Journal of Liver Cancer

Original Article

Hepatocellular carcinoma in Korea: an analysis of the 2016-2018 Korean Nationwide Cancer Registry: Jihyun An, Young Chang, Gwang Hyeon Choi, Won Sohn, Jeong Eun Song, Hyunjae Shin, Jae Hyun Yoon, Jun Sik Yoon, Hye Young Jang, Eun Ju Cho, Ji Won Han, Suk Kyun Hong, Ju-Yeon Cho, Kyu-Won Jung, Eun Hye Park, Eunyang Kim, Bo Hyun Kim; J Liver Cancer. 2025;25(1):109-122. Published online March 4, 2025; DOI: https://doi.org/10.17998/jlc.2025.02.20

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Backgrounds/Aims
Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018.
Methods
Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018.
Results
The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%).
Conclusions
Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Citations

Citations to this article as recorded by

Real-World Treatment Efficacy and Safety Profile of Sofosbuvir- and Velpatasvir-Based HCV Treatment in South Korea: Multicenter Prospective Study
Jae Hyun Yoon, Chang Hun Lee, Hoon Gil Jo, Ju-Yeon Cho, Jin Dong Kim, Jin Won Kim, Ga Ram You, Sung Bum Cho, Sung Kyu Choi
Viruses.2025; 17(7): 949. CrossRef

Correspondence

Correspondence to editorial on “Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea”: Ji Won Han, Bo Hyun Kim; J Liver Cancer. 2025;25(1):7-8. Published online February 27, 2025; DOI: https://doi.org/10.17998/jlc.2025.02.17

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34 Downloads

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Original Article

Evolving trends in treatment patterns for hepatocellular carcinoma in Korea from 2008 to 2022: a nationwide population-based study: Ji Won Han, Won Sohn, Gwang Hyeon Choi, Jeong Won Jang, Gi Hyeon Seo, Bo Hyun Kim, Jong Young Choi; J Liver Cancer. 2024;24(2):274-285. Published online August 26, 2024; DOI: https://doi.org/10.17998/jlc.2024.08.13

5,305 Views
200 Downloads
14 Citations

Abstract PDF Supplementary Material

Backgrounds/Aims
The treatment landscape for hepatocellular carcinoma (HCC) has significantly evolved over the past decade. We aimed to analyze trends in treatment patterns for HCC using a nationwide claims database from the Korean Health Insurance Review and Assessment Service.
Methods
This retrospective population-based cohort study analyzed 171,002 newly diagnosed HCC patients between 2008 and 2022. Etiologies and treatment modalities were categorized based on the ICD-10 codes and insurance data.
Results
The annual incidence decreased from 11,814 in 2008 to 10,443 in 2022. However, patients aged ≥70 increased noticeably, with those aged ≥80 rising from 3.8% in 2008 to 13.1% in 2022. From 2008 to 2022, the predominant cause of hepatitis B virus decreased from 68.9% to 59.7%, whereas nonalcoholic fatty liver disease increased from 8.9% to 15.8%. The initial treatment trends shifted: surgical resection and systemic therapy increased from 12.2% to 21.3% and from 0.2% to 9.6%, whereas transarterial therapy decreased from 49.9% to 36.6%. Best supportive care decreased from 31.7% to 21.3%. In the subgroup analysis, laparoscopic resection rate increased from 10.6% to 60.6% among the surgical resections. Sorafenib initially accounted for 100%, lenvatinib peaked at 36.5% in 2021, and atezolizumab-bevacizumab became the most widely used (63.1%) by 2022 among the systemic therapies.
Conclusions
This study demonstrates the temporal changes in the treatment patterns of Korean HCC patients. Surgical resection, particularly laparoscopic liver resection, and systemic therapy has increased significantly. These changes may have been influenced by reimbursement policies and advances in clinical research.

Citations

Citations to this article as recorded by

Correspondence to editorial on “Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea”
Ji Won Han, Bo Hyun Kim
Journal of Liver Cancer.2025; 25(1): 7. CrossRef
Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea
Soo Young Hwang, Ju Dong Yang
Journal of Liver Cancer.2025; 25(1): 4. CrossRef
Hepatocellular carcinoma in Korea: an analysis of the 2016-2018 Korean Nationwide Cancer Registry
Jihyun An, Young Chang, Gwang Hyeon Choi, Won Sohn, Jeong Eun Song, Hyunjae Shin, Jae Hyun Yoon, Jun Sik Yoon, Hye Young Jang, Eun Ju Cho, Ji Won Han, Suk Kyun Hong, Ju-Yeon Cho, Kyu-Won Jung, Eun Hye Park, Eunyang Kim, Bo Hyun Kim
Journal of Liver Cancer.2025; 25(1): 109. CrossRef
All-cause and disease-specific mortality in young adults with MASLD: A nationwide cohort study
Jeayeon Park, Goh Eun Chung, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Kyungdo Han, Eun Ju Cho
JHEP Reports.2025; 7(9): 101477. CrossRef
Novel Immunotherapy for Advanced Hepatocellular Carcinoma
Hyun Bin Choi, Jeong-Ju Yoo
The Korean Journal of Medicine.2025; 100(3): 102. CrossRef
Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCC
Hee Sun Cho, Soon Kyu Lee, Ji Won Han, Jung Hyun Kwon, Soon Woo Nam, Jaejun Lee, Keungmo Yang, Pil Soo Sung, Jeong Won Jang, Seung Kew Yoon, Jong Young Choi
Frontiers in Immunology.2025;[Epub] CrossRef
The PNPLA3 I148M variant is associated with immune cell infiltration and advanced fibrosis in MASLD: a prospective genotype–phenotype study
Jaejun Lee, Jung Hoon Cha, Hee Sun Cho, Keungmo Yang, Hyun Yang, Heechul Nam, Mi Young Byun, Seok Keun Cho, Jinsung Park, Hyuk Wan Ko, Seong Wook Yang, Pil Soo Sung, Si Hyun Bae
Journal of Gastroenterology.2025; 60(10): 1284. CrossRef
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
Journal of Liver Cancer.2025; 25(2): 160. CrossRef
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
Journal of Liver Cancer.2025; 25(2): 140. CrossRef
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 Ki, Young-In Yoon, Boram Lee, Eun Sun Jang, Yun Kyung Jung, Kyung Sik Kim
Annals of Surgical Treatment and Research.2025; 109(3): 123. CrossRef
Epidemiology and etiologic trends of hepatocellular carcinoma in cirrhotic patients in Mexico: a multicenter retrospective study (2018–2024)
Nahum Méndez-Sánchez, Mariana M Ramírez-Mejía, Carlos Cortez-Hernández, Elianee M Tovar-Bojorquez, Raúl Contreras-Omaña, Juan D Monsiváis-Morales, Jacqueline Cordova-Gallardo, Mauricio Castillo-Barradas, Nubia Guzmán-Rodríguez, María S González-Huezo, Adr
Annals of Hepatology.2025; : 102131. CrossRef
Surgeon’s aspect of an expert consensus-based practical recommendation for surgical treatment of hepatocellular carcinoma
Jai Young Cho
Annals of Surgical Treatment and Research.2025; 109(3): 121. 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
Pathogenesis and management of metabolic dysfunction-associated steatohepatitis-related hepatocellular carcinoma: a narrative review
Han Ah Lee
The Ewha Medical Journal.2024;[Epub] CrossRef

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

3,999 Views
70 Downloads

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 Article

Diagnostic performance of serum exosomal miRNA-720 in hepatocellular carcinoma: Jeong Won Jang, Ji Min Kim, Hye Seon Kim, Jin Seoub Kim, Ji Won Han, Soon Kyu Lee, Heechul Nam, Pil Soo Sung, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon; J Liver Cancer. 2022;22(1):30-39. Published online March 21, 2022; DOI: https://doi.org/10.17998/jlc.2022.02.25

6,849 Views
176 Downloads
6 Citations

Abstract PDF Supplementary Material

Background/Aim
Hepatocellular carcinoma (HCC) is associated with poor prognosis, largely due to late detection. Highly accurate biomarkers are urgently needed to detect early-stage HCC. Our study aims to explore the diagnostic performance of serum exosomal microRNA (miR)-720 in HCC.
Methods
Exosomal miRNA was measured via quantitative real-time PCR. A correlation analysis of exosomal miR-720 and tumor or clinico-demographic data of patients with HCC was performed. The receiver operating characteristic (ROC) curve was used to assess the diagnostic capacity of serum exosomal miR-720 for HCC, in comparison with α-fetoprotein (AFP) and prothrombin induced by vitamin K absence or antagonist-II (PIVKA-II).
Results
MiR-720 was chosen as a potential HCC marker via miR microarray based on significant differential expression between tumor and non-tumor samples. Serum exosomal miR-720 was significantly upregulated in patients with HCC (n=114) versus other liver diseases (control, n=30), with a higher area under the ROC curve (AUC=0.931) than the other markers. Particularly, serum exosomal miR-720 showed superior performance in diagnosing small HCC (< 5 cm; AUC=0.930) compared with AFP (AUC=0.802) or PIVKA-II (AUC=0.718). Exosomal miR-720 levels showed marginal correlation with tumor size. The proportion of elevated miR-720 also increased with intrahepatic tumor stage progression. Unlike AFP or PIVKA-II showing a significant correlation with aminotransferase levels, the exosomal miR-720 level was not affected by aminotransferase levels.
Conclusions
Serum exosomal miR-720 is an excellent biomarker for the diagnosis of HCC, with better performance than AFP or PIVKA-II. Its diagnostic utility is maintained even in small HCC and is unaffected by aminotransferase levels.

Citations

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Zinnat Ara Moni, Zahid Hasan, Md. Shaheen Alam, Nitai Roy, Farhadul Islam
Cancer Medicine.2025;[Epub] CrossRef
Blood circulating miRNAs as pancreatic cancer biomarkers: An evidence from pooled analysis and bioinformatics study
Tomasz Powrózek, Michael Ochieng’ Otieno, Debora Maffeo, Elisa Frullanti, Javier Martinez-Useros
International Journal of Biological Macromolecules.2025; 308: 142469. CrossRef
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Asian Journal of Pharmaceutical Sciences.2025; 20(5): 101065. CrossRef
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Frontiers in Molecular Biosciences.2024;[Epub] CrossRef
Emerging role of exosomal microRNA in liver cancer in the era of precision medicine; potential and challenges
Tarek El Hayek, Osama Abdulwahab Alnaser-Almusa, Sulaiman Mamoun Alsalameh, Maya Taofik Alhalabi, Ahmad Nedal Sabbah, Eman Abdullah Alshehri, Tanveer Ahmad Mir, Naresh Kumar Mani, Khaled Al-Kattan, Raja Chinnappan, Ahmed Yaqinuddin
Frontiers in Molecular Biosciences.2024;[Epub] CrossRef
Exosomal non-coding RNAs (ncRNAs) as potential biomarkers in tumor early diagnosis
Jingyue Chang, Lingquan Zhang, Zeting Li, Chungen Qian, Juan Du
Biochimica et Biophysica Acta (BBA) - Reviews on Cancer.2024; 1879(6): 189188. CrossRef

Review Article

Advances in immune checkpoint inhibitors for hepatocellular carcinoma: Ji Won Han, Su-Hyung Park; J Liver Cancer. 2021;21(2):139-145. Published online September 30, 2021; DOI: https://doi.org/10.17998/jlc.2021.09.24

8,375 Views
120 Downloads
6 Citations

Abstract PDF

Hepatocellular carcinoma (HCC) is the fifth most common cancer, and the second leading cause of cancer-related death worldwide. Although recent advances in immune checkpoint inhibitor-based immunotherapy have initiated a new era for advanced HCC treatment, the majority of HCC patients receiving immune checkpoint blockades do not derive clinical benefit. Thus, there remains an urgent need for novel immunotherapeutic strategies with improved therapeutic efficacy. Here we review recent studies of immune checkpoint blockade in HCC, providing the necessary basis for the rational design of immunotherapy.

Citations

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Immunology, immunotherapy, and the tumor microenvironment in hepatocellular carcinoma: a comprehensive review
Miho Akabane, Yuki Imaoka, Ghee Rye Lee, Timothy M. Pawlik
Expert Review of Clinical Immunology.2025; 21(10): 1403. CrossRef
Role of transarterial chemoembolization for hepatocellular carcinoma with extrahepatic metastases in the era of advancing systemic therapy
Byeong Geun Song, Myung Ji Goh, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Joon Hyeok Lee, Moon Seok Choi
Journal of Liver Cancer.2024; 24(2): 243. CrossRef
Dynamic Peripheral T-Cell Analysis Identifies On-Treatment Prognostic Biomarkers of Atezolizumab plus Bevacizumab in Hepatocellular Carcinoma
Ji Won Han, Min Woo Kang, Soon Kyu Lee, Hyun Yang, Ji Hoon Kim, Jae-Sung Yoo, Hee Sun Cho, Eun Ji Jang, Deok Hwa Seo, Jung Hyun Kwon, Soon Woo Nam, Si Hyun Bae, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Pil Soo Sung
Liver Cancer.2024; : 1. CrossRef
Systematic Review of Molecular Targeted Therapies for Adult-Type Diffuse Glioma: An Analysis of Clinical and Laboratory Studies
Logan Muzyka, Nicolas K. Goff, Nikita Choudhary, Michael T. Koltz
International Journal of Molecular Sciences.2023; 24(13): 10456. CrossRef
Integrative analysis of lactylation-related genes and establishment of a novel prognostic signature for hepatocellular carcinoma
Diankui Cai, Xiaoqing Yuan, D. Q. Cai, Ang Li, Sijia Yang, Weibang Yang, Jinxin Duan, Wenfeng Zhuo, Jun Min, Li Peng, Jinxing Wei
Journal of Cancer Research and Clinical Oncology.2023; 149(13): 11517. CrossRef
Editorial on Immune Checkpoint Inhibitors in the Treatment of Hepatocellular Carcinoma
Samantha M Ruff, Timothy M Pawlik
Immunotherapy.2023; 15(16): 1323. CrossRef

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