Journal of Liver Cancer

Articles in E-pub version are posted online ahead of regular printed publication.

Review Article

Complications of immunotherapy in advanced hepatocellular carcinoma: Young-Gi Song, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim; Received October 16, 2023 Accepted November 21, 2023 Published online November 29, 2023; DOI: https://doi.org/10.17998/jlc.2023.11.21 [Accepted]

Abstract PDF: 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.

Case Report

Metastatic papillary renal cell carcinoma with portal vein tumor thrombosis confirmed on blind liver biopsy: Hun Kim, Tae Hoon Roh, Jun Seop Lee, Min Seong Kim, Beom Kyung Kim; Received August 16, 2023 Accepted November 5, 2023 Published online November 29, 2023; DOI: https://doi.org/10.17998/jlc.2023.11.05 [Accepted]

Abstract PDF: Portal vein tumor thrombosis (PVTT) is an uncommon condition in which tumor cells expand to the vessels, causing blood clot formation in the portal vein. PVTT is mainly associated with hepatocellular carcinoma, leading to an unfavorable prognosis; however, it can also develop in patients with other cancer types. Herein, we report a case of metastatic renal cell carcinoma diagnosed by a blind liver biopsy in a patient with dynamic computed tomography-confirmed portal vein thrombosis and cholangiopathy. This case illustrates the importance of systematic surveillance with routine laboratory tests and contrast-enhanced imaging studies on patients with cancer to detect potential liver infiltration of metastatic cancer.

Letter to the Editor

Performance of HCC Diagnosis in the KLCA-NCC Guidelines: A Closer Look at MRI Contrast Agents and HCC Imaging Hallmarks: Ji Hye Min, Young Kon Kim; Received September 4, 2023 Accepted October 8, 2023 Published online November 6, 2023; DOI: https://doi.org/10.17998/jlc.2023.09.27 [Accepted]

Research Article

Treatment options for solitary hepatocellular carcinoma ≤5 cm: Surgery vs Ablation: A multicenter retrospective study: Kazuya Kariyama, Kazuhiro Nouso, Atsushi Hiraoka, Hidenori Toyoda, Toshifumi Tada, Kunihiko Tsuji, Toru Ishikawa, Takeshi Hatanaka, Ei Itobayashi, Koichi Takaguchi, Akemi Tsutsui, Atsushi Naganuma, Satoshi Yasuda, Satoru Kakizaki, Akiko Wakuta, Shohei Shiota, Masatoshi Kudo, Takashi Kumada; Received August 5, 2023 Accepted September 11, 2023 Published online November 6, 2023; DOI: https://doi.org/10.17998/jlc.2023.09.11 [Accepted]

Abstract PDF: Introduction
The aim of this study was to compare the therapeutic efficacy of ablation and surgery in solitary Hepatocellular carcinoma (HCC) measuring ≤5 cm with a large HCC cohort database.
Methods
The study included consecutive 2067 patients with solitary HCC who were treated with either ablation (N=1248) or surgery (N=819). The patients were divided into three groups based on the tumor size and compared the outcomes of the two therapies using propensity score matching.
Results
No significant difference in recurrence-free survival (RFS) or overall survival (OS) was found between surgery and ablation groups for tumors measuring ≤2 cm or >2 cm but ≤3 cm. For tumors measuring >3 cm but ≤5 cm, RFS was significantly better with surgery than with ablation (3.6 and 2.0 years, respectively, p = 0.0297). However, no significant difference in OS was found between surgery and ablation in this group (6.7 and 6.0 years, respectively, p = 0.668).
Discussion/Conclusion
The study suggests that surgery and ablation can be equally used as a treatment for solitary HCC no more than 3 cm in diameter. For HCCs measuring 3–5 cm, the OS was not different between therapies; thus, ablation and less invasive therapy can be considered a treatment option; however, special caution should be taken to prevent recurrence.

Ahead-of-print articles