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Volume 17(1); March 2017
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Review Articles
Animal Models of Liver Cancer: Current Status and Application in Preclinical Research
Hye-Lim Ju, Simon Weonsang Ro
J Liver Cancer. 2017;17(1):1-14.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.1
  • 3,444 Views
  • 110 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. HCC develops in various causes – Viral hepatitis infection, toxins, or other liver conditions - by activation of oncogenes and/or inactivation of tumor suppressors. Understanding of signal pathways and protein-protein interactions critical in tumor development may lead to novel treatment strategy. To evaluate the progression of HCC and effects of potential therapies, various animal models have been established. Experimental models of HCC provide valuable tools to investigate the risk factors, new treatment modalities and biologic characteristics. Subcutaneous xenograft models have been widely used in the past. However, with the advancement of in vivo imaging technology, investigators are more concerned with the orthotopic models nowadays. Genetically engineered mouse models have greatly facilitated studies of gene function in HCC development. Lately, a novel approach for stable gene expression in mouse hepatocytes by hydrodynamic injection has been developed. Each model has its own advantages and disadvantages. Therefore, selecting the optimal models based on study objectives is necessary. In this review, we highlight both the frequently used mouse models and some emerging ones with emphasis on their merits or defects, and give advices for investigators to choose a ‘‘best-fit’’ animal model in HCC research.
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The Role of Combination of Transarterial Chemoebolization and Radiofrequency Ablation for Hepatocellular Carcinoma Treatment
Byoung Kuk Jang
J Liver Cancer. 2017;17(1):15-18.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.15
  • 1,512 Views
  • 26 Downloads
AbstractAbstract PDF
Recently, various combination therapies have been applied to the treatment of hepatocellular carcinoma (HCC). Among various treatment modalities, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) were combined to improve the therapeutic effect of RFA. The decrease of blood flow by TACE can increase the size of the ablation area by reducing heat loss during RFA. Based on these theoretical advantages, TACE and RFA combination therapy have been tried for the treatment of patients with HCC which is not feasible to be removed by surgery. However, TACE and RFA combination therapy has not been standardized by various protocols for each study. This review discusses the implications and role of this treatment, although there are several limitations to clearly demonstrate the indications and efficacy of TACE and RFA combination therapies.
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The General Rules for the Study of Primary Liver Cancer
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
J Liver Cancer. 2017;17(1):19-44.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.19
  • 2,953 Views
  • 212 Downloads
  • 30 Citations
AbstractAbstract 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.

Citations

Citations to this article as recorded by  
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    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
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    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
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    Kiyoon Min, Sathish Kumar Karuppannan, Giyoong Tae
    Biophysics Reviews.2024;[Epub]     CrossRef
  • Clinical Significance of Biliary Invasion at Diagnosis in Barcelona Clinic Liver Cancer Stage B–C Hepatocellular Carcinoma: A Nationwide Cohort Analysis in South Korea
    Chai Hong Rim, Won Sup Yoon, Sunmin Park
    Oncology.2024; : 1.     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
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Original Articles
Selection of Proper Modality in Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma
Seo hee Choi, Joong Yeol Woo, Jinsil Seong
J Liver Cancer. 2017;17(1):45-53.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.45
  • 2,766 Views
  • 44 Downloads
  • 1 Citation
AbstractAbstract PDF
Background/Aims
As the optimal stereotactic body radiation therapy (SBRT) modality for hepatocellular carcinoma (HCC) has not been confirmed, we aimed herein to provide a practical guideline by our retrospective review.
Methods
Thirty-nine patients with primary HCC who underwent liver SBRT via 3 modalities (helical tomotherapy [HT]: 22, volumetric modulated arc therapy [VMAT]: 13, Cyberknife: 4) at our institution between July 2014 and July 2015 were included. Modalities were compared with regard to dose conformity index (CI), homogeneity index (HI), clinical results, and patient compliance.
Results
VMAT SBRT had favorable conformity (CI: 0.7±0.2), homogeneity (HI: 1.1±0.0), and shortest treatment time (100.2±26.1 seconds). HT SBRT yielded good dosimetric outcomes, especially in conformity (CI: 1.0±0.2). Although the Cyberknife SBRT synchrony system allowed real-time tumor targeting, the treatment time was longest (3,015.0±447.3 seconds), invasive pre-treatment procedures were required, and the HI (1.3±0.0) was lowest.
Conclusions
All 3 modalities yielded competent dosimetric planning parameters. VMAT SBRT was most appropriate for tumors with residual lipiodol or patients with poor conditions. HT SBRT is available for multiple or irregular targets. Cyberknife SBRT is recommended for carefully selected patients and tumors indicated for sono-guided fiducial insertion.

Citations

Citations to this article as recorded by  
  • Plan quality analysis of stereotactic ablative body radiotherapy treatment planning in liver tumor
    Anirut Watcharawipha, Somvilai Chakrabandhu, Anupong Kongsa, Damrongsak Tippanya, Imjai Chitapanarux
    Journal of Applied Clinical Medical Physics.2023;[Epub]     CrossRef
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Outcomes of Surgical Resection for Ruptured Hepatocellular Carcinoma
Hae Won Lee, Chang-Sup Lim, Hyo-Sin Kim
J Liver Cancer. 2017;17(1):54-59.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.54
  • 2,286 Views
  • 31 Downloads
  • 1 Citation
AbstractAbstract PDF
Background/Aims
Many recent studies have shown excellent outcomes of surgical resection for ruptured hepatocellular carcinoma (HCC). In addition, there are several reports suggesting that a ruptured HCC did not increase the risk for peritoneal dissemination of a tumor after surgical resection. However, the impact of HCC rupture on recurrence and patient survival has not yet been clarified.
Methods
The medical data of patients who underwent surgical resection for ruptured HCC in our center between January 2011 and December 2015 were retrospectively reviewed. The outcomes of the patients were investigated.
Results
Among 128 patients who underwent surgical resection for HCC, 5 patients (3.9%) had a ruptured HCC. All patients underwent elective operation in a stable condition. Transarterial chemoembolization (TACE) was performed for achieving hemostasis in four patients except one who achieved spontaneous hemostasis. Two patients had tumor recurrence and one patient died due to HCC recurrence during the median follow-up duration of 28.3 months (range, 24.3–62.3 months). One patient who developed late intrahepatic recurrence at 40.0 months after resection was managed well by means of radiofrequency ablation and TACE and is now alive for 5 years without any evidence of viable tumor. However, the other patient who showed early peritoneal seeding at 1.9 months after resection finally died despite aggressive treatments.
Conclusions
Rupture of HCC might result in peritoneal seeding of the tumor in the early postoperative stage, which could lead to a poor result. Nonetheless, surgical resection may be the best treatment option yielding good survival, even for a ruptured HCC.

Citations

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  • Ruptured Massive Hepatocellular Carcinoma Cured by Transarterial Chemoembolization
    Ji Eun Lee, Joong-Won Park, In Joon Lee, Bo Hyun Kim, Seoung Hoon Kim, Hyun Beom Kim
    Journal of Liver Cancer.2020; 20(2): 154.     CrossRef
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Factors Affecting Prognosis of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: Implications for Future Therapeutic Strategies
Sang Jun Suh, Hyung Joon Yim, Dong Won Lee, Jong Jin Hyun, Young Kul Jung, Ji Hoon Kim, Yeon Seok Seo, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um
J Liver Cancer. 2017;17(1):60-71.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.60
  • 2,425 Views
  • 26 Downloads
  • 1 Citation
AbstractAbstract PDF
Background/Aims
Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) exhibits poor prognosis. The aim of this study is to evaluate factors associated with survival of HCC patients with PVTT to suggest better therapeutic options.
Methods
Patients with HCC which were newly diagnosed at three tertiary hospitals between January 2004 and December 2012, were reviewed retrospectively. Among them, Barcelona Clinic of Liver Cancer stage C patients with PVTT were identified. Factors affecting overall survival (OS) were analyzed and efficacies of the treatment modalities were compared.
Results
Four hundred sixty five patients with HCC and PVTT were included. Liver function, tumor burden, presence of extrahepatic tumor, alfa fetoprotein, and treatment modalities were significant factors associated with OS. Treatment outcomes were different according to the initial modalities. OS of the patients who received hepatic resection, radiofrequency ablation (RFA), transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), sorafenib, systemic cytotoxic chemotherapy, radiation therapy (without combination), and supportive care were 27.8, 7.1, 6.7, 5.3, 2.5, 3.0, 1.8, and 0.9 months, respectively (P<0.001). Curative-intent treatments such as hepatic resection or RFA were superior to noncurativeintent treatments (P<0.001). TACE or HAIC was superior to sorafenib or systemic chemotherapy (P<0.001). Combining radiotherapy to TACE or HAIC did not provide additional benefit on OS (P=0.096).
Conclusions
Treatment modalities as well as baseline factors significantly influenced on OS of HCC patients with PVTT. Whenever possible, curative intent treatments should be preferentially considered. If unable, locoregional therapy would be a better choice than systemic therapy in HCC patients with PVTT.

Citations

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  • Value of surgical resection compared to transarterial chemoembolization in the treatment of hepatocellular carcinoma with portal vein tumor thrombus: A meta-analysis of hazard ratios from five observational studies
    Keera Kang, Sung Kyu Song, Chul-Woon Chung, Yongkeun Park
    Annals of Hepato-Biliary-Pancreatic Surgery.2020; 24(3): 243.     CrossRef
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Case Reports
A Case of Hepatocellular Carcinoma with Pulmonary Metastasis Who Showed Complete Response by Cytotoxic Chemotherapy after Sorafenib Failure
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
J Liver Cancer. 2017;17(1):72-76.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.72
  • 2,313 Views
  • 27 Downloads
AbstractAbstract 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.
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A Case of a Patient with Hepatocellular Carcinoma and Lung Metastasis Who Failed Sorafenib Treatment and Achieved Complete Remission after Lung Resection and Radiation Therapy
Jung Hwan Yu, Jung Il Lee
J Liver Cancer. 2017;17(1):77-81.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.77
  • 1,734 Views
  • 21 Downloads
AbstractAbstract PDF
In hepatocellular carcinoma (HCC), sorafenib is the only approved systemic chemotherapy, and has been applied for those with advanced HCC especially with systemic metastasis. However, the treatment results are suboptimal leaving many cases with disease progression despite the use of optimum dose. There is no established guideline for those that fail to respond to sorafenib treatment. In this case, a 46-years-old male with metastatic lung cancer from HCC experienced progression despite sorafenib treatment. Then, the patient received surgical resection of the metastatic lung mass followed by radiation therapy and achieved complete remission for 10 months after the surgical treatment and radiation therapy. Alpha-fetoprotein level was normalized and complete remission has been maintained.
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A Case of Advanced Hepatocellular Carcinoma with Long-term Post-progression Survival under Repeated Transarterial Chemoembolization after Sorafenib Failure
Jihyun Lee, Hwi Young Kim, Yong Jin Jung, Tae Hun Kim, Kwon Yu
J Liver Cancer. 2017;17(1):82-87.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.82
  • 1,851 Views
  • 10 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma is the third leading cause of cancer related mortality worldwide. Only 30% of patients are eligible for curative surgical resection at diagnosis. For patients with advanced hepatocellular carcinoma with accompanying portal vein tumor thrombosis, Sorafenib is recommended as first-line treatment. However, survival gain from sorafenib is unsatisfactory, and there is no standard therapy for patients who are intolerable or refractory to sorafenib. Here we report a case of a 52-year-old man who initially achieved partial response after sorafenib treatment, but eventually showed disease progression and was treated subsequently with transarterial chemoembolization (TACE). Multinodular recurrence occurred, but he was treated with repeated TACE, and has survived for 4 years so far.
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A Case of Achieving Complete Remission with Combination of Sorafenib and Tegafur in Patients with Hepatocellular Carcinoma with Progression of Disease after Sorafenib Therapy
Sang Youn Hwang, Seon-Mi Lee, Jung Woo Im, Ki Jeong Jeon, Sang Bu Ahn, Jin-Young Park, Cheol-Won Choi, Kwang-Mo Yang
J Liver Cancer. 2017;17(1):88-93.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.88
  • 1,922 Views
  • 11 Downloads
AbstractAbstract PDF
Sorafenib is the only approved targeted agent as the first line systemic therapy for treatment of advanced hepatocellular carcinoma (HCC). However, the improvement of survival duration under 3 months is far from clinical satisfactory and most patients experience disease progression within 6 months after sorafenib therapy. Unfortunately, second line systemic therapy after treatment failure of sorafenib was not established and there were no clear guidelines for salvage treatment modalities. Recently, studies suggests that combination of sorafenib and single cytotoxic agent can be relatively effective and safe strategy that achieves promising rates of local and systemic control in advanced HCC patients. Based on above suggestions, we herein offer our experience of a case achieved complete remission by combination therapy of sorafenib and tegafur in the patient with progressed disease after sorafenib therapy.
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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
  • 2,022 Views
  • 13 Downloads
AbstractAbstract 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.
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A Case of Sarcomatoid Cholangiocarcinoma Which Developed at the Site Previously Treated by Transarterial Chemoembolization
Changkun Lee, Kyung Min Kang, Hae Lim Lee, Sung Won Lee, Heejeong Lee, Nam Ik Han
J Liver Cancer. 2017;17(1):100-104.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.100
  • 1,977 Views
  • 15 Downloads
AbstractAbstract PDF
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.
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