Journal of Liver Cancer

Original Articles

The effect of nucleos(t)ide analogues on clinical outcomes of patients treated with transarterial chemoembolization and radiofrequency ablation for hepatitis B virus-related hepatocellular carcinoma: Jae Min Park, Won Hyeok Choe, Jeong Han Kim, So Young Kwon, Byung Chul Yoo; J Liver Cancer. 2021;21(2):155-162. Published online September 30, 2021; DOI: https://doi.org/10.17998/jlc.2021.09.22

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Background/Aims
Because hepatitis B virus (HBV) replication has been known to play an important role in cancer recurrence after curative treatment of HBV-related hepatocellular carcinoma (HCC), we examined whether treatment based on nucleos(t)ide analogues (NAs) might decrease the recurrence rate and improve patient survival.
Methods
The retrospective cohort study enrolled 73 patients with chronic hepatitis B who were treated with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) with curative intent for HCC. Among those, 30 and 43 patients were treated with tenofovir disoproxil fumarate (TDF) and entecavir (ETV), respectively.
Results
Of the 73 patients, 51 experienced HCC recurrence, and 14 patients were dead during a follow-up of 73±34 months. Multivariate analyses showed that tumor size (hazard ratio [HR], 1.590; 95% confidence-interval [CI], 1.106-2.285; P=0.012) and Child-Pugh class B (vs. class A/non cirrhosis; HR, 5.794; 95% CI, 2.311-14.523; P=0.001) was significantly associated with HCC recurrence, and Child-Pugh class B (HR, 7.357; 95% CI, 2.100-25.777; P=0.002) was an independent unfavorable prognostic factor for survival. During NAs therapy, TDF was superior to ETV for complete viral response at 1 year after the date of combination of TACE and RFA (P=0.016). However, the risks of HCC recurrence and survival were not significantly different between those treated with TDF versus ETV.
Conclusions
TDF was superior to ETV for achieving complete viral response. However, the recurrence and mortality after TACE and RFA for HBV-related HCC were not significantly different between patients treated with TDF versus ETV.

Citations

Citations to this article as recorded by

Enhanced prognosis of HCC patients undergoing radical treatments with tenofovir versus entecavir: A meta-analysis based on propensity score matching studies
Qingyan Kong, Mengshi Yi, Fei Teng, Zheyu Chen
Asian Journal of Surgery.2024; 47(1): 55. CrossRef
Tenofovir versus entecavir on the prognosis of hepatitis B virus-related hepatocellular carcinoma: a systematic review and meta-analysis
Hui Liu, Cheng-Long Han, Bao-Wen Tian, Zi-Niu Ding, Ya-Fei Yang, Yun-Long Ma, Chun-Cheng Yang, Guang-Xiao Meng, Jun-Shuai Xue, Dong-Xu Wang, Zhao-Ru Dong, Zhi-Qiang Chen, Jian-Guo Hong, Tao Li
Expert Review of Gastroenterology & Hepatology.2023; 17(6): 623. 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

Survival Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients Treated with Sorafenib: Jeong Han Kim, Hyung Min Yu, Yong Hwang, Soon Young Ko, Won Hyeok Choe, So Young Kwon; J Liver Cancer. 2016;16(1):23-30. Published online March 31, 2016; DOI: https://doi.org/10.17998/jlc.16.1.23

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Abstract PDF: Background/Aims
Nucleos(t)ide analogues (NAs) help reduce the recurrence rate after the curative treatment of hepatitis B related hepatocellular carcinoma (HCC). Sorafenib has been shown to improve survival of advanced HCC patients. Whether antiviral therapy with NAs could help such patients is unknown. Our aim is to investigate the usefulness of antiviral therapy for advanced-stage HCC treated with sorafenib.
Methods
We performed a retrospective cohort study in advanced-stage HCC patients treated with sorafenib between June 2007 and December 2013. Patients in group A (the nonantiviral therapy group) were treated with sorafenib alone. Those in group B (the antiviral therapy group) were treated with sorafenib and NAs. Progression-free survival (PS) and overall survival (OS) were compared between these two groups.
Results
Finally, 23 patients in group A and 40 patients in group B were enrolled in the study. The mean number of days of treatment with sorafenib was 79 (34-231) days and 96 (33-449) days for group A and B, respectively (P=0.286). The mean PS of group A and B was 97 (14-449) days and 51 (0-461) days, respectively (P=0.068). The OS was 154 (44-741) days in group A and 138 (30-1,025) days in group B (P=0.665). PS and OS showed no significant difference between the two groups.
Conclusions
This study shows that there was no significant survival gain of using antiviral therapy in patients with advanced-stage HCC treated with sorafenib. In consideration of costeffectiveness, antiviral therapy may be not mandatory. (J Liver Cancer 2016;16:23-30)

Case Reports

A Case of Hepatocellular Carcinoma with Improved Decompansated Liver Cirrhosis with Combination Treatment of Transarterial Chemoembolization and Radiofrequency Ablation: Hyung Min Yu, Won Hyeok Choe, So Young Kwon, Jeong Han Kim; J Liver Cancer. 2014;14(2):131-134. Published online September 30, 2014; DOI: https://doi.org/10.17998/jlc.14.2.131

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Abstract PDF: A 54-year-old female patient with no medical history visited our hospital complaining of both pretibial pitting oedema for 6 months, and abdominal distension for 1 month. Computed tomography and magnetic resonance imaging revealed an 2.3cm sized tumour at segment 2 of the liver. Her Child-Turcotte-Pugh (CTP) class was C (score 11) at the initial visit. She was diagnosed as hepatocellular carcinoma (UICC stage II, BCLC stage D), and then she underwent conservative treatment for 1 month. After one month of conservative treatment, her liver function was improved to CTP class B (score 8), and then she underwent combination treatment of transarterial chemoembolization and radiofrequency ablation. However, her liver function was deteriorated gradually. She was transferred to other hospital for liver transplantation eventually. (J Liver Cancer 2014;14:131-134)

A Case of Hepatocellular Carcinoma with Early Multiple Recurrences after Liver Resection: Jae Hong Ahn, Hyung Joon Yim, Seung Young Kim, Jeong Han Kim, Yeon Seok Seo, Seung Hwa Lee, Hwan Hoon Chung, Tae Jin Song, Hong Sik Lee, Sang Woo Lee, Soon Ho Um, Jai Hyun Choi, Ho Sang Ryu; Journal of the Korean Liver Cancer Study Group. 2009;9(1):29-32. Published online June 30, 2009

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Abstract PDF: Hepatic resection is a standard curative therapy for hepatocellular carcinoma (HCC) although only 10~30% of patients are indicated due to advanced stage or poor hepatic reserve. Five year survival rate after resection was reported as a mean of 55% (25~93%), but cases of early recurrence after hepatic resection had poor prognosis. As early recurrence after hepatic resection is the one of the most important factors that determines the prognosis, many investigators have been trying to determine the factors associated with early recurrence. We report a case of early multiple recurrence of HCC after curative hepatic resection probably due to microvascular invasion of tumor and too close resection margin. We would like to suggest that additional prophylactic measures need to be sought in this group of patients because these factors may influence on early recurrence.

A Case of Massive Hepatocellular Carcinoma Treated by Hepatic Resection, which did not Respond to Transarterial Chemoembolization: Jeong Han Kim, Hyung Joon Yim, Seung Young Kim, Jae Hong Ahn, Ji Hoon Kim, Yeon Seok Seo, Seung Hwa Lee, Hwan Hoon Chung, Tae Jin Song, Hong Sik Lee, Sang Woo Lee, Jai Hyun Choi; Journal of the Korean Liver Cancer Study Group. 2009;9(1):63-66. Published online June 30, 2009

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Abstract PDF: Surgical resection is the treatment of choice for hepatocellular carcinoma (HCC) in non-cirrhotic patients. The optimal indication for resection is a single tumor in a suitable location for resection. However, limit of the tumor size is not clear. We report a case of successful hepatic resection in patients with massive HCC sized more than 15 cm that did not respond to transarterial chemoembolization (TACE). A 49-year-old male patient had received TACE two times for massive HCC. However, the tumor size increased. Right hemihepatectomy was performed despite the extensive tumor size and underlying liver cirrhosis. Ascites and wound infection were developed after resection, but the patient’s general condition got recovered soon. Until 6 months after surgery, recurrence has not been detected. However, distant metastasis was noted at 7th month. Although recurrence with distant metastasis was noted, we think aggressive surgical approach prolonged this patient’s survival.

A Case of Hepatocellular Carcinoma with Rib Metastasis in a Young Patient in Twenties: Seung Young Kim, Hyung Joon Yim, Jae Hong Ahn, Sung Woo Jung, Jeong Han Kim, Ji Hoon Kim, Ju-Han Lee, Seung Hwa Lee, Hwan Hoon Chung, jong Eun Yeon, Hong Sik Lee, Sang Woo Lee, Kwan Soo Byun, Jai Hyun Choi; Journal of the Korean Liver Cancer Study Group. 2009;9(1):86-89. Published online June 30, 2009

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Abstract PDF: Helatocellular carcinoma (HCC) is uncommon in young adults, and young HCC patients is known to show poor prognosis than older HCC patients because they have a more advanced tumor stage at diagnosis. We describe a case of HCC in a 28-year old chronic hepatitis B virus carrier who showed multiple nodular HCC with bone metastasis at diagnosis. In spite of multidisciplinary treatment including transarterial chemoembolization (TACE) for liver mass and radiotherapy for metastatic bone lesion, the patient died of cancer progression and weakened general condition 15 months after diagnosis. Therefore, we need to consider periodic surveillance in young chronic hepatitis B virus carriers.

A Case of Successful Pulmonary Resection in Patient with Lung Metastasis of Hepatocellular Carcinoma: Ik Yoon, Hyung Joon Yim, Jin Nam Kim, Sun Min Park, Jeong Han Kim, Seung Hwa Lee, Ju-Han Lee, Hwan-Hoon Chung, Hong Sik Lee, Hyung Joo Park, Sang Woo Lee, Jai Hyun Choi; Journal of the Korean Liver Cancer Study Group. 2008;8(1):81-85. Published online June 30, 2008

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Abstract PDF: Lung is the most common site of extrahepatic metastasis from hepatocellular carcinoma (HCC). Until now, there have been few reports about surgical resection for pulmonary metastasis from HCC, but the role and the indication of surgery for pulmonary metastasis remains unclear. We report a case of advanced HCC with pulmonary metastasis, which was effectively treated by metastasectomy. A 45-year-old male patient who had received TACE (transarterial chemoembolization) 14 times for hepatocellular carcinoma was found to have solitary metastasis in the right hilar area of the lung. Surgical metastasectomy was performed and pulmonary metastatic nodule was successfully removed. Primary tumor in the liver was effectively treated with TACE and follow-up CT (computed tomography) showed no viable tumor in the liver and the lung.

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