From articles published in Journal of Liver Cancer during the past two years (2023 ~ ).
Guideline
- 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma
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J Liver Cancer. 2023;23(1):1-120. Published online December 9, 2022
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DOI: https://doi.org/10.17998/jlc.2022.11.07
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- Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.
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Citations
Citations to this article as recorded by

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Youngju Song, Jinhong Jung, Jin‐hong Park, So Yeon Kim, Jonggi Choi, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young‐Suk Lim, Han Chu Lee, Sang Min Yoon
Journal of Medical Imaging and Radiation Oncology.2025; 69(1): 144. CrossRef - Comparison of Metastasectomy and Stereotactic Body Radiation Therapy for Pulmonary Oligometastasis From Hepatocellular Carcinoma: A Propensity Score-Weighted Analysis
Young Seob Shin, Jae Kwang Yun, Jinhong Jung, Jin-hong Park, Si Yeol Song, Eun Kyung Choi, Sehoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Geun Dong Lee, Sang Min Yoon
International Journal of Radiation Oncology*Biology*Physics.2025; 121(2): 432. CrossRef - Serum Ferritin Levels and Liver‐Related Events in Individuals With Steatotic Liver Disease: A Longitudinal Cohort Study
Byeong Geun Song, Myung Ji Goh, Wonseok Kang, Geum‐Youn Gwak, Yong‐Han Paik, Moon Seok Choi, Joon Hyeok Lee, Dong Hyun Sinn
Alimentary Pharmacology & Therapeutics.2025; 61(3): 491. CrossRef - A Machine Learning Model to Predict De Novo Hepatocellular Carcinoma Beyond Year 5 of Antiviral Therapy in Patients With Chronic Hepatitis B
Yeonjung Ha, Seungseok Lee, Jihye Lim, Kwanjoo Lee, Young Eun Chon, Joo Ho Lee, Kwan Sik Lee, Kang Mo Kim, Ju Hyun Shim, Danbi Lee, Dong Keon Yon, Jinseok Lee, Han Chu Lee
Liver International.2025;[Epub] CrossRef - Hepatic artery infusion chemotherapy: A resurgence
Andrew Kai-Yip Fung, Kenneth Siu Ho Chok
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef - Nomogram for predicting early cancer-related death due to recurrence after liver resection in hepatocellular carcinoma patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C: a multicenter study
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BMC Gastroenterology.2025;[Epub] CrossRef - Tenofovir Disoproxil Fumarate Versus Entecavir: Effects on Lipid Profiles and Cardiovascular Outcomes in People Living With Chronic Hepatitis B
Log Young Kim, Jae Young Kim, Jeong‐Ju Yoo, Sang Gyune Kim, Young‐Seok Kim
Journal of Medical Virology.2025;[Epub] CrossRef - Multicenter, retrospective GUIDANCE001 study comparing transarterial chemoembolization with or without tyrosine kinase and immune checkpoint inhibitors as conversion therapy to treat unresectable hepatocellular carcinoma: Survival benefit in intermediate
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Hepatology.2025;[Epub] CrossRef - A Risk Prediction Model for Hepatocellular Carcinoma in the General Population Without Traditional Risk Factors for Liver Disease
Byeong Geun Song, GoEun Park, Myung Ji Goh, Wonseok Kang, Geum‐Youn Gwak, Yong‐Han Paik, Moon Seok Choi, Joon Hyeok Lee, Dong Hyun Sinn
Journal of Gastroenterology and Hepatology.2025;[Epub] CrossRef - Comparison of hepatocellular carcinoma incidence after long-term treatment with besifovir vs. tenofovir AF
Hyuk Kim, Jae-Young Kim, Yoon E. Shin, Hye-Jin Yoo, Jeong-Ju Yoo, Sang Gyune Kim, Young-Seok Kim
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Hepatology Research.2024; 54(6): 551. CrossRef - Research Progress of lncRNA-ATB/miR-141-3p/GP73 Ax-is-Mediated EMT Promoting TACE Refractoriness
棋 耿
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Jun Il Kim, Jayoun Lee, Gi Hong Choi, Min Woo Lee, Dong Ah Park, Jeong-Ju Yoo
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Liver Cancer.2024; 13(5): 468. CrossRef - Complications of immunotherapy in advanced hepatocellular carcinoma
Young-Gi Song, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Journal of Liver Cancer.2024; 24(1): 9. CrossRef - Liver resection in selective hepatocellular carcinoma with Vp3 or Vp4 portal vein tumor thrombosis improves prognosis
Manuel Lim, Jongman Kim, Jinsoo Rhu, Gyu-Seong Choi, Jae-Won Joh
Journal of Liver Cancer.2024; 24(1): 102. CrossRef - Comparison of atezolizumab plus bevacizumab and lenvatinib for hepatocellular carcinoma with portal vein tumor thrombosis
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Journal of Liver Cancer.2024; 24(1): 81. CrossRef - Programmed Death 1 and Cytotoxic T-Lymphocyte-Associated Protein 4 Gene Expression in Peripheral Blood Mononuclear Cells Can Serve as Prognostic Biomarkers for Hepatocellular Carcinoma
Ji Ah Lee, Hei-Gwon Choi, Hyuk Soo Eun, Jiyoon Bu, Tae Min Jang, Jeongdong Lee, Chae Yeon Son, Min Seok Kim, Woo Sun Rou, Seok Hyun Kim, Byung Seok Lee, Ha Neul Kim, Tae Hee Lee, Hong Jae Jeon
Cancers.2024; 16(8): 1493. CrossRef - Risk of Hepatocellular Carcinoma by Steatotic Liver Disease and Its Newly Proposed Subclassification
Byeong Geun Song, Aryoung Kim, Myung Ji Goh, Wonseok Kang, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Dong Hyun Sinn
Liver Cancer.2024; 13(5): 561. CrossRef - Efficacy and Safety of Surgical Resection in Elderly Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
Jin-Soo Lee, Dong Ah Park, Seungeun Ryoo, Jungeun Park, Gi Hong Choi, Jeong-Ju Yoo
Gut and Liver.2024; 18(4): 695. CrossRef - Consistent efficacy of hepatic artery infusion chemotherapy irrespective of PD‑L1 positivity in unresectable hepatocellular carcinoma
Ji Kim, Young Kim, Hee-Chul Nam, Chang-Wook Kim, Jae-Sung Yoo, Ji Han, Jeong Jang, Jong Choi, Seung Yoon, Ho Jong Chun, Jung Oh, Suho Kim, Sung Lee, Pil Sung
Oncology Letters.2024;[Epub] CrossRef - Risk of Bleeding in Hepatocellular Carcinoma Patients Treated with Atezolizumab/Bevacizumab: A Systematic Review and Meta-Analysis
Young-Gi Song, Kyeong-Min Yeom, Eun Ae Jung, Sang Gyune Kim, Young Seok Kim, Jeong-Ju Yoo
Liver Cancer.2024; : 1. CrossRef - Trends in alcohol use and alcoholic liver disease in South Korea: a nationwide cohort study
Jeong-Ju Yoo, Dong Hyeon Lee, Young Chang, Hoongil Jo, Young Youn Cho, Sangheun Lee, Log Young Kim, Jae Young Jang
BMC Public Health.2024;[Epub] CrossRef - Fatal intratumoral hemorrhage in a patient with hepatocellular carcinoma following successful treatment with atezolizumab/bevacizumab: A case report
Kyeong-Hoon Park, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
World Journal of Clinical Cases.2024; 12(22): 5177. CrossRef - Local Ablation for Hepatocellular Carcinoma: 2024 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association
Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi
Korean Journal of Radiology.2024; 25(9): 773. CrossRef - Atezolizumab-Induced Ulcerative Colitis in Patient with Hepatocellular Carcinoma: Case Report and Literature Review
Hyuk Kim, Yoon E Shin, Hye-Jin Yoo, Jae-Young Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Medicina.2024; 60(9): 1422. CrossRef - Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association
Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi
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Jae Hwan Lee, Kun Yung Kim, Chong-ho Lee, Minuk Kim, Chang Jin Yoon
Journal of Liver Cancer.2024; 24(2): 217. CrossRef - Recent update of proton beam therapy for hepatocellular carcinoma: a systematic review and meta-analysis
Sun Hyun Bae, Won Il Jang, Hanna Rahbek Mortensen, Britta Weber, Mi Sook Kim, Morten Høyer
Journal of Liver Cancer.2024; 24(2): 286. CrossRef - Re-assessing the diagnostic value of the enhancing capsule in hepatocellular carcinoma imaging
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Journal of Liver Cancer.2024; 24(2): 206. CrossRef - Assessment of real-time US-CT/MR-guided percutaneous gold fiducial marker implementation in malignant hepatic tumors for stereotactic body radiation therapy
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Joo Hyun Oh, Dong Hyun Sinn
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Yoon-E Shin, Hyuk Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
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Xiang Tang, Jinbin Chen, Wei Peng, Zhoutian Yang, Li Hu, Zhiwei Ye, Yizhen Fu, Dandan Hu, Zhongguo Zhou, Minshan Chen, Yaojun Zhang, Jun-Cheng Wang
ImmunoTargets and Therapy.2024; Volume 13: 559. CrossRef - Incorporating ALBI Grade with Geriatric Nutritional Risk Index Enhances Hepatocellular Carcinoma Risk Stratification
Heechul Nam, Pil Soo Sung, Sung Won Lee, Do Seon Song, Jung Hyun Kwon, Jeong Won Jang, Chang Wook Kim, Si Hyun Bae
Liver Cancer.2024; : 1. CrossRef - Pathogenesis and management of metabolic dysfunction-associated
steatohepatitis-related hepatocellular carcinoma: a narrative
review
Han Ah Lee
The Ewha Medical Journal.2024;[Epub] CrossRef - Hepatocellular Carcinoma Detected on Liver Ultrasound but not Confirmed on Dynamic Contrast-enhanced CT
Jaehong Jeong, Jeong Eun Song
Clinical Ultrasound.2024; 9(2): 108. CrossRef - Evolution of Liver Resection for Hepatocellular Carcinoma: Change Point Analysis of Textbook Outcome over Twenty Years
Yeshong Park, Ho-Seong Han, Seung Yeon Lim, Hyelim Joo, Jinju Kim, MeeYoung Kang, Boram Lee, Hae Won Lee, Yoo-Seok Yoon, Jai Young Cho
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Dong Ho Lee, Jae Young Lee
Scientific Reports.2024;[Epub] CrossRef - Evidence-based clinical recommendations for hypofractionated radiotherapy: exploring efficacy and safety - Part 4: Liver and locally recurrent rectal cancer
Hwa Kyung Byun, Gyu Sang Yoo, Soo-Yoon Sung, Jin-Ho Song, Byoung Hyuck Kim, Yoo-Kang Kwak, Yeon Joo Kim, Yeon-Sil Kim, Kyung Su Kim
Radiation Oncology Journal.2024; 42(4): 247. CrossRef - Serum Hepatocyte growth factor level as a biomarker for hepatitis C virus related hepatocellular carcinoma
El-Saeid M.E. El-Bawab, Khaled A. Elaziem, Mohammed M.A. Elfotoh, Ahmed Y.A. Mohammed
Al-Azhar Assiut Medical Journal.2024; 22(3): 151. CrossRef - Diagnostic performance of the 2022 KLCA-NCC criteria for hepatocellular carcinoma on magnetic resonance imaging with extracellular contrast and hepatobiliary agents: comparison with the 2018 KLCA-NCC criteria
Ja Kyung Yoon, Sunyoung Lee, Jeong Ah Hwang, Ji Eun Lee, Seung-seob Kim, Myeong-Jin Kim
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Jeong-Ju Yoo, Man Young Park, Eun Ju Cho, Su Jong Yu, Sang Gyune Kim, Yoon Jun Kim, Young Seok Kim, Jung-Hwan Yoon
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Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim
Korean Journal of Radiology.2023; 24(7): 606. CrossRef - Transarterial chemoembolization for hepatocellular carcinoma: 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association
Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim
Journal of Liver Cancer.2023; 23(2): 241. CrossRef - Transarterial chemoembolization for hepatocellular carcinoma: 2023 Expert consensus-based practical recommendations of the Korean Liver Cancer Association
Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim
Clinical and Molecular Hepatology.2023; 29(3): 521. 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 - A nationwide study on the current treatment status and natural prognosis of hepatocellular carcinoma in elderly
Jeong-Ju Yoo, Jayoun Lee, Gi Hong Choi, Min Woo Lee, Dong Ah Park
Scientific Reports.2023;[Epub] CrossRef - Diagnosis of hepatocellular carcinoma using Sonazoid: a comprehensive review
Woo Kyoung Jeong
Journal of Liver Cancer.2023; 23(2): 272. CrossRef - The Current Evidence of Intensity-Modulated Radiotherapy for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
Won Il Jang, Sunmi Jo, Ji Eun Moon, Sun Hyun Bae, Hee Chul Park
Cancers.2023; 15(20): 4914. CrossRef - 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
Journal of Liver Cancer.2023; 23(2): 377. CrossRef - Sonazoid contrast-enhanced ultrasonography for the diagnosis of hepatocellular carcinoma: strengths and shortcomings
Sung Won Lee, Min Kyu Kang, Xiang Zhang
Journal of Liver Cancer.2023; 23(2): 238. CrossRef - Sequential regorafenib or nivolumab therapy in recurrent hepatocellular carcinoma with sorafenib failure in liver transplant patients does not improve prognosis
Jieun Kwon, Jongman Kim, Jinsoo Rhu, Gyu-Seong Choi, Jae-Won Joh
Annals of Liver Transplantation.2023; 3(2): 104. CrossRef - Concurrent nivolumab and external beam radiation therapy for hepatocellular carcinoma with macrovascular invasion: A phase 2 study
Bo Hyun Kim, Hee Chul Park, Tae Hyun Kim, Young-Hwan Koh, Jung Yong Hong, Yuri Cho, Dong Hyun Sinn, Boram Park, Joong-Won Park
JHEP Reports.2023; : 100991. CrossRef - Regular Alpha-Fetoprotein Tests Boost Curative Treatment and Survival for Hepatocellular Carcinoma Patients in an Endemic Area
Joo Hyun Oh, Jonghyun Lee, Eileen L. Yoon, Soung Won Jeong, Soon Sun Kim, Young Eun Chon, Sang Bong Ahn, Dae Won Jun
Cancers.2023; 16(1): 150. CrossRef - Adjuvant and neoadjuvant therapies for hepatocellular carcinoma
Arndt Vogel, Robert C. Grant, Tim Meyer, Gonzalo Sapisochin, Grainne M. O’Kane, Anna Saborowski
Hepatology.2023;[Epub] CrossRef
Review Articles
- Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide
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Do Young Kim
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J Liver Cancer. 2024;24(1):62-70. Published online March 25, 2024
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DOI: https://doi.org/10.17998/jlc.2024.03.13
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11,441
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625
Downloads
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39
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Abstract
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- Approximately 80% of hepatocellular carcinoma (HCC) cases arise in sub-Saharan Africa and Eastern Asia, following a similarly high prevalence of chronic hepatitis B virus (HBV) carriers in these regions. The etiology and epidemiology of HCC have recently changed worldwide. Although HBV infection is the main contributor to HCC development, a slow but continuous decline in HBV infection rates has been reported since 1990. Owing to the widespread use of direct-acting antivirals, the incidence of hepatitis C virus-related HCC has remarkably decreased in Japan and European countries. In Korea, Taiwan, and Singapore, the incidence of HBV-related HCC has significantly decreased owing to vaccination against HBV. Globally, while HBV accounted for more than half of HCCs in 1990, this had decreased to 42% in 2019. In contrast, the proportion of patients with alcoholic- and nonalcoholic steatohepatitis (NASH) increased from 13% to 18% and from 5% to 6%, respectively. NASH-related HCC has characteristics that differ from those of virus-associated HCC. Compared with other etiologies, patients with NASHassociated HCC are older, have a higher body mass index, and have higher rates of type 2 diabetes mellitus, hypertension, hyperlipidemia, and cardiovascular disease. Nonalcoholic fatty liver disease (NAFLD)-associated HCC is also known to develop in the absence of cirrhosis, unlike alcohol-related and autoimmune liver diseases. Because patients with NAFLD usually have diabetes or obesity, surveying this population is challenging. Optimal selection of the target population and surveillance tools among patients with NAFLD needs to be determined.
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Citations
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Clinics and Research in Hepatology and Gastroenterology.2025; : 102570. CrossRef - Metabolic Cause of Cirrhosis Is the Emerging Etiology for Primary Liver Cancer in the Asia‐Oceania Region: Analysis of Global Burden of Disease (GBD) Study 2021
Suprabhat Giri, Sushrut Ingawale, Gaurav Khatana, Prasanna Gore, Dibya Lochan Praharaj, Vincent Wai‐Sun Wong, Daniel Q. Huang, Amit Singhal, Ashok Choudhury
Journal of Gastroenterology and Hepatology.2025;[Epub] CrossRef - Role of hepatotropic viruses in promoting hepatocellular carcinoma—current knowledge and recent advances
Piotr Starnawski, Klaudia Nowak, Zuzanna Augustyn, Dominik Malicki, Aleksandra Piąta, Dominika Lorek, Jakub Janczura
Medical Oncology.2025;[Epub] CrossRef - Immunotherapy as a Complement to Surgical Management of Hepatocellular Carcinoma
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Cancers.2024; 16(10): 1852. CrossRef - Inflammatory Response in the Pathogenesis and Treatment of Hepatocellular Carcinoma: A Double-Edged Weapon
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International Journal of Molecular Sciences.2024; 25(13): 7191. CrossRef - Impacts of smoking on alcoholic liver disease: a nationwide cohort study
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Frontiers in Public Health.2024;[Epub] CrossRef - Contemporary epidemiology of hepatocellular carcinoma: understanding risk factors and surveillance strategies
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Frontiers in Oncology.2024;[Epub] CrossRef - Biomarker discovery in hepatocellular carcinoma (HCC) for personalized treatment and enhanced prognosis
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BIOCELL.2024; 48(11): 1543. CrossRef
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Darine Daher, Karim Seif El Dahan, Amit G. Singal
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J Liver Cancer. 2023;23(1):127-142. Published online February 9, 2023
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DOI: https://doi.org/10.17998/jlc.2022.12.30
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8,881
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311
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- Non-alcoholic fatty liver disease (NAFLD), one of the most common causes of liver disease, is an increasingly common cause of hepatocellular carcinoma (HCC). Several demographic, clinical, and genetic factors contribute to HCC risk in NAFLD patients, which may inform risk stratification scores. Proven efficacious approaches to primary prevention approach in patients with non-viral liver disease remain an area of need. Semi-annual surveillance is associated with improved early tumor detection and reduced HCC-related mortality; however, patients with NAFLD have several challenges to effective surveillance, including under-recognition of at-risk patients, low surveillance utilization in clinical practice, and lower sensitivity of current tools for early-stage HCC detection. Treatment decisions are best made in a multidisciplinary fashion and are informed by several factors including tumor burden, liver dysfunction, performance status, and patient preferences. Although patients with NAFLD often have larger tumor burden and increased comorbidities compared to counterparts, they can achieve similar post-treatment survival with careful patient selection. Therefore, surgical therapies continue to provide a curative treatment option for patients diagnosed at an early stage. Although there has been debate about the efficacy of immune checkpoint inhibitors in patients with NAFLD, current data are insufficient to change treatment selection based on liver disease etiology.
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Matthew Man Pok Lee, Landon Long Chan, Stephen Lam Chan
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J Liver Cancer. 2023;23(2):262-271. Published online August 17, 2023
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DOI: https://doi.org/10.17998/jlc.2023.07.17
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5,952
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364
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14
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Abstract
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- Hepatocellular carcinoma (HCC) frequently presents as advanced stage with poor prognosis and high mortality. Systemic treatment is the treatment of choice for advanced disease. In 2007, the first multi-kinase inhibitor (MKI) sorafenib was approved and shown to modestly prolong overall survival (OS). The progress of systemic therapy has been slow afterwards until 2018 when lenvatinib, another MKI, was shown to be non-inferior to sorafenib on median OS as the first-line therapy for HCC. Since then, remarkable progress has been achieved on the treatment of advanced HCC, including the development of second-line targeted treatment, including regorafenib, cabozantinib and ramucirumab from 2017 to 2019. A growing focus has been placed on immune checkpoint inhibitors (ICIs) targeting programmed cell death-1 (PD-1), its ligand PD-L1, and cytotoxic T-lymphocyte-associated protein 4. These ICIs have proven their potency in treating HCC as both initial and subsequent line of therapy. At present, both regimens of atezolizumab combined with bevacizumab, as well as the combination of tremelimumab and durvalumab, are recommended as the first-line treatments based on positive phase III clinical trials. With the advancement of ICIs, it is anticipated that the role of MKIs in the treatment of HCC will evolve. In this article, lenvatinib, one of the most commonly used MKIs in HCC, is chosen to be reviewed.
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Jae Hyun Yoon, Sung Kyu Choi
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J Liver Cancer. 2023;23(2):300-315. Published online September 21, 2023
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DOI: https://doi.org/10.17998/jlc.2023.08.27
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6,129
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235
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13
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Abstract
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- Although hepatocellular carcinoma (HCC) is associated with a poor prognosis, management of early-stage HCC is often successful with highly efficacious treatment modalities such as liver transplantation, surgical resection, and radiofrequency ablation. However, unfavorable clinical outcomes have been observed under certain circumstances, even after efficient treatment. Factors that predict unsuitable results after treatment include tumor markers, inflammatory markers, imaging findings reflecting tumor biology, specific outcome indicators for each treatment modality, liver functional reserve, and the technical feasibility of the treatment modalities. Various strategies may overcome these challenges, including the application of reinforced treatment indication criteria with predictive markers reflecting tumor biology, compensation for technical issues with up-to-date technologies, modification of treatment modalities, downstaging with locoregional therapies (such as transarterial chemotherapy or radiotherapy), and recently introduced combination immunotherapies. In this review, we discuss the challenges to achieving optimal outcomes in the management of early-stage HCC and suggest strategies to overcome these obstacles.
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Recommendation and Guideline
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Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim
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J Liver Cancer. 2023;23(2):241-261. Published online July 14, 2023
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DOI: https://doi.org/10.17998/jlc.2023.05.22
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4,264
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237
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- Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.
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Shin Hye Hwang, Hyungjin Rhee
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J Liver Cancer. 2023;23(1):143-156. Published online March 9, 2023
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DOI: https://doi.org/10.17998/jlc.2023.02.16
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3,681
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175
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11
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Abstract
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- The cross-sectional imaging findings play a crucial role in the diagnosis of hepatocellular carcinoma (HCC). Recent studies have shown that imaging findings of HCC are not only relevant for the diagnosis of HCC, but also for identifying genetic and pathologic characteristics and determining prognosis. Imaging findings such as rim arterial phase hyperenhancement, arterial phase peritumoral hyperenhancement, hepatobiliary phase peritumoral hypointensity, non-smooth tumor margin, low apparent diffusion coefficient, and the LR-M category of the Liver Imaging-Reporting and Data System have been reported to be associated with poor prognosis. In contrast, imaging findings such as enhancing capsule appearance, hepatobiliary phase hyperintensity, and fat in mass have been reported to be associated with a favorable prognosis. Most of these imaging findings were examined in retrospective, single-center studies that were not adequately validated. However, the imaging findings can be applied for deciding the treatment strategy for HCC, if their significance can be confirmed by a large multicenter study. In this literature, we would like to review imaging findings related to the prognosis of HCC as well as their associated clinicopathological characteristics.
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Hanting Dai, Chuan Yan, Wanrong Huang, Yifan Pan, Feng Pan, Yamei Liu, Shunli Wang, Huifang Wang, Rongping Ye, Yueming Li
Journal of Magnetic Resonance Imaging.2025; 61(2): 970. CrossRef - Prediction early recurrence of hepatocellular carcinoma after hepatectomy using gadoxetic acid-enhanced MRI and IVIM
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European Journal of Radiology Open.2025; 14: 100643. CrossRef - Radiomics and machine learning based on preoperative MRI for predicting extrahepatic metastasis in hepatocellular carcinoma patients treated with transarterial chemoembolization
Gang Peng, Xiaojing Cao, Xiaoyu Huang, Xiang Zhou
European Journal of Radiology Open.2024; 12: 100551. CrossRef - Clinical Parameters Work Well as Predictive Factors for Atezolizumab and Bevacizumab Treatment in Hepatocellular Carcinoma
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Mingyue Song, Yuhao Tao, Hanjun Zhang, Mingzhan Du, Lingchuan Guo, Chunhong Hu, Weiguo Zhang
Magnetic Resonance Imaging.2024; 114: 110241. CrossRef - Prediction of PD-L1 expression in unresectable hepatocellular carcinoma with gadoxetic acid-enhanced MRI
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European Journal of Radiology.2024; 181: 111772. CrossRef - The histopathological and molecular heterogeneity of hepatocellular
carcinoma: a narrative review
Wonju Chung, Haeryoung Kim
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Diana Kadi, Marilyn F. Yamamoto, Emily C. Lerner, Hanyu Jiang, Kathryn J. Fowler, Mustafa R. Bashir
Journal of Liver Cancer.2023; 23(2): 284. CrossRef
- A multidisciplinary approach with immunotherapies for advanced hepatocellular carcinoma
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Yu Rim Lee
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J Liver Cancer. 2023;23(2):316-329. Published online September 22, 2023
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DOI: https://doi.org/10.17998/jlc.2023.09.04
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3,426
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153
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10
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Abstract
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- Hepatocellular carcinoma (HCC) is a highly aggressive disease that is usually diagnosed at an advanced stage. Advanced HCC has limited treatment options and often has a poor prognosis. For the past decade, tyrosine kinase inhibitors have been the only treatments approved for advanced HCC that have shown overall survival (OS) benefits; however, but their clinical efficacy has been limited. Recent trials have demonstrated promising advancements in survival outcomes through immunotherapy-based treatments, such as combinations of immune checkpoint inhibitors (ICIs) with other ICIs, antiangiogenic drugs, and locoregional therapies. The atezolizumab-bevacizumab and durvalumab-tremelimumab (STRIDE) regimen has significantly improved survival rates as a first-line treatment and has become the new standard of care. Therefore, combined treatments for advanced HCC can result in better treatment outcomes owing to their synergistic effects, which requires a multidisciplinary approach. Ongoing studies are examining other therapeutic innovations that can improve disease control and OS rates. Despite improvements in the treatment of advanced HCC, further studies on the optimal treatment selection and sequences, biomarker identification, combination approaches with other therapies, and development of novel immunotherapy agents are required. This review presents the current treatment options and clinical data of the ICI-based combination immunotherapies for advanced HCC from a multidisciplinary perspective.
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Medicina.2024; 60(1): 157. CrossRef - Hepatocellular Carcinoma: Advances in Systemic Therapy
Insija Ilyas Selene, Merve Ozen, Reema A. Patel
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Hyuk Kim, Yoon E Shin, Hye-Jin Yoo, Jae-Young Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Medicina.2024; 60(9): 1422. CrossRef - A Potential Pneumothorax Induced by Immune Checkpoint Inhibitors: A Case Report and Literature Review
Yoon-E Shin, Hyuk Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Medicina.2024; 60(10): 1634. CrossRef - Prediction of PD-L1 expression in unresectable hepatocellular carcinoma with gadoxetic acid-enhanced MRI
Jun Gu Kang, Kyunghwa Han, Taek Chung, Hyungjin Rhee
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Hyungjin Rhee, Young Nyun Park, Jin-Young Choi
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hepatocellular carcinoma: a narrative review
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Young-Gi Song, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
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J Liver Cancer. 2024;24(1):9-16. Published online November 29, 2023
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DOI: https://doi.org/10.17998/jlc.2023.11.21
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3,703
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199
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9
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Abstract
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- Immune checkpoint inhibitors (ICIs) are highly effective in cancer treatment. However, the risks associated with the treatment must be carefully balanced against the therapeutic benefits. Immune-related adverse events (irAEs) are generally unpredictable and may persist over an extended period. In this review, we analyzed common irAEs reported in highly cited original articles and systematic reviews. The prevalent adverse reactions include fatigue, pyrexia, rash, pruritus, diarrhea, decreased appetite, nausea, abdominal pain, constipation, hepatitis, and hypothyroidism. Therefore, it is crucial to conduct evaluations not only of gastrointestinal organs but also of cardiac, neurologic, endocrine (including the frequently affected thyroid), and ophthalmic systems before commencing ICIs. This review further explores commonly reported types of irAEs, specific irAEs associated with each ICI agent, rare yet potentially fatal irAEs, and available treatment options for managing them.
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Weixin Xu, Miaomiao Tao, Yeqiong Liu, Jun Yan, Jiali Hu, Lei Wang
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Yoon-E Shin, Hyuk Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
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carcinoma: a narrative review
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Original Articles
- Isolation and characterization of cancer-associated fibroblasts in the tumor microenvironment of hepatocellular carcinoma
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Kyoungdo Mun, Jiwon Han, Pureun Roh, Jonggeun Park, Gahee Kim, Wonhee Hur, Jeongwon Jang, Jongyoung Choi, Seungkew Yoon, Youngkyoung You, Hojoong Choi, Pilsoo Sung
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J Liver Cancer. 2023;23(2):341-349. Published online June 12, 2023
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DOI: https://doi.org/10.17998/jlc.2023.04.30
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5,227
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279
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Abstract
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- Background/Aim
Cancer-associated fibroblasts (CAFs) play an immunosuppressive role in the tumor microenvironment (TME) of human cancers; however, their characteristics and role in hepatocellular carcinoma (HCC) remain to be elucidated.
Methods
Nine tumor and surrounding liver tissue samples from patients with HCC who underwent surgery were used to isolate patient-derived CAFs. Cell morphology was observed using an optical microscope after culture, and cell phenotypes were evaluated using flow cytometry and immunoblotting. Cytokines secreted by CAFs into culture medium were quantified using a multiplex cytokine assay.
Results
CAFs were abundant in the TME of HCC and were adjacent to immune cells. After culture, the CAFs and non-tumor fibroblasts exhibited spindle shapes. We observed a robust expression of alpha-smooth muscle actin and fibroblast activation protein in CAFs, whereas alpha-fetoprotein, epithelial cell adhesion molecule, platelet/endothelial cell adhesion molecule-1, and E-cadherin were not expressed in CAFs. Furthermore, CAFs showed high secretion of various cytokines, namely C-X-C motif chemokine ligand 12, interleukin (IL)-6, IL-8, and C-C motif chemokine ligand 2.
Conclusions
CAFs are abundant in the TME of HCC and play a crucial role in tumor progression. These fibroblasts secrete cytokines that promote tumor growth and metastasis.
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- Cancer-associated fibroblasts in hepatocellular carcinoma: heterogeneity, mechanisms and therapeutic targets
Yutong Li, Mawieh Hamad, Eyad Elkord
Hepatology International.2025;[Epub] CrossRef - Rebuilding the microenvironment of primary tumors in humans: a focus on stroma
Siwon Mun, Hyun Jin Lee, Pilnam Kim
Experimental & Molecular Medicine.2024; 56(3): 527. CrossRef - Intrahepatic IgA complex induces polarization of cancer-associated fibroblasts to matrix phenotypes in the tumor microenvironment of HCC
Jong Geun Park, Pu Reun Roh, Min Woo Kang, Sung Woo Cho, Suhyun Hwangbo, Hae Deok Jung, Hyun Uk Kim, Ji Hoon Kim, Jae-Sung Yoo, Ji Won Han, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Young Kyoung You, Ho Joong Choi, Jae Yong Ryu, Pil Soo Sung
Hepatology.2024; 80(5): 1074. CrossRef - Machine learning model reveals roles of interferon‑stimulated genes in sorafenib‑resistant liver cancer
Deok Seo, Ji Park, Hee Jung, Min Kang, Byung Kang, Dong Lee, Jae Lee, Seung Yoon, Jeong Jang, Jae Ahn, Pil Sung
Oncology Letters.2024;[Epub] CrossRef - Recent Advances in Immune-based Therapy for Hepatocellular Carcinoma
Kyung Won Park, Tae Hoon Park, Eun Ji Jang, Pil Soo Sung
Journal of Digestive Cancer Research.2024; 12(2): 115. CrossRef - Wound healing: insights into autoimmunity, ageing, and cancer ecosystems through inflammation and IL-6 modulation
Lukáš Lacina, Michal Kolář, Lucie Pfeiferová, Peter Gál, Karel Smetana
Frontiers in Immunology.2024;[Epub] CrossRef - Prognostic significance of combined PD-L1 expression in malignant and infiltrating cells in hepatocellular carcinoma treated with atezolizumab and bevacizumab
Jaejun Lee, Jae-Sung Yoo, Ji Hoon Kim, Dong Yeup Lee, Keungmo Yang, Bohyun Kim, Joon-Il Choi, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Ji Won Han, Pil Soo Sung
Frontiers in Immunology.2024;[Epub] CrossRef
- Subclassification of advanced-stage hepatocellular carcinoma with macrovascular invasion: combined transarterial chemoembolization and radiotherapy as an alternative first-line treatment
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Sujin Jin, Won-Mook Choi, Ju Hyun Shim, Danbi Lee, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Jinhong Jung, Sang Min Yoon, Jonggi Choi
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J Liver Cancer. 2023;23(1):177-188. Published online March 23, 2023
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DOI: https://doi.org/10.17998/jlc.2023.03.04
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2,561
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113
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Abstract
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Supplementary Material
- Background/Aim
The Barcelona Clinic Liver Cancer (BCLC) guidelines recommend systemic therapy as the only first-line treatment for patients with BCLC stage C hepatocellular carcinoma (HCC) despite its heterogeneity of disease extent. We aimed to identify patients who might benefit from combined transarterial chemoembolization (TACE) and radiation therapy (RT) by subclassifying BCLC stage C.
Methods
A total of 1,419 treatment-naïve BCLC stage C patients with macrovascular invasion (MVI) who were treated with combined TACE and RT (n=1,115) or systemic treatment (n=304) were analyzed. The primary outcome was overall survival (OS). Factors associated with OS were identified and assigned points by the Cox model. The patients were subclassified into three groups based on these points.
Results
The mean age was 55.4 years, and 87.8% were male. The median OS was 8.3 months. Multivariate analysis revealed a significant association of Child-Pugh B, infiltrative-type tumor or tumor size ≥10 cm, main or bilateral portal vein invasion, and extrahepatic metastasis with poor OS. The sub-classification was categorized into low (point ≤1), intermediate (point=2), and high (point ≥3) risks based on the sum of points (range, 0–4). The OS in the low, intermediate, and high-risk groups was 22.6, 8.2, and 3.8 months, respectively. In the low and intermediate-risk groups, patients treated with combined TACE and RT exhibited significantly longer OS (24.2 and 9.5 months, respectively) than those who received systemic treatment (6.4 and 5.1 months, respectively; P<0.0001).
Conclusions
Combined TACE and RT may be considered as a first-line treatment option for HCC patients with MVI when classified into low- and intermediate-risk groups.
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- Management strategies for advanced hepatocellular carcinoma with
portal vein tumor thrombosis
Jeayeon Park, Su Jong Yu
The Ewha Medical Journal.2025;[Epub] CrossRef - Liver resection in selective hepatocellular carcinoma with Vp3 or Vp4 portal vein tumor thrombosis improves prognosis
Manuel Lim, Jongman Kim, Jinsoo Rhu, Gyu-Seong Choi, Jae-Won Joh
Journal of Liver Cancer.2024; 24(1): 102. CrossRef - Comparison of atezolizumab plus bevacizumab and lenvatinib for hepatocellular carcinoma with portal vein tumor thrombosis
Jeayeon Park, Yun Bin Lee, Yunmi Ko, Youngsu Park, Hyunjae Shin, Moon Haeng Hur, Min Kyung Park, Dae-Won Lee, Eun Ju Cho, Kyung-Hun Lee, Jeong-Hoon Lee, Su Jong Yu, Tae-Yong Kim, Yoon Jun Kim, Tae-You Kim, Jung-Hwan Yoon
Journal of Liver Cancer.2024; 24(1): 81. CrossRef - A Machine Learning Algorithm Facilitates Prognosis Prediction and Treatment Selection for Barcelona Clinic Liver Cancer Stage C Hepatocellular Carcinoma
Ji W. Han, Soon K. Lee, Jung H. Kwon, Soon W. Nam, Hyun Yang, Si H. Bae, Ji H. Kim, Heechul Nam, Chang W. Kim, Hae L. Lee, Hee Y. Kim, Sung W. Lee, Ahlim Lee, U I. Chang, Do S. Song, Seok-Hwan Kim, Myeong J. Song, Pil S. Sung, Jong Y. Choi, Seung K. Yoon,
Clinical Cancer Research.2024; 30(13): 2812. CrossRef - Limited Generalizability of Retrospective Single-Center Cohort Study in Comparison to Multicenter Cohort Study on Prognosis of Hepatocellular Carcinoma
Ye Rim Kim, Sung Won Chung, Min-Ju Kim, Won-Mook Choi, Jonggi Choi, Danbi Lee, Han Chu Lee, Ju Hyun Shim
Journal of Hepatocellular Carcinoma.2024; Volume 11: 1235. CrossRef - Portal vein tumor thrombosis in hepatocellular carcinoma patients: Is it the end?
Walaa Abdelhamed, Hend Shousha, Mohamed El-Kassas
Liver Research.2024;[Epub] CrossRef - How to optimize the treatment strategy for advanced-stage hepatocellular carcinoma with macrovascular invasion
Beom Kyung Kim
Journal of Liver Cancer.2023; 23(1): 121. CrossRef
Review Articles
- Multidisciplinary approach for hepatocellular carcinoma patients: current evidence and future perspectives
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Joo Hyun Oh, Dong Hyun Sinn
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J Liver Cancer. 2024;24(1):47-56. Published online March 25, 2024
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DOI: https://doi.org/10.17998/jlc.2024.02.27
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3,721
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201
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6
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Abstract
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- Management of hepatocellular carcinoma (HCC) is challenging due to the complex relationship between underlying liver disease, tumor burden, and liver function. HCC is also notorious for its high recurrence rate even after curative treatment for early-stage tumor. Liver transplantation can substantially alter patient prognosis, but donor availability varies by each patient which further complicates treatment decision. Recent advancements in HCC treatments have introduced numerous potentially efficacious treatment modalities. However, high level evidence comparing the risks and benefits of these options is limited. In this complex situation, multidisciplinary approach or multidisciplinary team care has been suggested as a valuable strategy to help cope with escalating complexity in HCC management. Multidisciplinary approach involves collaboration among medical and health care professionals from various academic disciplines to provide comprehensive care. Although evidence suggests that multidisciplinary care can enhance outcomes of HCC patients, robust data from randomized controlled trials are currently lacking. Moreover, the implementation of a multidisciplinary approach necessitates increased medical resources compared to conventional cancer care. This review summarizes the current evidence on the role of multidisciplinary approach in HCC management and explores potential future directions.
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Clinical and Molecular Hepatology.2025; 31(Suppl): S228. CrossRef - Exploring the role of liver resection as a first-line treatment option for multinodular BCLC-A hepatocellular carcinoma
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Hepatology International.2024; 18(6): 1661. CrossRef - Modern Management of Common Bile Duct Stones: Breakthroughs, Challenges, and Future Perspectives
Yanguang Sha, Zhilin Wang, Rongmei Tang, Ke Wang, Chen Xu, Guangbin Chen
Cureus.2024;[Epub] CrossRef
- Advancing Korean nationwide registry for hepatocellular carcinoma: a systematic sampling approach utilizing the Korea Central Cancer Registry database
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Bo Hyun Kim, E Hwa Yun, Jeong-Hoon Lee, Geun Hong, Jun Yong Park, Ju Hyun Shim, Eunyang Kim, Hyun-Joo Kong, Kyu-Won Jung, Young-Suk Lim
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J Liver Cancer. 2024;24(1):57-61. Published online March 26, 2024
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DOI: https://doi.org/10.17998/jlc.2024.03.03
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2,520
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73
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5
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Abstract
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Supplementary Material
- Hepatocellular carcinoma (HCC) presents a substantial public health challenge in South Korea as evidenced by 10,565 new cases annually (incidence rate of 30 per 100,000 individuals), in 2020. Cancer registries play a crucial role in gathering data on incidence, disease attributes, etiology, treatment modalities, outcomes, and informing health policies. The effectiveness of a registry depends on the completeness and accuracy of data. Established in 1999 by the Ministry of Health and Welfare, the Korea Central Cancer Registry (KCCR) is a comprehensive, legally mandated, nationwide registry that captures nearly all incidence and survival data for major cancers, including HCC, in Korea. However, detailed information on cancer staging, specific characteristics, and treatments is lacking. To address this gap, the KCCR, in partnership with the Korean Liver Cancer Association (KLCA), has implemented a systematic approach to collect detailed data on HCC since 2010. This involved random sampling of 10-15% of all new HCC cases diagnosed since 2003. The registry process encompassed four stages: random case selection, meticulous data extraction by trained personnel, expert validation, anonymization of personal data, and data dissemination for research purposes. This random sampling strategy mitigates the biases associated with voluntary reporting and aligns with stringent privacy regulations. This innovative approach positions the KCCR and KLCA as foundations for advancing cancer control and shaping health policies in South Korea.
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Hwi Young Kim, Hye Ah Lee, Pompilia Radu, Jean-François Dufour
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Jaejun Lee, Jong Young Choi, Soon Kyu Lee
Journal of Liver Cancer.2024; 24(2): 253. CrossRef - Incorporating ALBI Grade with Geriatric Nutritional Risk Index Enhances Hepatocellular Carcinoma Risk Stratification
Heechul Nam, Pil Soo Sung, Sung Won Lee, Do Seon Song, Jung Hyun Kwon, Jeong Won Jang, Chang Wook Kim, Si Hyun Bae
Liver Cancer.2024; : 1. CrossRef
- Diagnosis of hepatocellular carcinoma using Sonazoid: a comprehensive review
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Woo Kyoung Jeong
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J Liver Cancer. 2023;23(2):272-283. Published online September 19, 2023
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DOI: https://doi.org/10.17998/jlc.2023.08.25
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2,835
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133
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5
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Abstract
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- Sonazoid contrast-enhanced ultrasonography (CEUS) is a promising technique for the detection and diagnosis of focal liver lesions, particularly hepatocellular carcinoma (HCC). Recently, a collaborative effort between the Korean Society of Radiology and Korean Society of Abdominal Radiology resulted in the publication of guidelines for diagnosing HCC using Sonazoid CEUS. These guidelines propose specific criteria for identifying HCC based on the imaging characteristics observed during Sonazoid CEUS. The suggested diagnostic criteria include nonrim arterial phase hyperenhancement, and the presence of late and mild washout, or Kupffer phase washout under the premise that the early or marked washout should not occur during the portal venous phase. These criteria aim to improve the accuracy of HCC diagnosis using Sonazoid CEUS. This review offers a comprehensive overview of Sonazoid CEUS in the context of HCC diagnosis. It covers the fundamental principles of Sonazoid CEUS and its clinical applications, and introduces the recently published guidelines. By providing a summary of this emerging technique, this review contributes to a better understanding of the potential role of Sonazoid CEUS for diagnosing HCC.
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DOI: https://doi.org/10.17998/jlc.2024.08.07
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Abstract
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- Cholangiocarcinoma (CCA) is a rare and aggressive cancer, mostly diagnosed at advanced or metastatic stage, at which point systemic treatment represents the only therapeutic option. Chemotherapy has been the backbone of advanced CCA treatment. More recently, immunotherapy has changed the therapeutic landscape, as immune checkpoint inhibitors have yielded the first improvement in survival and currently, the addition of either durvalumab or pembrolizumab to standard of care cisplatin plus gemcitabine represents the new first-line treatment option. However, the use of immunotherapy in subsequent lines has not demonstrated its efficacy and therefore, it is not approved, except for pembrolizumab in the selected microsatellite instability-high population. In addition, advances in comprehensive genomic profiling have led to the identification of targetable genetic alterations, such as isocitrate dehydrogenase 1 (IDH1), fibroblast growth factor receptor 2 (FGFR2), human epidermal growth factor receptor 2 (HER2), proto-oncogene B-Raf (BRAF), neurotrophic tropomyosin receptor kinase (NTRK), rearranged during transfection (RET), Kirsten rat sarcoma virus (KRAS), and mouse double minute 2 homolog (MDM2), thus favoring the development of a precision medicine approach in previously treated patients. Despite these advances, the use of molecularly driven agents is limited to a subgroup of patients. This review aims to provide an overview of the newly approved systemic therapies, the ongoing studies, and future research challenges in advanced CCA management.
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