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JLC : Journal of Liver Cancer

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3 "Jinhong Jung"
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Original Articles
Subclassification of advanced-stage hepatocellular carcinoma with macrovascular invasion: combined transarterial chemoembolization and radiotherapy as an alternative first-line treatment
Sujin Jin, Won-Mook Choi, Ju Hyun Shim, Danbi Lee, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Jinhong Jung, Sang Min Yoon, Jonggi Choi
J Liver Cancer. 2023;23(1):177-188.   Published online March 23, 2023
DOI: https://doi.org/10.17998/jlc.2023.03.04
  • 1,267 Views
  • 84 Downloads
  • 1 Citation
AbstractAbstract PDFSupplementary Material
Background/Aim
The Barcelona Clinic Liver Cancer (BCLC) guidelines recommend systemic therapy as the only first-line treatment for patients with BCLC stage C hepatocellular carcinoma (HCC) despite its heterogeneity of disease extent. We aimed to identify patients who might benefit from combined transarterial chemoembolization (TACE) and radiation therapy (RT) by subclassifying BCLC stage C.
Methods
A total of 1,419 treatment-naïve BCLC stage C patients with macrovascular invasion (MVI) who were treated with combined TACE and RT (n=1,115) or systemic treatment (n=304) were analyzed. The primary outcome was overall survival (OS). Factors associated with OS were identified and assigned points by the Cox model. The patients were subclassified into three groups based on these points.
Results
The mean age was 55.4 years, and 87.8% were male. The median OS was 8.3 months. Multivariate analysis revealed a significant association of Child-Pugh B, infiltrative-type tumor or tumor size ≥10 cm, main or bilateral portal vein invasion, and extrahepatic metastasis with poor OS. The sub-classification was categorized into low (point ≤1), intermediate (point=2), and high (point ≥3) risks based on the sum of points (range, 0–4). The OS in the low, intermediate, and high-risk groups was 22.6, 8.2, and 3.8 months, respectively. In the low and intermediate-risk groups, patients treated with combined TACE and RT exhibited significantly longer OS (24.2 and 9.5 months, respectively) than those who received systemic treatment (6.4 and 5.1 months, respectively; P<0.0001).
Conclusions
Combined TACE and RT may be considered as a first-line treatment option for HCC patients with MVI when classified into low- and intermediate-risk groups.

Citations

Citations to this article as recorded by  
  • How to optimize the treatment strategy for advanced-stage hepatocellular carcinoma with macrovascular invasion
    Beom Kyung Kim
    Journal of Liver Cancer.2023; 23(1): 121.     CrossRef
Stereotactic body radiation therapy for elderly patients with small hepatocellular carcinoma: a retrospective observational study
Jeong Yun Jang, Jinhong Jung, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Jin-hong Park, Sang Min Yoon
J Liver Cancer. 2022;22(2):136-145.   Published online September 16, 2022
DOI: https://doi.org/10.17998/jlc.2022.08.18
  • 2,587 Views
  • 72 Downloads
  • 5 Citations
AbstractAbstract PDFSupplementary Material
Background/Aim
We aimed to investigate the efficacy and safety of stereotactic body radiation therapy (SBRT) in elderly patients with small hepatocellular carcinomas (HCC).
Methods
Eighty-three patients (89 lesions) with HCC who underwent SBRT between January 2012 and December 2018 were reviewed in this retrospective observational study. The key inclusion criteria were as follows: 1) age ≥75 years, 2) contraindications for hepatic resection or percutaneous ablative therapies, 3) no macroscopic vascular invasion, and 4) no extrahepatic metastasis.
Results
The patients were 75-90 years of age, and 49 (59.0%) of them were male. Most patients (94.0%) had an Eastern Cooperative Oncology Group performance status of 0 or 1. Seventy-four patients (89.2%) had Child-Pugh class A hepatic function before SBRT. The median tumor size was 1.6 cm (range, 0.7-3.5). The overall median follow-up period was 34.8 months (range, 7.3-99.3). The 5-year local tumor control rate was 90.1%. The 3-year and 5-year overall survival rate was 57.1% and 40.7%, respectively. Acute toxicity grade ≥3 was observed in three patients (3.6%) with elevated serum hepatic enzymes; however, no patient experienced a worsening of the Child-Pugh score to ≥2 after SBRT. None of the patients developed late toxicity (grade ≥3).
Conclusions
SBRT is a safe treatment option with a high local control rate in elderly patients with small HCC who are not eligible for other curative treatments.

Citations

Citations to this article as recorded by  
  • Radiofrequency Ablation versus Surgical Resection in Elderly Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
    Jeong-Ju Yoo, Sujin Koo, Gi Hong Choi, Min Woo Lee, Seungeun Ryoo, Jungeun Park, Dong Ah Park
    Current Oncology.2024; 31(1): 324.     CrossRef
  • Radiotherapy trend in elderly hepatocellular carcinoma: retrospective analysis of patients diagnosed between 2005 and 2017
    Bong Kyung Bae, Jeong Il Yu, Hee Chul Park, Myung Ji Goh, Yong-Han Paik
    Radiation Oncology Journal.2023; 41(2): 98.     CrossRef
  • Loco-regional therapies competing with radiofrequency ablation in potential indications for hepatocellular carcinoma: a network meta-analysis
    Ha Il Kim, Jihyun An, Seungbong Han, Ju Hyun Shim
    Clinical and Molecular Hepatology.2023; 29(4): 1013.     CrossRef
  • Has the growing evidence of radiotherapy for hepatocellular carcinoma increased the use of radiotherapy in elderly patients?
    Tae Hyun Kim
    Radiation Oncology Journal.2023; 41(3): 141.     CrossRef
  • Chronic Liver Disease in the Older Patient—Evaluation and Management
    Daniel Anthony DiLeo, Tolga Gidener, Ayse Aytaman
    Current Gastroenterology Reports.2023; 25(12): 390.     CrossRef
Case Report
Combined Transarterial Chemoembolization and External Beam Radiotherapy in a Patient with Recurrent Huge Hepatocellular Carcinoma after Hepatic Resection
Jesang Yu, Jinhong Jung, Sang Min Yoon
J Liver Cancer. 2020;20(1):90-97.   Published online March 31, 2020
DOI: https://doi.org/10.17998/jlc.20.1.90
  • 3,146 Views
  • 79 Downloads
AbstractAbstract PDF
The optimal treatment strategy for unresectable huge hepatocellular carcinoma (HCC) is yet to be established. Non-surgical monotherapy demonstrated insufficient oncologic outcomes in previously reported studies. To improve the clinical outcomes of unresectable huge HCC, combined locoregional treatments can be considered in selected cases. Here, we report a case of 58-year-old male patient who was treated with combined transarterial chemoembolization (TACE) and external beam radiotherapy for recurrent HCC after a previous hepatic resection. After combined TACE and radiotherapy for the intrahepatic lesion, two metastases were diagnosed in the pelvic bones and lung; each lesion was successfully treated with salvage radiotherapy. During the long-term follow-up period (around 8 years 7 months after combined TACE and radiotherapy for the recurrent huge HCC), no definite viable tumors were observed in any of the treated liver, bone, and lung lesions.

JLC : Journal of Liver Cancer