- A Case of Sarcomatoid Cholangiocarcinoma Which Developed at the Site Previously Treated by Transarterial Chemoembolization
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Changkun Lee, Kyung Min Kang, Hae Lim Lee, Sung Won Lee, Heejeong Lee, Nam Ik Han
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J Liver Cancer. 2017;17(1):100-104. Published online March 31, 2017
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DOI: https://doi.org/10.17998/jlc.17.1.100
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 Abstract
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- Intrahepatic sarcomatoid carcinoma is a rare tumor with poor prognosis due to its highly invasive
and metastatic nature and difficulty for early detection. The most common form of intrahepatic
sarcomatoid carcinoma is the sarcomatoid hepatocellular carcinoma, the development of which is
usually associated with previous treatment for hepatocellular carcinoma. In contrast, sarcomatoid
cholangiocarcinoma is extremely rare and results from spontaneous sarcomatoid transformation
during the development of tumor. Here, we report a case of sarcomatoid cholangiocarcinoma,
in a 58-year-old male, which developed at the site of previous treatment for hepatocellular
carcinoma. A 9 × 7 cm sized tumor which had not been detected in the computed tomography
exam 3 months before diagnosis was newly observed. The tumor rapidly progressed and the
patient died only 31 days after the diagnosis.
- High-level Expression of Interleukin-17 and C-reactive Protein Predicts Tumor Progression in Unresectable Hepatocellular Carcinoma Treated by Transarterial Chemoembolization
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Myeong Jun Song, Sung Won Lee, Eun-Jee Oh, Bohyun Jang, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon
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J Liver Cancer. 2016;16(2):108-117. Published online September 30, 2016
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DOI: https://doi.org/10.17998/jlc.16.2.108
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Abstract
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- Background/Aim
s: Transarterial chemoembolization (TACE) is the standard locoregional
treatment in patients with unresectable hepatocellular carcinoma (HCC). Angiogenesis and
inflammation play important roles in tumor growth in HCC. In this study, we evaluated the
associations between the levels of growth factors and inflammatory markers and clinical
prognosis in patients with unresectable HCC treated with TACE.
Methods
The clinical outcomes of 58 HCC patients treated with TACE at the Catholic Medical
Centers from January, 2012 to February 2015 were evaluated. Baseline levels of the growth
factors vascular endothelial growth factor, fibroblast growth factor, platelet-derived growth
factor, and hepatocyte growth factor and the inflammatory cytokines interleukin (IL)-17 and
high sensitivity C-reactive protein (hs-CRP) were compared with the treatment outcomes. The
primary endpoint was time to progression (TTP); the secondary endpoint was overall survival
(OS).
Results
During the 20.8 months of follow-up, TTP was significantly delayed in patients with
low levels of hs-CRP (≤0.15) and IL-17 (≤0.94) and a maximal tumor diameter ≤5 cm (P =0.010,
P =0.015, and 0.048, respectively). Patients with HCC with low hs-CRP and IL-17 levels had
a longer survival than that of those with high hs-CRP levels and IL-17 (35.1 vs. 22.5 months,
P =0.000; 41 vs. 21.8 months, P =0.000, respectively). However, any baseline growth factors
were not significantly correlated with TTP and OS.
Conclusions
Elevated IL-17 and hs-CRP may be predictive of a poor outcome in patients
with HCC treated with TACE. A better understanding of this relationship will require further
investigation of the immune mechanisms underlying tumor progression.
- Comparative Study between Metronomic Chemotherapy and Transarterial Chemoembolization in Patients with Child-Pugh Class B Advanced Hepatocellular Carcinoma
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Hyun Yang, Myeong Jun Song, Hee Chul Nam, Hae Lim Lee, Sung Won Lee, Do Seon Song, Jeong Won Jang, Si Hyun Bae, Jong Yong Choi, Seung Kew Yoon
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J Liver Cancer. 2015;15(2):92-99. Published online September 30, 2015
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DOI: https://doi.org/10.17998/jlc.15.2.92
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Abstract
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- Background/Aim
s: Metronomic (MET) chemotherapy is a treatment characterized by
frequent infusion of low doses of chemotherapeutic agent without extended break. The aim
of this study is to evaluate the efficacy of MET chemotherapy compared with transarterial
chemoembolization (TACE) in patients with child B class advanced hepatocellular carcinoma
(HCC).
Methods
Seventy-three patients with child B class advanced HCC were analyzed between
April, 2007 and August, 2013 according to two treatment groups: (i) MET chemotherapy group
(n=43, Epirubicin 35 mg/body surface area [BSA] every 4 weeks, and cisplatin 15 mg/BSA and
5-fluorouracil 50 mg/BSA weekly for 3 weeks) via an implantable port system with 1 week
break. (ii) TACE group (n=30, Adriamycin 20-50 mg) every 4 weeks. Primary endpoint was
overall survival (OS).
Results
The median survival times in the MET and TACE groups were 4.5 months and
3.1 months, respectively. The overall survival rate showed significantly better in the MET
treatment group than in the TACE group (P=0.039). When the factors affecting patient
OS were analyzed, MET chemotherapy (P=0.038, hazard ratio {HR} 0.538 [95% confidence
interval {CI} 0.299-0.967]) was independently associated with OS. Larger maximal tumor size,
extrahepatic metastasis and advanced stage also were significant factors for OS (P=0.009, HR
1.064 [95% CI 1.014-16.064]; P=0.014, HR 2.120 [95% CI 1.164-3.861]; P=0.019, HR 2.046 [95% CI
1.125-3.720], respectively).
Conclusions
MET chemotherapy showed survival benefit than TACE in patients with child
class B advanced HCC. Therefore, MET chemotherapy may be considered as a treatment
option for advanced HCC with poor liver function. (J Liver Cancer 2015;15:92-99)
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Citations
Citations to this article as recorded by  - A comparative study of sorafenib and metronomic chemotherapy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma with poor liver function
Hyun Yang, Hyun Young Woo, Soon Kyu Lee, Ji Won Han, Bohyun Jang, Hee Chul Nam, Hae Lim Lee, Sung Won Lee, Do Seon Song, Myeong Jun Song, Jung Suk Oh, Ho Jong Chun, Jeong Won Jang, Angelo Lozada, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon
Clinical and Molecular Hepatology.2017; 23(2): 128. CrossRef
- A Case of Hepatocellular Carcinoma in a 10 Year Old Child Treated with Yttrium Radioembolization and Transarterial Chemoembolization
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Sung Won Lee, Hee Yeon Kim, Do Seon Song, Chung-Hwa Park, Myeong Jun Song, Jong Young Choi, Seung Kew Yoon, Jung Suk Oh, Ho Jong Chun, Si Hyun Bae
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):137-140. Published online September 30, 2012
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Abstract
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- Hepatocellular carcinoma (HCC) in childhood is rare but is the second most common malignant liver neoplasm after
hepatoblastoma in children. Surgical resectability is the foundation of curative therapy but only one third of newly diagnosed
HCCs are resectable, and unresectable HCC remains largely unresponsive to systemic chemotherapy. In all reported series of
HCC in children, therapeutic results are poor with overall survival less than 30%. Systemic chemotherapy is only partially
effective but if preoperative downstaging can be achieved, it would result in a higher survival rate. There are scarce data
regarding local ablative treatments such as transarterial chemoembolization (TACE) and therefore survival benefits are still
unclear. TACE may be considered as a therapeutic alternative in cases of unresectable tumors after systemic chemotherapy or in
unresectable, non-metastatic HCCs. The use of orthotopic liver transplantation in childhood HCC remains controversial.
Radioembolization is a mode of treatment that aims to selectively target radiation to all liver tumors using yttrium-90
microspheres while limiting the dose to normal liver parenchyma. It may be considered as another treatment option in childhood
HCC with the purpose of preoperative downstaging but further studies are required to determine the treatment benefits and safety
of radioembolization treatment.
- A Case of Progressive Superior Mesenteric Vein Thrombosis after Percutaneous Transhepatic Obliteration in Infiltrative Hepatocellular Carcinomaswith Portal Vein Thrombosis
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Hee Yeon Kim, Chung-Hwa Park, Sung won Lee, Do Seon Song, Myeong Jun Song, Jong Young Choi, Seung Kew Yoon, Si Hyun Bae, Jung Suk Oh, Ho Jong Chun
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):146-150. Published online September 30, 2012
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Abstract
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- Percutaneous transhepatic obliteration of gastroesophageal varices is one of the effective emergency procedure when
endoscopic therapy is not indicated or has been failed. One of the major complications of this procedure is portal thrombosis. A
53-year-old male with hepatitis B virus infection was diagnosed of infiltrative hepatocellular carcinoma with right portal vein
thrombosis. On the next day after being hospitalization, the patient developed variceal bleeding. With medical management,
endoscopic therapy was initially attempted, however, it ended in failure. Emergency percutaneous transhepatic obliteration of
bleeding gastroesophageal varices was considered as a next option. Bleeding from gastroesophageal varices was stopped after
percutaneous obliateration, however, portal thrombosis was extended to splenic vein or superior mesenteric veins.
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