Journal of Liver Cancer

Editorial

Radiofrequency for hepatocellular carcinoma larger than 3 cm: potential for applications in daily practice: Ji Hoon Kim, Pil Soo Sung; J Liver Cancer. 2024;24(1):1-2. Published online March 14, 2024; DOI: https://doi.org/10.17998/jlc.2024.02.13

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Case Report

Multidisciplinary approach for hepatocellular carcinoma arising from cirrhotic liver with Budd-Chiari syndrome: a case report: Sangmi Kim, Ji Hoon Kim, Ji Won Han, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Pil Soo Sung; J Liver Cancer. 2022;22(2):202-206. Published online September 20, 2022; DOI: https://doi.org/10.17998/jlc.2022.09.17

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Abstract PDF: Budd-Chiari syndrome (BCS) is defined by the obstruction of the hepatic venous outflow between the small hepatic veins and the junction of the inferior vena cava (IVC) with the right atrium. BCS with IVC obstruction occasionally progresses to hepatocellular carcinoma (HCC). Here, we report the case of a patient with HCC arising from a cirrhotic liver with BCS, in whom the hepatic portion of the IVC was obstructed, and who had a favorable outcome with a multidisciplinary approach and IVC balloon angioplasty.

Original Articles

An Analysis for Survival Predictors for Patients with Hepatocellular Carcinoma Who Failed to Sorafenib Treatment in Pre-regorafenib Era: Chan Uk Lee, Young-Sun Lee, Ji Hoon Kim, Minjin Lee, Sehwa Kim, Young Kul Jung, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun; J Liver Cancer. 2019;19(2):117-127. Published online September 30, 2019; DOI: https://doi.org/10.17998/jlc.19.2.117

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Abstract PDF: Background/Aims
Sorafenib is the standard treatment for patients with advanced hepatocellular carcinoma (HCC). We aimed to investigate the prognosis predictors and the role of second-line cytotoxic systemic chemotherapy (CSC) in patients with advanced HCC after sorafenib discontinuation in the pre-regorafenib era.
Methods
From 2007 to 2015 in the pre-regorafenib era, the medical records of 166 HCC patients, who had permanently discontinued sorafenib, were retrospectively reviewed. For further analysis of survival factors after sorafenib treatment failure, we compared the survival of patients who had maintained liver function after second-line treatment with the best supportive care (BSC) group and selective BSC (SBSC) group.
Results
After discontinuation of sorafenib, median overall survival (OS) was 2.8 (1.9-3.7) months. The OS in patients who discontinued sorafenib due to adverse effect, progression, and poor clinical condition were 5.5 (2.4-8.6), 5.5 (2.2-8.9), and 0.9 (0.5-1.3) months, respectively (P<0.001). The independent predictive factors of survival after sorafenib failure were serum level of bilirubin and albumin, α-fetoprotein, discontinuation cause, and second-line CSC. In comparison with survival between second-line CSC and BSC group, the CSC group showed better survival outcome compared to the BSC group (10.6 vs. 1.6 months, P<0.001) and SBSC group (10.6 vs. 4.2 months, P=0.023).
Conclusions
The survival after sorafenib failure in patients who discontinued sorafenib due to progression and adverse effects was significantly better than in those who discontinued treatment due to clinical deterioration. In the pre-regorafenib era, patients who received second-line CSC showed better survival than those who received only supportive care after sorafenib failure.

Factors Affecting Prognosis of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: Implications for Future Therapeutic Strategies: Sang Jun Suh, Hyung Joon Yim, Dong Won Lee, Jong Jin Hyun, Young Kul Jung, Ji Hoon Kim, Yeon Seok Seo, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um; J Liver Cancer. 2017;17(1):60-71. Published online March 31, 2017; DOI: https://doi.org/10.17998/jlc.17.1.60

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Abstract PDF

Background/Aims
Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) exhibits poor prognosis. The aim of this study is to evaluate factors associated with survival of HCC patients with PVTT to suggest better therapeutic options.
Methods
Patients with HCC which were newly diagnosed at three tertiary hospitals between January 2004 and December 2012, were reviewed retrospectively. Among them, Barcelona Clinic of Liver Cancer stage C patients with PVTT were identified. Factors affecting overall survival (OS) were analyzed and efficacies of the treatment modalities were compared.
Results
Four hundred sixty five patients with HCC and PVTT were included. Liver function, tumor burden, presence of extrahepatic tumor, alfa fetoprotein, and treatment modalities were significant factors associated with OS. Treatment outcomes were different according to the initial modalities. OS of the patients who received hepatic resection, radiofrequency ablation (RFA), transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), sorafenib, systemic cytotoxic chemotherapy, radiation therapy (without combination), and supportive care were 27.8, 7.1, 6.7, 5.3, 2.5, 3.0, 1.8, and 0.9 months, respectively (P<0.001). Curative-intent treatments such as hepatic resection or RFA were superior to noncurativeintent treatments (P<0.001). TACE or HAIC was superior to sorafenib or systemic chemotherapy (P<0.001). Combining radiotherapy to TACE or HAIC did not provide additional benefit on OS (P=0.096).
Conclusions
Treatment modalities as well as baseline factors significantly influenced on OS of HCC patients with PVTT. Whenever possible, curative intent treatments should be preferentially considered. If unable, locoregional therapy would be a better choice than systemic therapy in HCC patients with PVTT.

Citations

Citations to this article as recorded by

Value of surgical resection compared to transarterial chemoembolization in the treatment of hepatocellular carcinoma with portal vein tumor thrombus: A meta-analysis of hazard ratios from five observational studies
Keera Kang, Sung Kyu Song, Chul-Woon Chung, Yongkeun Park
Annals of Hepato-Biliary-Pancreatic Surgery.2020; 24(3): 243. CrossRef

Review Articles

The General Rules for the Study of Primary Liver Cancer: Jae Young Jang, June Sung Lee, Hyung-Joon Kim, Jae-Jun Shim, Ji Hoon Kim, Bo Hyun Kim, Choon Hyuck Kwon, Seung Duk Lee, Hae Won Lee, Jung Hoon Kim, Woo Kyoung Jeong, Jin-Young Choi, Heung Kyu Ko, Dong Ho Lee, Haeryoung Kim, Baek-hui Kim, Sang Min Yoon, Soon Ho Um; J Liver Cancer. 2017;17(1):19-44. Published online March 31, 2017; DOI: https://doi.org/10.17998/jlc.17.1.19

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30 Citations

Abstract PDF

The General Rules for the Study of Primary Liver Cancer was published in June 2001 as the first edition. Since then, the 5th edition of the General Rules for the Study of Primary Liver Cancer was published by the 17th Committee of the Korean Liver Cancer Association based on the most recent data. The 5th edition of the General Rules for the Study of Primary Liver Cancer ranged over numerous topics such as anatomy, medical assessment of the patients, staging of hepatocellular carcinoma, description of the image findings, summary of hepatic resection, description of the surgical specimens, liver transplantation, reporting the pathological findings, pathological examinations of liver specimen, non-surgical treatment, radiotherapy, and assessment of tumor response after non-surgical treatment of hepatocellular carcinoma. The 5th General Rules for the Study of Primary Liver Cancer will not only become the basis of academic development for liver cancer studies in Korea, but also serve as the primary form of national liver cancer data accumulation based on standardized rules.

Citations

Citations to this article as recorded by

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Macroscopic Characterization of Hepatocellular Carcinoma: An Underexploited Source of Prognostic Factors
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The Issues for Improving Prognosis in Intermediate Stage of Hepatocellular Carcinoma: Yang Jae Yoo, Ji Hoon Kim; J Liver Cancer. 2014;14(2):80-88. Published online September 30, 2014; DOI: https://doi.org/10.17998/jlc.14.2.80

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Abstract PDF: Hepatocellular carcinoma (HCC) is one of major malignant tumor with heterogeneity and poor prognosis. In contrast to other solid malignant tumors, the prognosis of HCC is affected by not only progression of tumor itself but also residual liver function. Therefore, diverse staging systems are developed in HCC and there was no universal consensus for best staging system. However, Barcelona Clinic Liver Cancer (BCLC) system, which was endorsed by Western expert guidelines, is most commonly used staging system. BCLC system defined intermediate stage as single tumor more than 5cm, 2-3 tumor more than 3cm or ≥ 4 tumor at any size with Child-Pugh A or B and performance status 0-1 and allocated transarterial chemoembolization (TACE) as primary treatment for this stage. Intermediate stage include heterogeneous patients population and inevitably showed diverse prognosis. Among HCC patients, about 20% belonged to intermediate stage and intermediate stage means relatively little progressed stage, fair liver function and performance status. Therefore, improvement of survival of intermediate HCC patients may be a cornerstone leading improvement of survival of overall HCC patients. Hence, the strategy for optimal classification and treatment modality for intermediate HCC patients at pre and post treatment to improve prognosis in this patients will be discussed in this review. (J Liver Cancer 2014;14:80-88)

Case Reports

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.

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