Journal of Liver Cancer

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/Aim
s: 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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Background/Aim
s: 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

Case Report

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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