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26 "Do Young Kim"
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Review Article
Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide
Do Young Kim
J Liver Cancer. 2024;24(1):62-70.   Published online March 25, 2024
DOI: https://doi.org/10.17998/jlc.2024.03.13
  • 2,739 Views
  • 185 Downloads
  • 2 Citations
AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • Immunotherapy as a Complement to Surgical Management of Hepatocellular Carcinoma
    Susan J. Kim, Kaelyn C. Cummins, Allan Tsung
    Cancers.2024; 16(10): 1852.     CrossRef
  • Inflammatory Response in the Pathogenesis and Treatment of Hepatocellular Carcinoma: A Double-Edged Weapon
    Linda Galasso, Lucia Cerrito, Valeria Maccauro, Fabrizio Termite, Irene Mignini, Giorgio Esposto, Raffaele Borriello, Maria Elena Ainora, Antonio Gasbarrini, Maria Assunta Zocco
    International Journal of Molecular Sciences.2024; 25(13): 7191.     CrossRef
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Original Articles
The efficacy of treatment for hepatocellular carcinoma in elderly patients
Han Ah Lee, Sangheun Lee, Hae Lim Lee, Jeong Eun Song, Dong Hyeon Lee, Sojung Han, Ju Hyun Shim, Bo Hyun Kim, Jong Young Choi, Hyunchul Rhim, Do Young Kim
J Liver Cancer. 2023;23(2):362-376.   Published online September 14, 2023
DOI: https://doi.org/10.17998/jlc.2023.08.03
  • 1,730 Views
  • 86 Downloads
  • 2 Citations
AbstractAbstract PDFSupplementary Material
Background/Aim
Despite the increasing proportion of elderly patients with hepatocellular carcinoma (HCC) over time, treatment efficacy in this population is not well established.
Methods
Data collected from the Korean Primary Liver Cancer Registry, a representative cohort of patients newly diagnosed with HCC in Korea between 2008 and 2017, were analyzed. Overall survival (OS) according to tumor stage and treatment modality was compared between elderly and non-elderly patients with HCC.
Results
Among 15,186 study patients, 5,829 (38.4%) were elderly. A larger proportion of elderly patients did not receive any treatment for HCC than non-elderly patients (25.2% vs. 16.7%). However, OS was significantly better in elderly patients who received treatment compared to those who did not (median, 38.6 vs. 22.3 months; P<0.001). In early-stage HCC, surgery yielded significantly lower OS in elderly patients compared to non-elderly patients (median, 97.4 vs. 138.0 months; P<0.001), however, local ablation (median, 82.2 vs. 105.5 months) and transarterial therapy (median, 42.6 vs. 56.9 months) each provided comparable OS between the two groups after inverse probability of treatment weighting (IPTW) analysis (all P>0.05). After IPTW, in intermediate-stage HCC, surgery (median, 66.0 vs. 90.3 months) and transarterial therapy (median, 36.5 vs. 37.2 months), and in advanced-stage HCC, transarterial (median, 25.3 vs. 26.3 months) and systemic therapy (median, 25.3 vs. 26.3 months) yielded comparable OS between the elderly and non-elderly HCC patients (all P>0.05).
Conclusions
Personalized treatments tailored to individual patients can improve the prognosis of elderly patients with HCC to a level comparable to that of non-elderly patients.

Citations

Citations to this article as recorded by  
  • 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
  • Achieving Sufficient Therapeutic Outcomes of Surgery in Elderly Hepatocellular Carcinoma Patients through Appropriate Selection
    Han Ah Lee
    Gut and Liver.2024; 18(4): 556.     CrossRef
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Clinical characteristics and prognosis of Korean patients with hepatocellular carcinoma with respect to etiology
Wonjoon Jang, Hye Won Lee, Jae Seung Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Do Young Kim
J Liver Cancer. 2022;22(2):158-166.   Published online September 27, 2022
DOI: https://doi.org/10.17998/jlc.2022.09.18
  • 3,138 Views
  • 72 Downloads
  • 7 Citations
AbstractAbstract PDFSupplementary Material
Background/Aim
The profile of patients with hepatocellular carcinoma (HCC) has changed globally; the role of etiology in predicting prognosis of HCC patients remains unclear. We aimed to analyze the characteristics and prognosis of Korean patients with HCC according to disease etiology.
Methods
This retrospective observational study included patients diagnosed with HCC between 2010 and 2014 in a single center in Korea. Patients with HCC aged <19 years old, had coinfection with other viral hepatitis, had missing follow-up data, were Barcelona Clinic Liver Cancer stage D, or died before 1 month were excluded.
Results
A total of 1,595 patients with HCC were analyzed; they were classified into the hepatitis B virus (HBV) group (1,183 [74.2%]), hepatitis C virus (HCV) group (146 [9.2%]), and non-B non-C (NBNC) group (266 [16.7%]). The median overall survival of all patients was 74 months. The survival rates at 1, 3, and 5 years were 78.8%, 62.0% and 54.9% in the HBV group; 86.0%, 64.0%, and 48.6% in the HCV group; and 78.4%, 56.5%, and 45.9% in the NBNC group, respectively. NBNC-HCC has a poorer prognosis than other causes of HCC. Survival was significantly longer in the HBV group with early-stage HCC than in the NBNC group. Furthermore, survival was shorter in patients with early-stage HCC and diabetes mellitus (DM) than in those without DM.
Conclusions
The etiology of HCC affected clinical characteristics and prognosis to some extent. NBNC-HCC patients showed shorter overall survival than viral-related HCC patients. Additionally, the presence of DM is an additional important prognostic factor in patients with early-stage HCC.

Citations

Citations to this article as recorded by  
  • The Epidemiology of Hepatitis B Virus Infection in Korea: 15-Year Analysis
    Log Young Kim, Jeong-Ju Yoo, Young Chang, Hoongil Jo, Young Youn Cho, Sangheun Lee, Dong Hyeon Lee, Jae Young Jang
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Comparison of Surgical Resection and Radiofrequency Ablation in Elderly Patients with Hepatocellular Carcinoma
    Jun Il Kim, Jayoun Lee, Gi Hong Choi, Min Woo Lee, Dong Ah Park, Jeong-Ju Yoo
    Digestive Diseases and Sciences.2024; 69(3): 1055.     CrossRef
  • Focal Segmental Glomerulosclerosis Followed by Acute Hepatitis A Infection: Case Report
    Min-Woo An, Jeong-Ju Yoo, Jin Kuk Kim, Ahrim Moon, Sang Gyune Kim, Young Seok Kim
    Medicina.2023; 59(5): 819.     CrossRef
  • Validation of MELD 3.0 scoring system in East Asian patients with cirrhosis awaiting liver transplantation
    Jeong-Ju Yoo, Jong-In Chang, Ji Eun Moon, Dong Hyun Sinn, Sang Gyune Kim, Young Seok Kim
    Liver Transplantation.2023; 29(10): 1029.     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
  • Statin use and the risk of hepatocellular carcinoma among patients with chronic hepatitis B: an emulated target trial using longitudinal nationwide population cohort data
    Dong Hyun Sinn, Danbee Kang, Yewan Park, Hyunsoo Kim, Yun Soo Hong, Juhee Cho, Geum-Youn Gwak
    BMC Gastroenterology.2023;[Epub]     CrossRef
  • Addition of Kidney Dysfunction Type to MELD-Na for the Prediction of Survival in Cirrhotic Patients Awaiting Liver Transplantation in Comparison with MELD 3.0 with Albumin
    Kyeong-Min Yeom, Jong-In Chang, Jeong-Ju Yoo, Ji Eun Moon, Dong Hyun Sinn, Young Seok Kim, Sang Gyune Kim
    Diagnostics.2023; 14(1): 39.     CrossRef
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Case Reports
Curative liver transplantation after lung resection for advanced hepatocellular carcinoma with lung metastasis and inferior vena cava tumor thrombosis: a case report
Dong Jin Joo, Do Young Kim, Jinsil Seong, Hyun Jeong Kim, Jae Geun Lee, Dai Hoon Han, Gi Hong Choi, Myoung Soo Kim, Jin Sub Choi, Soon Il Kim
J Liver Cancer. 2021;21(2):181-186.   Published online September 30, 2021
DOI: https://doi.org/10.17998/jlc.2021.09.08
  • 4,134 Views
  • 98 Downloads
  • 1 Citation
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) with distant metastasis is an absolute contraindication for liver transplantation (LT). However, it is still unclear whether LT is feasible or acceptable in such patients, albeit after being treated with a multidisciplinary approach and after any metastatic lesion is ruled out. We report one such successful treatment with living donor LT (LDLT) after completely controlling far-advanced HCC with inferior vena cava tumor thrombosis and multiple lung metastases. The patient has been doing well without HCC recurrence for eight years since LDLT. The current patient could be an anecdotal case, but provides a case for expanding LDLT indications in the context of advanced HCC and suchlike.

Citations

Citations to this article as recorded by  
  • Inferior Vena Cava Thrombectomy and Stenting as Bridge to Liver Transplantation After Radiotherapy-Induced Thrombosis
    Raphael PH Meier, Shani Kamberi, Josue Alvarez-Casas, Barton F. Lane, Chandra S. Bhati, Saad Malik, William Twaddell, Kirti Shetty, Adam Fang, Hyun S. Kim, Daniel G. Maluf
    Progress in Transplantation.2023;[Epub]     CrossRef
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A Case of Lymphocyte-Rich Hepatocellular Carcinoma in a Patient Who Was Treated for Colon Cancer
Jae Won Song, Ho Soo Chun, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Young Nyun Park, Dai Hoon Han, Do Young Kim
J Liver Cancer. 2021;21(1):69-75.   Published online March 31, 2021
DOI: https://doi.org/10.17998/jlc.21.1.69
  • 3,938 Views
  • 88 Downloads
  • 2 Citations
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) primarily originates in the liver with hepatic differentiation. However, HCCs are not homogenous, and approximately 35% of HCC cases are classified as histopathological variants that present distinct pathologic characteristics. In particular, the lymphocyte-rich variant is the rarest subtype accounting for less than 1% of HCCs, which is not well known to date about molecular features and pathophysiology. Herein, we present a case of a patient who was suspected of metastatic liver cancer and confirmed as lymphocyte-rich HCC pathologically. A 78-year-old woman who underwent a right hemicolectomy for colon cancer was referred to our hospital for a newly detected liver mass. We could not make a decision because of insufficient evidence for diagnosis from imaging studies. After resection, we found that it was a lymphocyte-rich HCC. The pathologic features and prognostic trends of this subtype are also discussed.

Citations

Citations to this article as recorded by  
  • Characterization of lymphocyte‐rich hepatocellular carcinoma and the prognostic role of tertiary lymphoid structures
    Bokyung Ahn, Hee‐Sung Ahn, Jinho Shin, Eunsung Jun, Eun‐Young Koh, Yeon‐Mi Ryu, Sang‐Yeob Kim, Chang Ohk Sung, Ju Hyun Shim, JeongYeon Hong, Kyunggon Kim, Hyo Jeong Kang
    Liver International.2024; 44(5): 1202.     CrossRef
  • Uncommon variants of hepatocellular carcinoma: Not one size fits all
    Reetu Kundu, Nalini Gupta, Debajyoti Chatterjee, Ajay Duseja
    Diagnostic Cytopathology.2022; 50(1): 28.     CrossRef
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Original Article
Serum PD-1 Levels Change with Immunotherapy Response but Do Not Predict Prognosis in Patients with Hepatocellular Carcinoma
Hye Won Lee, Kyung Joo Cho, Soon Young Shin, Ha Yan Kim, Eun Ju Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han
J Liver Cancer. 2019;19(2):108-116.   Published online September 30, 2019
DOI: https://doi.org/10.17998/jlc.19.2.108
  • 5,645 Views
  • 154 Downloads
  • 5 Citations
AbstractAbstract PDFSupplementary Material
Background/Aims
Programmed death receptor 1 (PD-1) is a promising new target for treatment of patients with hepatocellular carcinoma (HCC). A high expression level of programmed death-ligand 1 (PD-L1) is a possible prognostic indicator for poor outcome in other malignancies. Here, we investigated the clinical significance of PD-1 and PD-L1 in patients with HCC.
Methods
We enrolled patients with HCC who underwent surgical resection at Severance Hospital between 2012 and 2017 and investigated the levels of PD-L1 in HCC tissues (tPD-L1) and PD-L1/PD-1 in serum (sPD-L1/sPD-1). We also aimed to determine whether expression levels correlated with clinical and histological features.
Results
A total of 72 patient samples were analyzed. The median sPD-L1 and sPD-1 levels were 25.72 and 341.44 pg/mL, respectively. A positive correlation was detected between tPD-L1 and sPD-1 levels (R2=0.426, P<0.001). The median sPD-1 level increased linearly with tPD-L1 score (P=0.002). During the follow-up period, HCC recurred in eight (11.1%) patients and liverrelated mortality occurred in eight (11.1%) patients. Higher sPD-L1 levels (≥19.18 pg/mL) tended to be associated with liver-related mortality (hazard ratio 6.866; 95% confidence interval, 0.804-58.659, P=0.078). sPD-1 levels of patients treated with nivolumab as a second-line therapy changed serially, and a >50% reduction in sPD-1 levels was observed immediately after nivolumab administration. However, sPD-1 level was not associated directly with prognosis in patients with advanced HCC.
Conclusions
The results demonstrated that PD-L1 and PD-1 levels changed according to the immunotherapy. However, no significant association with clinical outcome in patients with HCC was detected.

Citations

Citations to this article as recorded by  
  • Blood-based biomarkers for immune-based therapy in advanced HCC: Promising but a long way to go
    Pil Soo Sung, Isaac Kise Lee, Pu Reun Roh, Min Woo Kang, Jaegyoon Ahn, Seung Kew Yoon
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Serum levels of soluble programmed death-ligand 1 (sPD-L1): A possible biomarker in predicting post-treatment outcomes in patients with early hepatocellular carcinoma
    Tudor Mocan, Maria Ilies, Iuliana Nenu, Rares Craciun, Adelina Horhat, Ruxandra Susa, Iulia Minciuna, Ioana Rusu, Lavinia-Patricia Mocan, Andrada Seicean, Cristina Adela Iuga, Nadim Al Hajjar, Mihaela Sparchez, Daniel-Corneliu Leucuta, Zeno Sparchez
    International Immunopharmacology.2021; 94: 107467.     CrossRef
  • Interfacial interactions of SERS-active noble metal nanostructures with functional ligands for diagnostic analysis of protein cancer markers
    Han-Jung Ryu, Won Kyu Lee, Yoon Hyuck Kim, Jae-Seung Lee
    Microchimica Acta.2021;[Epub]     CrossRef
  • Current Status and Future Direction of Immunotherapy in Hepatocellular Carcinoma: What Do the Data Suggest?
    Hye Won Lee, Kyung Joo Cho, Jun Yong Park
    Immune Network.2020;[Epub]     CrossRef
  • Nivolumab for Advanced Hepatocellular Carcinoma with Multiple Lung Metastases after Sorafenib Failure
    Jaewoong Kim, Jin Won Chang, Jun Yong Park
    Journal of Liver Cancer.2020; 20(1): 72.     CrossRef
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Case Reports
A Case of Successful Living Donor Liver Transplantation after Downstaging of Hepatocellular Carcinoma with the Beyond Milan Criteria by Radioembolization, Hepatic Arterial Infusion Chemotherapy, and Stereotactic Body Radiation Therapy
Yeong Jin Kim, Yeon Seung Chung, Beom Kyung Kim, Jin Sil Sung, Do Young Kim
J Liver Cancer. 2017;17(2):182-185.   Published online September 30, 2017
DOI: https://doi.org/10.17998/jlc.17.2.182
  • 2,019 Views
  • 18 Downloads
AbstractAbstract PDF
Liver transplantation for patients with hepatocellular carcinoma (HCC) within the Milan criteria generally yields a 4-year overall survival rate of 75% and 4-year recurrence free survival rate of 83%. But, many HCC patients present with the disease beyond the Milan criteria. On the other hands, the overall survival of patients with advanced HCC with portal vein invasion is very poor. We report a
case
of successful living donor liver transplantation for advanced HCC with portal vein invasion by down-staging through radioembolization, hepatic arterial infusion chemotherapy, and stereotactic body radiation therapy.
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A Case of Complete Remission in Patient with Extrahepatic Metastasis after Curative Resection of Hepatocellular Carcinoma by Radiotherapy, Lung Resection and Systemic Chemotherapy
Yeong Jin Kim, Hye won Lee, Ji Hoon Lee, Jin Sil Sung, Do Young Kim
J Liver Cancer. 2016;16(1):63-66.   Published online March 31, 2016
DOI: https://doi.org/10.17998/jlc.16.1.63
  • 991 Views
  • 8 Downloads
AbstractAbstract PDF
Surgical resection is mainstay treatment of hepatocellular carcinoma (HCC). However, its prognosis is poor, because of the high incidence of HCC recurrence (cumulative 5-year HCC recurrence rate of 70-80%). The most common site of HCC recurrence is the remnant liver, and extrahepatic recurrence occurs in 6.7-13.5% of patients. Because the tumor characteristics in extrahepatic recurrence are usually multiple and aggressive, the optimal treatment modality has not yet been determined. We report a case of complete remission and long term survival over 60 months in patient with extrahepatic metastasis after curative resection of HCC by aggressive treatment, which include lung resection for lung metastasis, radiotherapy for mediastinal lymph node metastasis, and systemic chemotherapy.
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Original Article
Subclassification of Hepatocellular Carcinoma with Barcelona Clinic Liver Cancer Intermediate Stage
Hye Won Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Snag Hoon Ahn, Kwang-Hyub Han, Beom Kyung Kim
J Liver Cancer. 2016;16(1):17-22.   Published online March 31, 2016
DOI: https://doi.org/10.17998/jlc.16.1.17
  • 1,434 Views
  • 15 Downloads
AbstractAbstract PDF
Background/Aims
Hepatocellular carcinoma (HCC) with Barcelona Clinic Liver Cancer (BCLC) intermediate stage includes a highly heterogeneous population. Here, we aimed to subclassify hepatocellular carcinoma with BCLC intermediate stage for better prognostification.
Methods
Between 2003 and 2008, 325 patients who were newly diagnosed as HCC with BCLC intermediate stage were considered eligible. Tumor factor and liver function were used for sub-classification. Overall survival (OS) was analyzed using Kaplan-Meier method with a comparison by log-rank test.
Results
A total of 325 patients with intermediate stage HCC were analyzed. Patients with tumor size ≥7 cm, tumor number ≥4 and Child-Pugh class B had the worse OS compared to those with tumor size <7 cm, tumor number <4 and Child-pugh class A, respectively (all P<0.05). These three variables affected the OS independently from multivariate Cox regression analysis (all P<0.05). So, using these three variables, patients were finally sub-classified as those with fulfilling none of three factors (B-a), one of three factors (B-b), two of three factors (B-c) and all of three factors (B-d) with the median OS of 39.2, 20.6, 12.0 and 8.3 months with statistical significances (all P<0.05 between B-a and B-b, between B-b and B-c, and between B-c and B-d), respectively.
Conclusions
Sub-classification of HCC with BCLC intermediate stage may be useful in not only prognostification but also guidance of treatment strategies. (J Liver Cancer 2016;16:17-22)
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Review Article
Experience and Expectation for Molecular Target Therapy in Hepatocellular Carcinoma
Do Young Kim
J Liver Cancer. 2016;16(1):12-16.   Published online March 31, 2016
DOI: https://doi.org/10.17998/jlc.16.1.12
  • 1,077 Views
  • 14 Downloads
AbstractAbstract PDF
Sorafenib, the first-approved molecular targeted agent (MTA), is actively used in patients with advanced hepatocellular carcinoma (HCC) worldwide. Accumulating experiences suggest that the efficacy of this drug is modest and the adverse events are not minimal, although those are manageable. Given that newer drugs targeting various molecules involved in hepatocarcinogenesis have been failed to show efficacy compared with sorafenib, the perspectives regarding development of novel MTA appear to be gloomy. Nonetherless, it is necessary to maximize the efficacy of sorafenib by combining this drug with locoregional therapies and by finding biomarkers predicting the outcomes of patients treated with sorafenib. A series of data indicate that combining sorafenib and locoregional therapies including transarterial chemoemolization could improve patients outcome. Unfortunately, there has been no biomarkers identified which could predict the response to sorafenib. Global investigation of therapeutic decisions in HCC and of its treatment with sorafeNib (GIDEON) is a global, non-interventional, observational study to evaluate the safety and efficacy of sorafenib, particularly in patients with Child-Pugh B. The final report of GIDEON study is going to be published soon, and the Korean GIDEON data suggest that sorafenib in patients with decreased liver function might be safe and effective as in patients with Child-Pugh A. The way to conquer HCC using molecular approach is still long and the era of immune-oncology seems to get started. (Journal of Liver Cancer 2016;16:12-16)
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Case Report
A Case of Rapidly Recurred Hepatocellular Carcinoma with Distant Metastasis after Surgical Resection
Mi Yeon Kim, Hye Won Lee, Kyu Sik Jung, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Kwang-Hyub Han, Do Young Kim
J Liver Cancer. 2015;15(2):136-139.   Published online September 30, 2015
DOI: https://doi.org/10.17998/jlc.15.2.139
  • 994 Views
  • 10 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is one of the cancers with poor prognosis. However, surgical resection is the treatment of choice as curative aim for early HCC with preserved liver function. A 5 year survival rate after curative resection is over 50%. We experienced a case of rapidly recurred HCC with bone metastasis after surgical resection. In our case, microscopically microvessel invasion was present after resection. Microvascular invasion (MVI) is an important factor to influence survival and/or HCC recurrence. So we suggested the patients with MVI need to follow up intensively and adjuvant therapy may be considered.
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Review Article
Role of Yttrium-90 Radioembolization in the Management of Hepatocellular Carcinoma
Do Young Kim
J Liver Cancer. 2015;15(1):11-18.   Published online March 31, 2015
DOI: https://doi.org/10.17998/jlc.15.1.11
  • 1,094 Views
  • 8 Downloads
AbstractAbstract PDF
Yttrium-90 radioembolization has emerged as a novel therapy for hepatocellular carcinoma (HCC) of intermediate or advanced stage. Yttrium-90 has characteristics of short half-life and tissue penetration depth. Potent anti-cancer effect by this isotope enables to kill the tumor for 6 months after administration. Although transarterial chemoembolization (TACE) is the standard modality for multinodular HCC without vascular invasion, big size or numerous nodules does not allow enough treatment effect of TACE. Post-embolization syndrome resulting poor quality of life, liver dysfunction and hepatic arterial damage are other pitfalls of TACE. In several studies, radioembolization showed survival comparable to TACE, shorter hospital stay and less treatment sessions. In advanced HCC with portal vein invasion, radioembolization demonstrated similar or better survival compared with sorafenib. The atrophy of lobe treated by radioembolization and hypertrophy in the contralateral lobe can be called radiation lobectomy, which makes it possible to perform a following curative therapy. The role of radioembolization in unresectable HCC in terms of downstaging or bridge to transplantation needs to be further studied. Radioembolization is contraindicated in HCC patients with main portal vein occlusion and with poor liver function. The International guidelines for HCC have some limitations and thus rooms for radioembolization to be incorporated.
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Case Reports
A Case of Positive Tumor Marker Response after Intra-arterial Deferoxamine Infusion Therapy in a Hepatocellular Carcinoma Patient with Decompensated Liver Function
Hyun Ju Kim, Wonseok Kang, Mi Na Kim, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han
J Liver Cancer. 2014;14(2):127-130.   Published online September 30, 2014
DOI: https://doi.org/10.17998/jlc.14.2.127
  • 1,261 Views
  • 6 Downloads
AbstractAbstract PDF
Treatment of hepatocellular carcinoma is often very challenging when the underlying liver function is decompensated. Recent experimental and clinical studies showed that some chelating agents, including deferoxamine, display anti-proliferative actions against tumor cells, thereby exhibiting anti-cancer effect in certain cancers, including hepatocellular carcinoma. Based on previous studies, we herein offer our experience of positive tumor marker response after intra-arterial deferoxamine infusion in a patient presenting with advanced hepatocellular carcinoma with decompensated hepatic function. Validation of the efficacy of intra-arterial deferoxamine therapy in the setting of advanced hepatocellular carcinoma with underlying decompensated hepatic function is warranted. (J Liver Cancer 2014;14:127-130)
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A Case of Partial Response of Hepatocellular Carcinoma Induced by Concurrent Chemoradiation and Hepatic Arterial Infusion Chemotherapy after Trans-Arterial Chemoembolization
Myung Eun Song, Sangheun Lee, Mi Na Kim, Dong-Jun Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Chae Yoon Chon, Kwang-Hyub Han, Jinsil Seong, Do Young Kim
Journal of the Korean Liver Cancer Study Group. 2013;13(2):152-157.   Published online September 30, 2013
DOI: https://doi.org/10.17998/jlc.13.2.152
  • 1,003 Views
  • 7 Downloads
AbstractAbstract PDF
A 63-year-old man patient was referred for treatment of infiltrative hepatocellular carcinoma with hilar invasion after transarterial chemoembolization. Serum alkaline phosphatase and bilirubin were elevated, liver dynamic CT showed infiltrative type mass in left hepatic lobe and right hepatic dome with hilar invasion and left intrahepatic duct dilatation. Also CT showed obliteration of left portal vein and metastasis of lymph node around common bile duct. He was diagnosed as hepatocellular carcinoma (UICC stage IV-A, BCLC stage C). With the percutaneous transhepatic biliary drainage and the concurrent chemoradiation therapy and the 4th cycle of hepatic arterial infusion chemotherapy for infiltrative mass, viable tumor was decreased in resectable size at eight months from initial diagnosis.
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A Case of Recurred Hepatocellular Carcinoma after Treated by Trans-Arterial Chemoembolization
Sangheun Lee, Mi Na Kim, Young Eun Chon, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Chae Yoon Chon, Kwang-Hyub Han
Journal of the Korean Liver Cancer Study Group. 2013;13(1):74-79.   Published online February 28, 2013
DOI: https://doi.org/10.17998/jlc.13.1.74
  • 1,153 Views
  • 4 Downloads
AbstractAbstract PDF
Hepatocelluar carcinoma (HCC) is the most common primary liver cancer in the world and the most prevalent cancer among patients liver cirrhosis. The management of HCC depends on tumor stage and the degree of liver dysfunction. Patients with intermediate-stage HCC are ineligible for surgical or local ablative treatments. Current treatment guidelines recommend trans-arterial chemoembolization (TACE) for intermediate stage of HCC. However, tumor recurrence after TACE is universal and the survival benefit is relatively small. Hence, new strategies are needed to improve the outcome of HCC patients undergoing TACE. Recently, the combination of target agents with TACE has shown promising overall survival in advanced HCC. It is necessary to investigate new treat strategy how to increase treatment outcome of advanced HCC by new treat strategy.
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JLC : Journal of Liver Cancer