Membranous obstruction of the inferior vena cava (MOVC) is a rare subset of Budd-Chiari syndrome (BCS) with a subacute onset that is often complicated by cirrhosis and hepatocellular carcinoma (HCC). Here we report a case of recurrent HCC in a patient with cirrhosis and BCS that was treated with several episodes of transarterial chemoembolization followed by surgical tumorectomy, whereas the MOVC was successfully treated with balloon angioplasty followed by endovascular stenting. The patient was followed up for 9.9 years without anticoagulation and experienced no stent thrombosis. After the tumorectomy, the patient was HCC-free for 4.4 years of follow-up.
Background/Aims To reduce the cancer burden, the Korean government initiated the National Cancer Control Plan including the National Liver Cancer Screening Program (NLCSP). Ultrasonography examinations and α-fetoprotein tests at six-month intervals are currently offered for high-risk individuals. High-risk individuals are identified by reviewing the National Health Insurance Service claims data for medical use for the past two years using International Classification of Diseases Codes for specific liver disease. We surveyed the attitudes and opinions towards the NLCSP to understand the issues surrounding the NLCSP in Korea.
Methods Altogether, 90 Korean Liver Cancer Association members participated in online and offline surveys between November and December 2019.
Results Approximately one-quarter (27%) of the survey participants rated the NLCSP as very contributing and about two-thirds (68%) as contributing to some extent toward reducing hepatocellular carcinoma (HCC)-related deaths in Korea. Most (87.8%) responded that the current process of identifying high-risk individuals needs improvement. Many (78.9%) were concerned that the current process identifies individuals who use medical services and paradoxically misses those who do not. When asked for the foremost priority for improvement, solving ‘duplication issues between the NLCSP and private clinic HCC screening practices’ was the most commonly selected choice (23.3%).
Conclusions The survey participants positively rated the role of the NLCSP in reducing liver cancer deaths. However, many participants rated the NCLSP as needing improvement in all areas. This survey can be a relevant resource for future health policy decisions regarding the NLCSP in Korea.
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Hepatocellular carcinoma (HCC) shows a poor prognosis with high recurrence rate even after
surgical resection. To improve prognosis of HCC patient, regular surveillance for high-risk
group is recommended, but cost-benefit of the surveillance under 40 years old Asian male
with hepatitis B infection is unclear. We share a 39-year-old male case which showed early
recurrence and rapid extrahepatic metastasis after surgical resection for single huge HCC.
Based on the pathologic finding, this case was diagnosed with ‘stemness’-related markerexpressing
HCC. Further molecular classification for HCC could be beneficial to estimate
individual risk for HCC recurrence and to predict prognosis.
Jang Eun Lee, Na Ri Yoon, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Dong Goo Kim, Ho Jong Chun, Byung Gil Choi, Hae Giu Lee, Hong Seok Jang, Chan Kwon Jung, Eun Sun Jang
Journal of the Korean Liver Cancer Study Group. 2009;9(1):82-85. Published online June 30, 2009
The prognosis of young patients with hepatocellular carcinoma is remains controversial. Here we report a case of advanced
hepatocellular carcinoma in twenty, successfully treated with transarterial chemolipidolization (TACL), systemic chemotherapy,
radiation therapy and surgical resection. Previously healthy 28 years old woman was admitted for treatment of hepatocellular
carcinoma. Abdominal CT showed a diffuse infiltrative HCC involving both lobes with intrahepatic bile duct invasion and
pericardial lymphadenopathy. She was treated TAC with systemic chemotherapy and external beam radiotherapy. 6 months
after these treatments, main tumor and the pericardial lymph node were decreased in size. And then extended left lobectomy
and systemic chemotherapy were done. The pericardial lymph node was markedly decreased. The patient has been followed
for 10 months without evidence of regional tumor recurrence.