Journal of Liver Cancer

Special Contribution

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.

Review Article

Complications of immunotherapy in advanced hepatocellular carcinoma: Young-Gi Song, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim; J Liver Cancer. 2024;24(1):9-16. Published online November 29, 2023; DOI: https://doi.org/10.17998/jlc.2023.11.21

7,280 Views
255 Downloads
11 Citations

Abstract PDF

Immune checkpoint inhibitors (ICIs) are highly effective in cancer treatment. However, the risks associated with the treatment must be carefully balanced against the therapeutic benefits. Immune-related adverse events (irAEs) are generally unpredictable and may persist over an extended period. In this review, we analyzed common irAEs reported in highly cited original articles and systematic reviews. The prevalent adverse reactions include fatigue, pyrexia, rash, pruritus, diarrhea, decreased appetite, nausea, abdominal pain, constipation, hepatitis, and hypothyroidism. Therefore, it is crucial to conduct evaluations not only of gastrointestinal organs but also of cardiac, neurologic, endocrine (including the frequently affected thyroid), and ophthalmic systems before commencing ICIs. This review further explores commonly reported types of irAEs, specific irAEs associated with each ICI agent, rare yet potentially fatal irAEs, and available treatment options for managing them.

Citations

Citations to this article as recorded by

METTL3-mediated SMPDL3A promotes cell growth, metastasis and immune process of hepatocellular carcinoma by regulating LRPPRC
Weixin Xu, Miaomiao Tao, Yeqiong Liu, Jun Yan, Jiali Hu, Lei Wang
Cellular Signalling.2025; 127: 111543. CrossRef
Case Report: A rare small bowel sarcoma
Jiwu Guo, Jie Mao
Frontiers in Surgery.2025;[Epub] CrossRef
Disparate patterns of disease time burden in patients with HCC on immunotherapy or tyrosine kinase inhibitors
Rex Wan-Hin Hui, Matthew Shing-Hin Chung, Lu Li, Xianhua Mao, Chi-Leung Chiang, Carlos King-Ho Wong, Ian Chi-Kei Wong, Ka-Shing Cheung, Man-Fung Yuen, Wai-Kay Seto, Lung-Yi Mak
JHEP Reports.2025; 7(11): 101578. CrossRef
Intrahepatic IgA complex induces polarization of cancer-associated fibroblasts to matrix phenotypes in the tumor microenvironment of HCC
Jong Geun Park, Pu Reun Roh, Min Woo Kang, Sung Woo Cho, Suhyun Hwangbo, Hae Deok Jung, Hyun Uk Kim, Ji Hoon Kim, Jae-Sung Yoo, Ji Won Han, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Young Kyoung You, Ho Joong Choi, Jae Yong Ryu, Pil Soo Sung
Hepatology.2024; 80(5): 1074. CrossRef
Risk of Bleeding in Hepatocellular Carcinoma Patients Treated with Atezolizumab/Bevacizumab: A Systematic Review and Meta-Analysis
Young-Gi Song, Kyeong-Min Yeom, Eun Ae Jung, Sang Gyune Kim, Young Seok Kim, Jeong-Ju Yoo
Liver Cancer.2024; : 1. CrossRef
Targeted therapies in hepatocellular carcinoma: past, present, and future
Rushabh Gujarathi, Joseph W. Franses, Anjana Pillai, Chih-Yi Liao
Frontiers in Oncology.2024;[Epub] CrossRef
Atezolizumab-Induced Ulcerative Colitis in Patient with Hepatocellular Carcinoma: Case Report and Literature Review
Hyuk Kim, Yoon E Shin, Hye-Jin Yoo, Jae-Young Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Medicina.2024; 60(9): 1422. CrossRef
A Potential Pneumothorax Induced by Immune Checkpoint Inhibitors: A Case Report and Literature Review
Yoon-E Shin, Hyuk Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Medicina.2024; 60(10): 1634. CrossRef
The histopathological and molecular heterogeneity of hepatocellular carcinoma: a narrative review
Wonju Chung, Haeryoung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
Pathogenesis and management of metabolic dysfunction-associated steatohepatitis-related hepatocellular carcinoma: a narrative review
Han Ah Lee
The Ewha Medical Journal.2024;[Epub] CrossRef
Current perspectives on the pharmacological treatment of advanced hepatocellular carcinoma: a narrative review
Hye-Jin Yoo, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
The Ewha Medical Journal.2024;[Epub] CrossRef

Original Article

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, Jeong-Ju Yoo; J Liver Cancer. 2023;23(1):189-201. Published online March 24, 2023; DOI: https://doi.org/10.17998/jlc.2023.03.11

4,097 Views
95 Downloads
4 Citations

Abstract PDF Supplementary Material

Background/Aim
Abdominal ultrasonography (USG) is recommended as a surveillance test for high-risk groups for hepatocellular carcinoma (HCC). This study aimed to analyze the current status of the national cancer surveillance program for HCC in South Korea and investigate the effects of patient-, physician-, and machine-related factors on HCC detection sensitivity.
Methods
This multicenter retrospective cohort study collected surveillance USG data from the high-risk group for HCC (liver cirrhosis or chronic hepatitis B or C >40 years of age) at eight South Korean tertiary hospitals in 2017.
Results
In 2017, 45 experienced hepatologists or radiologists performed 8,512 USG examinations. The physicians had a mean 15.0±8.3 years of experience; more hepatologists (61.4%) than radiologists (38.6%) participated. Each USG scan took a mean 12.2±3.4 minutes. The HCC detection rate by surveillance USG was 0.3% (n=23). Over 27 months of follow-up, an additional 135 patients (0.7%) developed new HCC. The patients were classified into three groups based on timing of HCC diagnosis since the 1st surveillance USG, and no significant intergroup difference in HCC characteristics was noted. HCC detection was significantly associated with patient-related factors, such as old age and advanced fibrosis, but not with physician- or machine-related factors.
Conclusions
This is the first study of the current status of USG as a surveillance method for HCC at tertiary hospitals in South Korea. It is necessary to develop quality indicators and quality assessment procedures for USG to improve the detection rate of HCC.

Citations

Citations to this article as recorded by

The Visualization of the Importance of Covariance Importance in a Machine Learning Model for Advanced Liver Fibrosis in a Nationally Representative Sample
Alexander A. Huang, Samuel Y. Huang
JGH Open.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
Long-Term HBsAg Titer Kinetics with Entecavir/Tenofovir: Implications for Predicting Functional Cure and Low Levels
Soon Kyu Lee, Soon Woo Nam, Jeong Won Jang, Jung Hyun Kwon
Diagnostics.2024; 14(5): 495. 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

Case Reports

Rare Case of Pyogenic Brain Abscess after Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma: Case Report and Literature Review: Jun-Ho Myeong, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim; J Liver Cancer. 2021;21(1):81-86. Published online March 31, 2021; DOI: https://doi.org/10.17998/jlc.21.1.81

5,292 Views
77 Downloads
1 Citation

Abstract PDF

Transarterial chemoembolization (TACE) is a useful treatment option for hepatocellular carcinoma (HCC). TACE can particularly be used as a treatment for localized HCC, where surgical resection is impossible due to decreased liver function. However, TACE is associated with several complications, including vascular complications, liver failure, non-target embolization, infection, and death. The main risk factor for complications after TACE is decreased liver function. There have been only few reports of brain abscesses after TACE that are difficult to be distinguished from hepatic encephalopathy. Here, we report a rare case of brain abscess caused by Klebsiella pneumoniae that occurred after TACE.

Citations

Citations to this article as recorded by

Brain abscess caused by escherichia coli following embolization of a giant arteriovenous malformation. Clinical case
A.M. Netliukh, O.YA. Kobyletskyi, N.V. Aliieva, A.A. Sukhanov
Ukrainian Interventional Neuroradiology and Surgery.2023; 46(4): 63. CrossRef

Early Experience of Oncolytic Virus Injection Combined with Sorafenib in a Patient with Advanced Hepatocellular Carcinoma and Portal Vein Thrombosis: Hyun Ho Jo, Seong Joon Chun, Jeong-Ju Yoo, Min Hee Lee, Sang Gyune Kim, Young Seok Kim; J Liver Cancer. 2020;20(2):177-182. Published online September 30, 2020; DOI: https://doi.org/10.17998/jlc.20.2.177

5,876 Views
79 Downloads
1 Citation

Abstract PDF

JX-594 is a modified oncolytic poxvirus designed to selectively replicate in and destroy cancer cells. In a pilot study, JX-594 injection followed by sorafenib was well-tolerated in three patients and associated with objective tumor responses. In this study, we report a case in which a patient with advanced hepatocellular carcinoma and portal vein thrombosis was treated with a combination of JX-594 and sorafenib.

Citations

Citations to this article as recorded by

Recent progress in combination therapy of oncolytic vaccinia virus
Seyedeh Nasim Mirbahari, Miles Da Silva, Abril Ixchel Muñoz Zúñiga, Nika Kooshki Zamani, Gabriel St-Laurent, Mehdi Totonchi, Taha Azad
Frontiers in Immunology.2024;[Epub] CrossRef

A Case of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Treated by Hepatic Arterial Infusion Chemotherapy and Radiotherapy: Jin Yong Lee, Jeong-Ju Yoo, Seong Joon Chun, Sun Hyun Bae, Jae Myeong Lee, Sang Gyune Kim, Young Seok Kim; J Liver Cancer. 2020;20(1):78-83. Published online March 31, 2020; DOI: https://doi.org/10.17998/jlc.20.1.78

7,576 Views
108 Downloads

Abstract PDF: Sorafenib is the standard treatment for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT). Additionally, hepatic arterial infusion chemotherapy has been used as a treatment option for advanced HCC. Here, we report a case of sustained partial response in a patient with advanced HCC with PVT after hepatic arterial infusion chemotherapy and radiation therapy.

Review Article

Clinical Application of Liver Stiffness Measurement for Assessing the Risk of Hepatocellular Carcinoma: Jeong-Ju Yoo, Eun-Ae Jung, Sang Gyune Kim; J Liver Cancer. 2019;19(1):12-18. Published online March 31, 2019; DOI: https://doi.org/10.17998/jlc.19.1.12

6,586 Views
107 Downloads
1 Citation

Abstract PDF

The most significant risk factor for hepatocellular carcinoma (HCC) is the presence of cirrhosis or advanced fibrosis of the liver. Liver biopsy was traditionally considered the gold standard for assessing the liver fibrosis burden. Recently, non-invasive methods, particularly transient elastography (TE), have proven effective at measuring fibrosis and determining cirrhosis. Clinical application of TE ranges from measuring fibrosis to predicting long-term prognosis and treatment response. Here, we focus on recent studies on the prognostic value of TE for predicting HCC.

Citations

Citations to this article as recorded by

Metabolic dysfunction associated fatty liver disease and the risk of hepatocellular carcinoma
Byeong Geun Song, Sung Chul Choi, Myung Ji Goh, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Seung Woon Paik
JHEP Reports.2023; : 100810. CrossRef

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