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JLC : Journal of Liver Cancer

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2 "Jonggi Choi"
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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
  • 1,268 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
Hepatocellular Carcinoma in Korea: an Analysis of the 2015 Korean Nationwide Cancer Registry
Jun Sik Yoon, Han Ah Lee, Hwi Young Kim, Dong Hyun Sinn, Dong Ho Lee, Suk Kyun Hong, Ju-Yeon Cho, Jonggi Choi, Young Chang, Hyun-Joo Kong, Eunyang Kim, Young-Joo Won, Jeong-Hoon Lee
J Liver Cancer. 2021;21(1):58-68.   Published online March 31, 2021
DOI: https://doi.org/10.17998/jlc.21.1.58
  • 6,070 Views
  • 257 Downloads
  • 17 Citations
AbstractAbstract PDFSupplementary Material
Background/Aim
s: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2015.
Methods
Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative sample of patients newly diagnosed with HCC in Korea, were analyzed. A total of 1,558 patients with HCC registered in the KPLCR in 2015 were investigated.
Results
The median age was 61.0 years (interquartile range, 54.0-70.0 years), and men accounted for 79.7% of the subjects. Hepatitis B virus infection was the most common underlying liver disease (58.1%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, stage 0, A, B, C, and D HCCs accounted for 14.2%, 31.5%, 7.6%, 39.0%, and 7.8% of patients, respectively. Transarterial therapy (32.1%) was the most commonly performed initial treatment, followed by surgical resection (23.2%), best supportive care (20.2%), and local ablation therapy (10.7%). Overall, 34.5% of patients were treated in accordance with the BCLC guidelines: 59.2% in stage 0/A, 48.4% in stage B, 18.1% in stage C, and 71.6% in stage D. The 1-, 3-, and 5-year OS rates were 67.1%, 50.9%, and 27.0%, respectively.
Conclusions
In 2015, approximately 45% of Korean HCC cases were diagnosed at a very early or early stage, and 35% of patients underwent potentially curative initial treatment. BCLC guidance was followed in 34.5% of patients; in patients with stage B or C disease, there was relatively low adherence.

Citations

Citations to this article as recorded by  
  • Factors associated with the survival outcomes of patients with untreated hepatocellular carcinoma: An analysis of nationwide data
    Min Jung Kwon, Soy Chang, Ji Hoon Kim, Ji Won Han, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Pil Soo Sung
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • The imitator of immune-tolerant chronic hepatitis B: A killer in disguise
    Moon Haeng Hur, Jeong-Hoon Lee
    Clinical and Molecular Hepatology.2023; 29(2): 363.     CrossRef
  • 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, J
    Journal of Liver Cancer.2023; 23(1): 189.     CrossRef
  • A Case of Transverse Myelitis Following Treatment with Atezolizumab for Advanced Hepatocellular Carcinoma
    Kyung Han Kim, Yang-Hyun Baek, Yeo Wool Kang, Byeol-A Yoon, Sang Yi Moon
    The Korean Journal of Gastroenterology.2023; 82(1): 35.     CrossRef
  • Comparative Analysis of Atezolizumab Plus Bevacizumab and Hepatic Artery Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multicenter, Propensity Score Study
    Ji Kim, Hee-Chul Nam, Chang-Wook Kim, Hee Cho, Jae-Sung Yoo, Ji Han, Jeong Jang, Jong Choi, Seung Yoon, Hyun Yang, Si Bae, Suho Kim, Jung Oh, Ho Chun, Chang Jeon, Jaegyoon Ahn, Pil Sung
    Cancers.2023; 15(17): 4233.     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
  • Modeling the Risk of Liver Cancer in Adults: A Machine Learning Investigation into the Role of Obesity and Overweight
    Bah Karamo, Bah Adama Ns , Jallow Amadou Wurry
    Archives of Pathology and Clinical Research.2023; 7(1): 034.     CrossRef
  • Concurrent nivolumab and external beam radiation therapy for hepatocellular carcinoma with macrovascular invasion: A phase 2 study
    Bo Hyun Kim, Hee Chul Park, Tae Hyun Kim, Young-Hwan Koh, Jung Yong Hong, Yuri Cho, Dong Hyun Sinn, Boram Park, Joong-Won Park
    JHEP Reports.2023; : 100991.     CrossRef
  • Surgical resection versus ablation for early hepatocellular carcinoma: The debate is still open
    Bo Hyun Kim
    Clinical and Molecular Hepatology.2022; 28(2): 174.     CrossRef
  • Cause of death and cause-specific mortality for primary liver cancer in South Korea: A nationwide population-based study in hepatitis B virus-endemic area
    Bo Hyun Kim, Dahhay Lee, Kyu-Won Jung, Young-Joo Won, Hyunsoon Cho
    Clinical and Molecular Hepatology.2022; 28(2): 242.     CrossRef
  • Impact of tumor size on hepatectomy outcomes in hepatocellular carcinoma: a nationwide propensity score matching analysis
    Suk Kyun Hong, Kwang-Woong Lee, Sola Lee, Su young Hong, Sanggyun Suh, Eui Soo Han, YoungRok Choi, Nam-Joon Yi, Kyung-Suk Suh
    Annals of Surgical Treatment and Research.2022; 102(4): 193.     CrossRef
  • Efficacy and feasibility of surgery and external radiotherapy for hepatocellular carcinoma with portal invasion: A meta-analysis
    Han Ah Lee, Yeon Seok Seo, In-Soo Shin, Won Sup Yoon, Hye Yoon Lee, Chai Hong Rim
    International Journal of Surgery.2022; 104: 106753.     CrossRef
  • Yoon et al. Hepatocellular Carcinoma in Korea: an Analysis of the 2015 Korean Nationwide Cancer Registry
    Jeong-Hoon Lee
    Journal of Liver Cancer.2022; 22(2): 207.     CrossRef
  • Surveillance for hepatocellular carcinoma: It is time to move forward
    Bo Hyun Kim, Yuri Cho, Joong-Won Park
    Clinical and Molecular Hepatology.2022; 28(4): 810.     CrossRef
  • Treatment patterns for hepatocellular carcinoma in patients with Child–Pugh class B and their impact on survival: A Korean nationwide registry study
    Dongsub Jeon, Gi‐Won Song, Han Chu Lee, Ju Hyun Shim
    Liver International.2022; 42(12): 2830.     CrossRef
  • Metastatic breast cancer from a hepatocellular carcinoma: a case report
    Hyewon Bang, Nam-Hee Kim, Seung Hye Choi, Si Hyun Bae, Eun Sun Jung, Ki Ouk Min, Yong Hwa Eom
    Korean Journal of Clinical Oncology.2022; 18(2): 93.     CrossRef
  • Current Status and Future Directions of Hepatocellular Carcinoma Surveillance Test Based on Cost-effective Analysis
    Jihyun An
    The Korean Journal of Gastroenterology.2021; 78(5): 255.     CrossRef

JLC : Journal of Liver Cancer