Journal of Liver Cancer

Special Contributions

Impact of the 2024 medical-policy conflict on hepatocellular carcinoma management in Korea: Soon Sun Kim, Hyun Yang, Jieun Kwon, Eunju Kim, Jeong Il Yu, Janghan Jung, Woosun Choi, Ji Eun Han, Moon Haeng Hur, Bo Hyun Kim, Sung Hyun Kim, Jeong Han Kim, Haeryoung Kim, Pyoung-Jae Park, Hyun Phil Shin, Su Jong Yu, Ki Tae Yoon, Sang Min Yoon, Minjong Lee, Jai Young Cho, Jin-Young Choi, Do Young Kim, June Sung Lee, Mi-Sook Kim, Kyung Sik Kim; J Liver Cancer. 2025;25(2):169-177. Published online September 2, 2025; DOI: https://doi.org/10.17998/jlc.2025.09.01

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Abstract PDF: In 2024, a nationwide conflict between the South Korean government and the medical community, the medical-policy conflict, profoundly impacted healthcare delivery. This study aimed to evaluate the changes in the management of hepatocellular carcinoma (HCC) following this crisis. We analyzed retrospective real-world data from university hospitals in the Seoul Metropolitan Area, supplemented with national healthcare data from the Health Insurance Review and Assessment Service. The analytical variables included changes in workforce composition, initial treatment modalities, HCC stage distribution, quality indicators for HCC care, regional and institutional variations in care delivery, and liver transplantation (LT) volume. A comparison between 2023 and 2024 revealed a marked decline in the number of medical trainees, a rise in the proportion of physician assistants, a 28.9% reduction in newly initiated HCC treatments, and an increased rate of stage IV diagnoses. Several quality indicators, including rates of multidisciplinary care and patient education, declined. The volume of LTs decreased by approximately 20% nationwide, with some regions ceasing LT procedures. The results suggest that serious disruptions occurred in HCC care following the conflict. The significant decrease in initial treatment and number of LT procedures, more advanced stages at diagnosis, and declining quality metrics indicate the emergence of healthcare gaps. Without the recovery of the clinical workforce and the reestablishment of a stable healthcare delivery system, the management of serious diseases such as HCC will remain structurally vulnerable. National-level efforts are urgently required to address regional disparities and restore essential medical services.

Expert survey on systemic therapy indications for hepatocellular carcinoma in Korea: bridging clinical practice and reimbursement criteria: Hyun Yang, Soon Sun Kim, Seong Hee Kang, Jieun Kwon, Do Young Kim, Eunju Kim, Hyun Phil Shin, Jeong Il Yu, Jeong-Ju Yoo, Eileen L. Yoon, Sangheun Lee, Young Eun Chon, Janghan Jung, Jaekyung Cheon, Woosun Choi, Seul Ki Han, Ji Eun Han, Moon Haeng Hur, Hyun Woong Lee, Hyung Joon Kim; J Liver Cancer. 2025;25(2):160-168. Published online July 7, 2025; DOI: https://doi.org/10.17998/jlc.2025.07.02

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Abstract PDF: This survey aimed to collect expert opinions from multidisciplinary specialists involved in the management of hepatocellular carcinoma (HCC) in Korea regarding real-world criteria for systemic therapy indications. In response to discrepancies between national reimbursement policies and clinical decision-making, members of the Korean Liver Cancer Association and Korean Association for the Study of the Liver participated in a web-based survey from February 4 to 14, 2025. A total of 89 respondents, primarily experienced clinicians, provided their views on major clinical scenarios including infiltrative HCC, bilobar multifocal disease, huge tumors, vascular invasion, extrahepatic metastasis, and transarterial chemoembolization (TACE) refractoriness. There was high agreement for including infiltrative HCC (69.7%), suspected portal vein invasion (70.8%), and TACE refractoriness (82.0%) as systemic therapy indications. TACE refractoriness, in particular, aligns with current guideline definitions. Additionally, over half of respondents (51.7%) supported extrahepatic metastasis under similar conditions. Notably, multidisciplinary discussion was emphasized across scenarios, but many respondents also favored allowing primary physician discretion in select cases. This report provides consolidated expert input to inform future updates to reimbursement policies and promote alignment with real-world clinical practice. These findings may help bridge the gap between national coverage criteria and clinical decision in systemic therapy for HCC.

Original Article

Identification of new biomarkers of hepatic cancer stem cells through proteomic profiling: Sung Hoon Choi, Ha Young Lee, Sung Ho Yun, Sung Jae Jang, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Do Young Kim; J Liver Cancer. 2025;25(1):123-133. Published online March 20, 2025; DOI: https://doi.org/10.17998/jlc.2025.03.08

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Abstract PDF Supplementary Material: Backgrounds/Aims
In hepatocellular carcinoma (HCC), which exhibits high mortality and recurrence rates globally, the traits of cancer stem cells (CSCs) that significantly influence recurrence and metastasis are not well understood. CSCs are self-renewing cell types identified in most liquid and solid cancers, contributing to tumor initiation, growth, resistance, recurrence, and metastasis following chemo-radiotherapy or trans-arterial chemoembolization therapy.
Methods
CSCs are classified based on the expression of cell surface markers such as CD133, which varies depending on the tumor type. Proteomic analysis of liver cancer cell lines with cancer stem cell potential and HCC cancer cell lines lacking stem cell propensity was conducted to compare and analyze specific expression patterns.
Results
Proteomic profiling and enrichment analysis revealed higher expression of the calcium-binding protein S100 family in CD133+ Huh7 cells than in CD133- or wild-type cells. Furthermore, elevated expression of S100 family members was confirmed in an actual CD133+ liver cancer cell line via protein-protein network analysis and quantitative polymerase chain reaction (qPCR).
Conclusion
The S100 family members are not only new markers of cancer stem cells but will also assist in identifying new treatment strategies for CSC metastasis and tumor advancement.

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

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91 Citations

Abstract 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

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Yazan Abboud, Vraj P. Shah, Michael Bebawy, Ahmed Al-Khazraji, Kaveh Hajifathalian, Paul J. Gaglio
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Syifaus Shodry, Yuliono Trika Nur Hasan, Iwal Reza Ahdi, Zulvikar Syambani Ulhaq
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Jae Woo Park, Jeong-Ju Yoo, Dong Hyeon Lee, Young Chang, Hoongil Jo, Young Youn Cho, Sangheun Lee, Log Young Kim, Jae Young Jang
The Korean Journal of Internal Medicine.2024; 39(6): 931. CrossRef
Pathogenesis and management of metabolic dysfunction-associated steatohepatitis-related hepatocellular carcinoma: a narrative review
Han Ah Lee
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Lower Incidence of Hepatocellular Carcinoma with Tenofovir Alafenamide in Chronic Hepatitis B: Evidence from a Large-Scale Cohort
Hye-Jin Yoo, Jae-Young Kim, Jeong-Ju Yoo, Hye Won Lee, Sang Gyune Kim, Young Seok Kim
JHEP Reports.2024; : 101268. CrossRef
Microwave ablation versus single-needle radiofrequency ablation for the treatment of HCC up to 4 cm: A randomized control trial
Katsutoshi Sugimoto, Kento Imajo, Hidekatsu Kuroda, Go Murohisa, Kazue Shiozawa, Kentaro Sakamaki, Takuya Wada, Hirohito Takeuchi, Kei Endo, Tamami Abe, Takashi Matsui, Takahiro Murakami, Masato Yoneda, Atsushi Nakajima, Shigehiro Kokubu, Takao Itoi
JHEP Reports.2024; : 101269. CrossRef
The histopathological and molecular heterogeneity of hepatocellular carcinoma: a narrative review
Wonju Chung, Haeryoung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
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Thang Viet Luong, Nam Van Duc Nguyen, Linh Duy Le, Hieu Nguyen Hoang Minh, Hai Nguyen Ngoc Dang
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Predicting Microvascular Invasion in Liver Transplant Recipients for Hepatocellular Carcinoma
Usman I Aujla, Imran Ali Syed, Kashif Rafi, Ammara Naveed, Ahmad K Malik, Muhammad Yasir Khan, Ihsan Ul Haq, Sohail Rashid, Osama T Butt, Faisal Dar
Cureus.2024;[Epub] CrossRef
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Iuliana Pompilia Radu, Bernhard Scheiner, Jonas Schropp, Maria Gabriela Delgado, Birgit Schwacha-Eipper, Chaonan Jin, Jean-Francois Dufour, Matthias Pinter
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Chronic Hepatitis C Infection Treated with Direct-Acting Antiviral Agents and Occurrence/Recurrence of Hepatocellular Carcinoma: Does It Still Matter?
Carlo Smirne, Maria Grazia Crobu, Irene Landi, Nicole Vercellino, Daria Apostolo, David James Pinato, Federica Vincenzi, Rosalba Minisini, Stelvio Tonello, Davide D’Onghia, Antonio Ottobrelli, Silvia Martini, Christian Bracco, Luigi Maria Fenoglio, Mauro
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Statin use and liver-related prognosis among patients with MASLD
Byungyoon Yun, Heejoo Park, Jian Lee, Beom Kyung Kim, Jin-Ha Yoon
JHEP Reports.2024; : 101313. CrossRef
Long-term results of surgical treatment of hepatocellular cancer in Russian real practice
V. V. Petkau, R. I. Rasulov, A. A. Muratov, G. V. Nurbekyan, I. B. Uvarov, A. A. Kirshin, R. V. Orlova, N. V. Popova, M. S. Dinikin, R. Yu. Khlobystin, A. V. Sultanbaev, K. V. Menshikov, O. G. Orlov
Meditsinskiy sovet = Medical Council.2024; (21): 114. CrossRef
Overall Survival and the Impact of Albumin-bilirubin Grade in Patients with Advanced Hepatocellular Carcinoma: Data from a Tertiary Care Hospital in a Lower-middle-income Country
Mohammad SS Naviwala, Waqas A Khan, Adeeba Zaki, Mahnoor Tariq, Faiza Ahmed, Warda Saleem, Munira Moosajee, Yasmin A Rashid
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The roles and mechanisms of miRNA in HBV-HCC carcinogenesis: Why no therapeutic agents after 30 years?
KURT SARTORIUS, BENN SARTORIUS, CHERIE WINKLER, ANIL CHUTURGOON, ANNA KRAMVIS, PING AN, WEIGANG ZHANG, YUNJIE LU
BIOCELL.2024; 48(11): 1543. CrossRef

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

5,284 Views
149 Downloads
4 Citations

Abstract PDF Supplementary 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

Management of hepatocellular carcinoma in elderly and adolescent/young adult populations
Han Ah Lee
Journal of Liver Cancer.2025; 25(1): 52. CrossRef
Immunological Landscape and Molecular Therapeutic Targets of the Tumor Microenvironment in Hepatocellular Carcinoma
Yusra Zarlashat, Abdul Ghaffar, Flora Guerra, Anna Picca
International Journal of Molecular Sciences.2025; 26(16): 7836. 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
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

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

6,071 Views
106 Downloads
13 Citations

Abstract PDF Supplementary 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

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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
Safety of tenofovir alafenamide in the context of hyperlipidemia and cardiovascular diseases: a nationwide analysis
Jae-Young Kim, Hyuk Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young-Seok Kim
Hepatology International.2025; 19(4): 959. CrossRef
Metabolic Dysfunction-Associated Steatotic Liver Disease in the Korean General Population: Epidemiology, Risk Factors, and Non-Invasive Screening
Yong Jun Choi, Jooheon Park, Han-Ik Cho, Myung Geun Shin, Eun-Hee Nah
Metabolites.2025; 15(5): 299. CrossRef
Nationwide analysis of renal outcomes in chronic hepatitis B patients treated with Tenofovir Alafenamide vs. Entecavir
Hyuk Kim, Jae Young Kim, Hye-Jin Yoo, Log Young Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young-Seok Kim
Scientific Reports.2025;[Epub] CrossRef
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
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
Evolving epidemiology of non-alcoholic fatty liver disease in South Korea: incidence, prevalence, progression, and healthcare implications from 2010 to 2022
Jae Woo Park, Jeong-Ju Yoo, Dong Hyeon Lee, Young Chang, Hoongil Jo, Young Youn Cho, Sangheun Lee, Log Young Kim, Jae Young Jang
The Korean Journal of Internal Medicine.2024; 39(6): 931. 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

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

6,270 Views
106 Downloads
3 Citations

Abstract 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

Small graft size and hepatocellular carcinoma outcomes in living donor liver transplantation: a retrospective multicentric cohort study
Deok-Gie Kim, Shin Hwang, Kwang-Woong Lee, Jong Man Kim, Young Kyoung You, Donglak Choi, Je Ho Ryu, Bong-Wan Kim, Dong-Sik Kim, Jai Young Cho, Yang Won Nah, Man ki Ju, Tae-Seok Kim, Jae Geun Lee, Myoung Soo Kim, Alessandro Parente, Ki-Hun Kim, Andrea Schl
International Journal of Surgery.2024; 110(8): 4859. CrossRef
Liver Transplant Beyond the Milan Criteria: Distant Metastases of Hepatocellular Carcinoma (Part II)
N. E. Kostrygin, D. A. Valyakis, D. S. Chumachenko, V. V. Polovinkin
Innovative Medicine of Kuban.2024; (4): 106. CrossRef
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; 33(4): 356. CrossRef

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

6,571 Views
99 Downloads
3 Citations

Abstract 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

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The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series
Fabrizio Bronte, Fabio D'Amato, Maria Rosa Barcellona, Giuseppe Bronte, Giuseppe Malizia, Salvatore Ialuna, Giorgio Fusco, Francesco Verderame, Enrico Bronte, Maria Grazia Bavetta
Cancer Reports.2025;[Epub] CrossRef
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

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

7,677 Views
164 Downloads
6 Citations

Abstract PDF Supplementary 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

Liquid biopsy for cancer immunotherapy: Biomarkers to predict and monitor response upon immune checkpoint blockade
Chae Yeon Son, Deborah Lee, Hyun Sung Park, Jung Hyun Choi, Dong Hyung Kim, Il Doh, Lifeng Kang, Jiyoon Bu, Sun Min Kim, Tae-Joon Jeon
Coordination Chemistry Reviews.2025; 539: 216767. CrossRef
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

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

2,562 Views
20 Downloads

Abstract 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.

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

1,627 Views
9 Downloads

Abstract 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.

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

2,081 Views
17 Downloads

Abstract 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)

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

1,664 Views
17 Downloads

Abstract 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)

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

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Abstract 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.

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

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Abstract 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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