSOCIATION
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