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5 "Sang Min Yoon"
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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
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
Review Article
External Beam Radiotherapy for Hepatocellular Carcinoma: a Review of the Current Guidelines in the East and the West
Sang Min Yoon
J Liver Cancer. 2021;21(1):25-33.   Published online March 31, 2021
DOI: https://doi.org/10.17998/jlc.21.1.25
  • 3,876 Views
  • 153 Downloads
  • 4 Citations
AbstractAbstract PDF
The incidence of hepatocellular carcinoma (HCC) is geographically heterogeneous depending on the underlying liver disease. Moreover, the decisions and recommendations about standard treatments differ between countries, especially between the East and the West. Because of the complexity of treatment decisions for the management of HCC, a multidisciplinary approach is recommended to maximize the therapeutic efficacy. External beam radiotherapy (RT) has been increasingly used to manage HCC when recommended treatments cannot be applied in real-world clinical practice. However, Western guidelines for the management of HCC do not recommend RT as a treatment option due to the lack of clinical evidence. RT has often been used more in Eastern countries than in Western countries; hence, it is necessary to review both Eastern and Western guidelines for HCC treatment regarding the recommendations about RT. In this study, the comments and potential roles of external beam RT are summarized from several treatment guidelines for the management of HCC.

Citations

Citations to this article as recorded by  
  • Novel paradigm in the treatment of hepatocellular carcinoma: Anticipating breakthroughs with particle therapy
    Sang Min Yoon
    Clinical and Molecular Hepatology.2023; 29(4): 977.     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
  • 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
  • Differences in radiotherapy application according to regional disease characteristics of hepatocellular carcinoma
    Chai Hong Rim
    Journal of Liver Cancer.2021; 21(2): 113.     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
  • 3,147 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.
Review Article
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
  • 2,308 Views
  • 173 Downloads
  • 26 Citations
AbstractAbstract 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  
  • Radiologic Patterns Determine the Outcomes of Initial and Subsequent Transarterial Chemoembolization in Intermediate-Stage Hepatocellular Carcinoma
    Ya-Wen Hung, I-Cheng Lee, Chen-Ta Chi, Rheun-Chuan Lee, Chien-An Liu, Nai-Chi Chiu, Hsuen-En Hwang, Yee Chao, Ming-Chih Hou, Yi-Hsiang Huang
    Liver Cancer.2024; 13(1): 29.     CrossRef
  • Non-Invasive Imaging Biomarkers to Predict the Hepatopulmonary Shunt Fraction Before Transarterial Radioembolization in Patients with Hepatocellular Carcinoma
    Charlie Alexander Hamm, Felix Busch, Anna Pöhlmann, Annabella Shewarega, Yubei He, Robin Schmidt, Han Xu, Gero Wieners, Bernhard Gebauer, Lynn Jeanette Savic
    Journal of Hepatocellular Carcinoma.2023; Volume 10: 27.     CrossRef
  • Histological subtypes of hepatocellular carcinoma: Their clinical and prognostic significance
    So Hyun Shin, Joon Young Park, Chungsu Hwang, Hyun Jung Lee, Dong Hoon Shin, Jee Yeon Kim, Je Ho Ryu, Kwang Ho Yang, Tae Beom Lee, Jung Hee Lee
    Annals of Diagnostic Pathology.2023; 64: 152134.     CrossRef
  • Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging
    Yoon Jung Hwang, Jae Seok Bae, Youngeun Lee, Bo Yun Hur, Dong Ho Lee, Haeryoung Kim
    Clinical and Molecular Hepatology.2023; 29(3): 733.     CrossRef
  • Preoperative Prediction of Microvascular Invasion with Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients with Single Hepatocellular Carcinoma: The Implication of Surgical Decision on the Extent of Liver Resection
    Na Reum Kim, Heejin Bae, Hyeo Seong Hwang, Dai Hoon Han, Kyung Sik Kim, Jin Sub Choi, Mi-Suk Park, Gi Hong Choi
    Liver Cancer.2023; : 1.     CrossRef
  • Microvascular Invasion in Hepatocellular Carcinoma: A Review of Its Definition, Clinical Significance, and Comprehensive Management
    Zehao Zheng, Renguo Guan, Wang Jianxi, Zhen Zhao, Tianyi Peng, Chunsheng Liu, Ye Lin, Zhixiang Jian, Yuan Seng Wu
    Journal of Oncology.2022; 2022: 1.     CrossRef
  • A clinical and pathological update on hepatocellular carcinoma
    Salvatore Lorenzo Renne, Luca Di Tommaso
    Journal of Liver Cancer.2022; 22(1): 14.     CrossRef
  • Comparing efficacies of different treatment regimens in patients with hepatocellular carcinoma accompanied by portal vein tumor thrombus using network meta-analysis
    Seungji Lee, Sung Kyu Song, Byungje Bae, Yongkeun Park
    Annals of Surgical Treatment and Research.2022; 103(5): 280.     CrossRef
  • Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up
    Mohammadreza Shaghaghi, Mounes Aliyari Ghasabeh, Sanaz Ameli, Maryam Ghadimi, Bita Hazhirkarzar, Roya Rezvani Habibabadi, Pegah Khoshpouri, Ankur Pandey, Pallavi Pandey, Ihab R. Kamel
    European Radiology.2021; 31(3): 1378.     CrossRef
  • Risk Factors for Beyond Milan Recurrence After Hepatic Resection for Single Hepatocellular Carcinoma No Larger Than 5 Centimeters
    Mina Kim, Taegyu Kim, Hyun Young Lee, Sung Yeon Hong, Hee‐Jung Wang, Bong‐Wan Kim
    Liver Transplantation.2021; 27(8): 1116.     CrossRef
  • Hepatocellular carcinoma: a clinical and pathological overview
    Salvatore Lorenzo Renne, Samantha Sarcognato, Diana Sacchi, Maria Guido, Massimo Roncalli, Luigi Terracciano, Luca Di Tommaso
    Pathologica.2021; 113(3): 203.     CrossRef
  • Prognostic significance of viable tumor size measurement in hepatocellular carcinomas after preoperative locoregional treatment
    Yoon Jung Hwang, Youngeun Lee, Hyunjin Park, Yangkyu Lee, Kyoungbun Lee, Haeryoung Kim
    Journal of Pathology and Translational Medicine.2021; 55(5): 338.     CrossRef
  • Response to Comment on “Subclassification of Microscopic Vascular Invasion in Hepatocellular Carcinoma”
    Gi Hong Choi, Incheon Kang, Young Nyun Park
    Annals of Surgery.2021; 274(6): e748.     CrossRef
  • Subclassification of Microscopic Vascular Invasion in Hepatocellular Carcinoma
    Incheon Kang, Mi Jang, Jae Geun Lee, Dai Hoon Han, Dong Jin Joo, Kyung Sik Kim, Myoung Soo Kim, Jin Sub Choi, Soon Il Kim, Young Nyun Park, Gi Hong Choi
    Annals of Surgery.2021; 274(6): e1170.     CrossRef
  • Up-to-date Knowledge on the Pathological Diagnosis of Hepatocellular Carcinoma
    Ji Hae Nahm, Young Nyun Park
    The Korean Journal of Gastroenterology.2021; 78(5): 268.     CrossRef
  • Survival according to recurrence patterns after resection for transplantable hepatocellular carcinoma in HBV endemic area: Appraisal of liver transplantation strategy
    Chung Gyo Seo, Sun Young Yim, Soon Ho Um, Yoo Ra Lee, Yoo Jin Lee, Tae Hyung Kim, Hyun Gil Goh, Young Sun Lee, Sang Jun Suh, Na Yeon Han, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Hyung Joon Yim, Ji Hoon Kim, Dong Sik Kim, Yoon Tae Jeen, Hoon
    Clinics and Research in Hepatology and Gastroenterology.2020; 44(4): 532.     CrossRef
  • Risk of Liver Cirrhosis and Hepatocellular Carcinoma after Fontan Operation: A Need for Surveillance
    Jun Sik Yoon, Dong Ho Lee, Eun Ju Cho, Mi Kyoung Song, Young Hun Choi, Gi Beom Kim, Yun Bin Lee, Jeong-Hoon Lee, Su Jong Yu, Haeryoung Kim, Yoon Jun Kim, Jung-Hwan Yoon, Eun Jung Bae
    Cancers.2020; 12(7): 1805.     CrossRef
  • Update on Hepatocellular Carcinoma: a Brief Review from Pathologist Standpoint
    Nese Karadag Soylu
    Journal of Gastrointestinal Cancer.2020; 51(4): 1176.     CrossRef
  • How Should We Assign Large Infiltrative Hepatocellular Carcinomas for Staging?
    Yoo Jin Lee, Yoo Ra Lee, Chung Gyo Seo, Hyun Gil Goh, Tae Hyung Kim, Sun Young Yim, Na Yeon Han, Jae Min Lee, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Hyonggin An, Beomjin Park, Yeon Seok Seo, Hyung Joon Yim, Ji Hoon Kim, Young Dong Yu, Dong Sik Kim, Yoon
    Cancers.2020; 12(9): 2589.     CrossRef
  • Substantial risk of recurrence even after 5 recurrence-free years in early-stage hepatocellular carcinoma patients
    Jihye Kim, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik
    Clinical and Molecular Hepatology.2020; 26(4): 516.     CrossRef
  • Role of tumor margin and ADC change in defining the need for additional treatments after the first TACE in patients with unresectable HCC
    Mohammadreza Shaghaghi, Mounes AliyariG hasabeh, Sanaz Ameli, Maryam Ghadimi, Bita Hazhirkarzar, Roya Rezvani Habibabadi, Hao Tang, Pegah Khoshpouri, Qingxia Wu, Ankur Pandey, Pallavi Pandey, Azarakhsh Baghdadi, Ihab R. Kamel
    European Journal of Radiology.2020; 133: 109389.     CrossRef
  • The 7th/8th American Joint Committee on Cancer and the Modified Union for International Cancer Control Staging System for Hepatocellular Carcinoma
    In-Gyu Kim, Xu-Guang Hu, Hee-Jung Wang, Bong-Wan Kim, Sung Yeon Hong, Xue-Yin Shen
    Yonsei Medical Journal.2019; 60(2): 140.     CrossRef
  • Hepatocellular carcinoma with extrahepatic metastasis: Are there still candidates for transarterial chemoembolization as an initial treatment?
    Jihye Kim, Dong-Hyun Sinn, Moon Seok Choi, Wonseok Kang, Geum-Youn Gwak, Yong-Han Paik, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Enzo Tagliazucchi
    PLOS ONE.2019; 14(3): e0213547.     CrossRef
  • Evaluation of early treatment response to radiotherapy for HCC using pre- and post-treatment MRI
    So Hee Song, Woo Kyoung Jeong, Dongil Choi, Young Kon Kim, Hee Chul Park, Jeong Il Yu
    Acta Radiologica.2019; 60(7): 826.     CrossRef
  • The Clinicopathological and Prognostic Significance of the Gross Classification of Hepatocellular Carcinoma
    Yangkyu Lee, Hyunjin Park, Hyejung Lee, Jai Young Cho, Yoo-Seok Yoon, Young-Rok Choi, Ho-Seong Han, Eun Sun Jang, Jin-Wook Kim, Sook-Hyang Jeong, Soomin Ahn, Haeryoung Kim
    Journal of Pathology and Translational Medicine.2018; 52(2): 85.     CrossRef
  • Hepatobiliary MRI as novel selection criteria in liver transplantation for hepatocellular carcinoma
    Ah Yeong Kim, Dong Hyun Sinn, Woo Kyoung Jeong, Young Kon Kim, Tae Wook Kang, Sang Yun Ha, Chul Keun Park, Gyu Seong Choi, Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Min-Ji Kim, Insuk Sohn, Sin-Ho Jung, Seung Woon Paik, Won Jae Lee
    Journal of Hepatology.2018; 68(6): 1144.     CrossRef

JLC : Journal of Liver Cancer