Journal of Liver Cancer

Original Articles

Heavy smoking increases early mortality risk in patients with hepatocellular carcinoma after curative treatment: Jaejun Lee, Jong Young Choi, Soon Kyu Lee; J Liver Cancer. 2024;24(2):253-262. Published online June 7, 2024; DOI: https://doi.org/10.17998/jlc.2024.06.02

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Backgrounds/Aims
Although cigarette smoking has been associated with an increased risk of hepatocellular carcinoma (HCC), its association with HCC mortality remains underexplored. We aimed to evaluate the effect of smoking on early mortality in HCC patients following curative treatment.
Methods
Data from the Korean Primary Liver Cancer Registry were examined for HCC patients who underwent liver resection or radiofrequency ablation between 2015 and 2018. Smoking cumulative dose was assessed in pack-years. The primary outcome was the 3-year overall survival (OS).
Results
Among 1,924 patients, 161 were classified as heavy smokers (≥40 pack-years). Heavy smokers exhibited a lower 3-year survival rate (77.1%) than nonsmokers (83.3%), with a significant difference observed in the 3-year OS (P=0.016). The assessment of smoking pack-years in relation to 3-year OS revealed a dose-dependent pattern, with the hazard ratio exceeding 1.0 at 20 pack-years and continuing to rise until 40 pack-years, reaching peak at 1.21 (95% confidence interval, 1.01-1.45). Multivariate Cox-regression analysis revealed heavy smoking, age ≥60 years, underlying cirrhosis, tumor size >3 cm, vascular invasion, and Child-Pugh class B/C as risk factors for 3-year OS. Subgroup analyses of patients with a tumor size <3 cm, absence of vascular invasion, and meeting the Milan criteria also showed inferior outcomes for heavy smokers in all three subgroups.
Conclusions
Heavy smoking, defined as a history of >40 pack-years, was linked to poorer 3-year survival outcomes in HCC patients undergoing curative treatments, underscoring the importance of smoking cessation in this population.

Citations

Citations to this article as recorded by

Differential Exercise Requirements for Nonalcoholic Fatty Liver Disease Resolution Across Age Groups: A Longitudinal Study of Korean Military Officers
Jaejun Lee, Dong Yeup Lee, Jae Hyeop Jung, Eunkyoung Bae, Jeong A. Yu, Hyun Yang
Journal of Physical Activity and Health.2025; 22(3): 323. CrossRef
Current Trends and Impact of Liver Biopsy on Survival in Hepatocellular Carcinoma: A Korean Multicenter Analysis
Seong Joon Chun, Jeong-Ju Yoo, Sang Gyune Kim, Young-Seok Kim
Diagnostics.2025; 15(7): 818. CrossRef
A comprehensive analysis of the impact of smoking on adverse clinical outcomes of steatotic liver diseases
Keungmo Yang, Jaejun Lee, Ji Won Han, Hyun Yang, Seung Yun Chae, Beom Sun Chung, Tom Ryu
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Aged Garlic Extract and Its Bioactive Molecules S-Allyl-Cysteine and S1-Propenyl-Cysteine: A Review Focusing on Evidences Supporting Their Use for Mitigating the Effects of Cigarette Smoking
Roberto Gambari, Alessia Finotti
Molecules.2025; 30(17): 3496. CrossRef
Impacts of smoking on alcoholic liver disease: a nationwide cohort study
Jeong-Ju Yoo, Dong Hyeon Lee, Sang Gyune Kim, Jae Young Jang, Young Seok Kim, Log Young Kim
Frontiers in Public Health.2024;[Epub] CrossRef

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

6,785 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

Citations to this article as recorded by

Diagnostic and Prognostic Significance of Exosomes and Their Components in Patients With Cancers
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
Extracellular vesicles in cancer immunotherapy: Therapeutic, challenges and clinical progress
Hamed Manoochehri, Anita S. La'ah, Ali Babaeizad, Mohsen Sheykhhasan, Mohadeseh Rostamipoor, Mahdiyeh Abbaspoor, Fariba Nikravesh, Samira Mozaffari Khosravi, Hanie Mahaki, Hamid Tanzadehpanah, Piao Yang
Asian Journal of Pharmaceutical Sciences.2025; 20(5): 101065. CrossRef
Prospects of liquid biopsy in the prognosis and clinical management of gastrointestinal cancers
Deepankar Mondal, Sapnita Shinde, Vibha Sinha, Vineeta Dixit, Souvik Paul, Rakesh Kumar Gupta, Suresh Thakur, Naveen Kumar Vishvakarma, Dhananjay Shukla
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

Case Report

Successful Sequential Therapy Involving Regorafenib after Failure of Sorafenib in a Patient with Recurrent Hepatocellular Carcinoma after Liver Transplantation: Soon Kyu Lee, Jeong Won Jang, Heechul Nam, Pil Soo Sung, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon; J Liver Cancer. 2020;20(1):84-89. Published online March 31, 2020; DOI: https://doi.org/10.17998/jlc.20.1.84

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104 Downloads
1 Citation

Abstract PDF

The efficacy and safety of sequential systemic therapy for the treatment of recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT) are not well established. This study describes a successful experience where sequential therapy with sorafenib followed by regorafenib was used to treat recurrent HCC in a 54-year old male LT recipient. After HCC recurred in both lungs 10 months after LT, sorafenib was administered with radiation therapy to treat pulmonary metastases. However, after 4 months of sorafenib treatment showed progressive pulmonary metastases, sequential regorafenib treatment was started. After 3 months (cycles) of regorafenib treatment, tumor response was partial, and after 6 months (cycles), disease status remained stable without signs of progression or drug-related serious adverse events. This case suggests that sequential systemic therapy is feasible in patient with recurrent HCC after LT.

Citations

Citations to this article as recorded by

Liver Transplant Beyond the Milan Criteria: Distant Metastases of Hepatocellular Carcinoma (Part II)
N. E. Kostrygin, D. A. Valyakis, D. S. Chumachenko, V. V. Polovinkin
Innovative Medicine of Kuban.2024; (4): 106. CrossRef

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