Journal of Liver Cancer

Recommendation and Guideline

Surgical treatment of hepatocellular carcinoma: an expert consensus-based practical recommendation from the Korean Liver Cancer Association: Min-Su Park, Jai Young Cho, Eunju Kim, Hee Young Na, YoungRok Choi, Na Reum Kim, Young-In Yoon, Boram Lee, Eun Sun Jang, Yun Kyung Jung, Kyung Sik Kim; J Liver Cancer. 2025;25(2):140-159. Published online September 22, 2025; DOI: https://doi.org/10.17998/jlc.2025.08.05

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Abstract PDF: Compared with other treatments, surgical resection is an effective treatment method with the lowest local recurrence rate and the highest survival rate for hepatocellular carcinoma (HCC). To achieve excellent results after surgical treatment, it is essential to carefully select patients who are suitable for hepatic resection and minimize postoperative complications and liver function decline through standardized surgical methods and pre- and postoperative management. However, domestic and international treatment guidelines only broadly recommend the application of hepatic resection for HCC with a single tumor and good liver function. Hence, practical treatment guidelines are required that can be standardized and used according to the varying clinical environments, including indications for hepatic resection, preoperative evaluation, basic principles of hepatic resection, minimally invasive hepatic resection, pre- and postoperative patient management, surgical treatment considerations in specific infection situations, and follow-up after surgical resection. Accordingly, an expert group from the Korean Liver Cancer Association Research Committee has developed practical recommendations based on expert consensus regarding the surgical treatment of HCC through a Delphi study.

Case Reports

Orbital metastasis of hepatocellular carcinoma: rare cause of exophthalmos in chronic liver disease: Eunjee Lim, Eun Sun Jang, Jin Ho Paik, Sook-Hyang Jeong, Jin-Wook Kim; J Liver Cancer. 2025;25(2):266-271. Published online May 22, 2025; DOI: https://doi.org/10.17998/jlc.2025.05.06

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Abstract PDF: Orbital metastasis from hepatocellular carcinoma (HCC) is extremely rare, and patients often present with ocular symptoms before the primary tumor is diagnosed. Here, we report two cases of orbital metastasis from HCC with distinct clinical courses. The first case involved a patient with no prior cancer history who presented with vision loss and was subsequently diagnosed with HCC following an orbital mass biopsy. The second case involved a patient with known HCC undergoing treatment who initially presented with periorbital swelling misdiagnosed as cellulitis before orbital metastasis was confirmed. Both cases highlight the importance of considering orbital metastasis in patients with ocular symptoms, even in the absence of a known malignancy. Given the poor prognosis and limited treatment options for orbital metastasis, early recognition through imaging and histopathological confirmation is crucial for appropriate management.

Hepatocellular carcinoma with Budd-Chiari syndrome due to membranous obstruction of the inferior vena cava with long-term follow-up: a case report: Choong Hee Kim, Gwang Hyeon Choi, Hee Young Na, Chang Jin Yoon, Jai Young Cho, Sangmi Jang, Ji Hye Kim, Eun Sun Jang, Jin-Wook Kim, Sook-Hyang Jeong; J Liver Cancer. 2022;22(2):194-201. Published online September 15, 2022; DOI: https://doi.org/10.17998/jlc.2022.08.24

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Abstract PDF: 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.

Original Article

A Survey of Liver Cancer Specialists’ Views on the National Liver Cancer Screening Program in Korea: Won Sohn, Young-Sun Lee, Jae Geun Lee, Jihyun An, Eun Sun Jang, Dong Ho Lee, Dong Hyun Sinn; J Liver Cancer. 2020;20(1):53-59. Published online March 31, 2020; DOI: https://doi.org/10.17998/jlc.20.1.53

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6 Citations

Abstract PDF Supplementary Material

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.

Citations

Citations to this article as recorded by

Potential role of Fibrosis‐4 score in hepatocellular carcinoma screening: The Kangbuk Samsung Health Study
Sujeong Shin, Won Sohn, Yoosoo Chang, Yoosun Cho, Min‐Jung Kwon, Sarah H. Wild, Christopher D. Byrne, Seungho Ryu
Hepatology Research.2024; 54(6): 551. CrossRef
Recent Hepatocellular Carcinoma Managements in Korea: Focus on the Updated Guidelines in 2022
Yuri Cho, Bo Hyun Kim, Young-Suk Lim
Digestive Disease Interventions.2024; 08(03): 169. CrossRef
Clinical practice guideline and real-life practice in hepatocellular carcinoma: A Korean perspective
Myung Ji Goh, Dong Hyun Sinn, Jong Man Kim, Min Woo Lee, Dong Ho Hyun, Jeong Il Yu, Jung Yong Hong, Moon Seok Choi
Clinical and Molecular Hepatology.2023; 29(2): 197. CrossRef
Current status of ultrasonography in national cancer surveillance program for hepatocellular carcinoma in South Korea: a large-scale multicenter study
Sun Hong Yoo, Soon Sun Kim, Sang Gyune Kim, Jung Hyun Kwon, Han-Ah Lee, Yeon Seok Seo, Young Kul Jung, Hyung Joon Yim, Do Seon Song, Seong Hee Kang, Moon Young Kim, Young-Hwan Ahn, Jieun Han, Young Seok Kim, Young Chang, Soung Won Jeong, Jae Young Jang, J
Journal of Liver Cancer.2023; 23(1): 189. CrossRef
Selecting the Target Population for Screening of Hepatic Fibrosis in Primary Care Centers in Korea
Huiyul Park, Eileen L. Yoon, Mimi Kim, Seon Cho, Jung-Hwan Kim, Dae Won Jun, Eun-Hee Nah
Journal of Clinical Medicine.2022; 11(6): 1474. CrossRef
Fibrosis Burden of Missed and Added Populations According to the New Definition of Metabolic Dysfunction-Associated Fatty Liver
Huiyul Park, Eileen L. Yoon, Mimi Kim, Jung-Hwan Kim, Seon Cho, Dae Won Jun, Eun-Hee Nah
Journal of Clinical Medicine.2021; 10(19): 4625. CrossRef

Case Reports

A Case of Rapid Progressive Extrahepatic Metastasis of Hepatocellular Carcinoma after Surgical Resection for Huge Single Mass: Eun Sun Jang, Haeryoung Kim, Young Rok Choi, Jai Young Cho, Yoo-Seok Yoon, Ho-Seong Han, Ji Hyun Kim, Jin-Wook Kim, Sook-Hyang Jeong; J Liver Cancer. 2016;16(1):42-46. Published online March 31, 2016; DOI: https://doi.org/10.17998/jlc.16.1.42

1,500 Views
15 Downloads
1 Citation

Abstract PDF

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.

Citations

Citations to this article as recorded by

Rapid Bone Metastasis in Hepatocellular Carcinoma: A Case Report
Laraib ., Uzma Khalid, Ayesha Khalid
Cureus.2025;[Epub] CrossRef

A Case of Advanced Hepatocellular Carcinoma in Twenties Treated by Multimodality Therapy: 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

871 Views
1 Download

Abstract PDF: 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.

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