Journal of Liver Cancer

Original Articles

Microwave ablation vs. liver resection for patients with hepatocellular carcinomas: Hyundam Gu, Yeonjoo Seo, Dong Jin Chung, Kwang Yeol Paik, Seung Kew Yoon, Jihye Lim; J Liver Cancer. 2025;25(1):99-108. Published online February 7, 2025; DOI: https://doi.org/10.17998/jlc.2025.02.02

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Backgrounds/Aims
Microwave ablation (MWA) is an emerging ablative therapy that surpasses previous methods by achieving higher temperatures and creating larger ablation zones within shorter periods. This study compared the therapeutic outcomes of MWA with those of liver resection in real-world clinical practice.
Methods
A total of 178 patients with 259 nodules who underwent MWA or liver resection between January 2015 and July 2023 were enrolled. Local tumor progression (LTP)-free survival, overall progression (OP)-free survival, and overall survival (OS) were assessed based on the treatment modality for the index nodule.
Results
Of the 178 patients, 134 with 214 nodules underwent MWA, and 44 with 45 nodules underwent liver resection. The median follow-up period was 2.0±1.5 years. The annual incidence of LTP was 3.7% for MWA and 1.4% for liver resection. Treatment modality did not significantly affect LTP-free survival (hazard ratio, 0.61; 95% confidence interval, 0.14-2.69; P=0.511). For nodules larger than 3 cm, LTP-free survival was not affected by the treatment modality. Similarly, OP-free survival and OS were not influenced by treatment modality.
Conclusions
MWA and liver resection demonstrated comparable treatment outcomes in terms of local tumor control, overall recurrence, and survival. MWA may be an alternative treatment option for select patients; however, further studies are necessary to generalize these findings.

Citations

Citations to this article as recorded by

Efficacy analysis of ultrasound-guided percutaneous hepatic microwave ablation for hepatocellular carcinoma
Pei Liu, Weirong Huang, Yimei Ji
Journal of Radiation Research and Applied Sciences.2025; 18(4): 101960. CrossRef

Enhanced radiofrequency ablation for recurrent hepatocellular carcinoma post-transarterial chemoembolization: a prospective study utilizing twin internally cooled-perfusion electrodes: Sungjun Hwang, Jae Hyun Kim, Sae-Jin Park, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Jeong Min Lee; J Liver Cancer. 2025;25(1):91-98. Published online February 7, 2025; DOI: https://doi.org/10.17998/jlc.2025.01.25

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56 Downloads

Abstract PDF: Backgrounds/Aims
Radiofrequency ablation (RFA) is widely employed for managing recurrent hepatocellular carcinoma (HCC) following transarterial chemoembolization (TACE). However, local tumor progression (LTP) after treatment remains a significant challenge. This study evaluates the efficacy of saline-perfused bipolar RFA using twin internally cooled-perfusion (TICP) electrodes in managing recurrent HCC post-TACE.
Methods
Between September 2017 and January 2019, 100 patients with 105 nodules (mean diameter, 1.6±0.5 cm) were prospectively enrolled. Bipolar RFA with TICP electrodes was performed under ultrasound-computed tomography/magnetic resonance fusion guidance. The primary outcome was the 2-year cumulative incidence of LTP.
Results
The technical success and technique efficacy rates were 100% and 97%, respectively. During a median follow-up period of 34.0 months (range, 3-41), the estimated LTP rates were 13.3% at 1 year and 17.7% at 2 years. Progression-free survival rates were 37.8% and 27.7% at 1 year and 2 years, respectively.
Conclusions
Saline-perfused bipolar RFA using TICP electrodes demonstrates promising results for recurrent HCC after TACE, achieving high technical success and effective local tumor control rates.

Recommendation and Guideline

Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association: Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi; J Liver Cancer. 2024;24(2):131-144. Published online August 30, 2024; DOI: https://doi.org/10.17998/jlc.2024.08.04

10,748 Views
441 Downloads
8 Citations

Abstract PDF Supplementary Material

Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the firstline treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and posttreatment management of patients.

Citations

Citations to this article as recorded by

Microwave ablation vs. liver resection for patients with hepatocellular carcinomas
Hyundam Gu, Yeonjoo Seo, Dong Jin Chung, Kwang Yeol Paik, Seung Kew Yoon, Jihye Lim
Journal of Liver Cancer.2025; 25(1): 99. CrossRef
Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea
Soo Young Hwang, Ju Dong Yang
Journal of Liver Cancer.2025; 25(1): 4. CrossRef
Efficacy and safety of ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma at specific anatomic sites of the liver: a systematic review and meta-analysis
Jiandong Zha, Fang Zhang, Tuoyu Cao, Shasha Li, Xuelian Shen, Liangliang Xu, Wenqi Chen
Frontiers in Surgery.2025;[Epub] CrossRef
Efficacy and safety of ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma at specific anatomic sites of the liver: a systematic review and meta-analysis
Yongsheng Fu, Qicong Zhu, Xin Zhao, Jingfen Lu, Wei Wang
BMC Gastroenterology.2025;[Epub] CrossRef
Immunotherapy in GI Cancers: Lessons from Key Trials and Future Clinical Applications
Supriya Peshin, Faizan Bashir, Naga Anvesh Kodali, Adit Dharia, Sajida Zaiter, Sakshi Singal, Nagaishwarya Moka
Antibodies.2025; 14(3): 58. CrossRef
Liver Cancer: Artificial Intelligence (AI)-Based Integrated Therapeutic Approaches
Mythileeswari Lakshmikanthan, Sakthivel Muthu, John T. D. Caleb, Yuvaraj Maria Francis, Indra Neel Pulidindi
Bioengineering.2025; 12(8): 837. CrossRef
Asian Conference on Tumor Ablation Guidelines for Hepatocellular Carcinoma
Shuichiro Shiina, Ryosuke Tateishi, Joon Il Choi, So Yeon Kim, Zhiqiang Meng, Lujun Shen, Sheng-Nan Lu, Jen-I. Hwang, Maki Tobari, Hitoshi Maruyama, Terguunbileg Batsaikhan, Qing Deng, Lariza Marie Canseco, Yoshinari Asaoka, Shi-Ming Lin, Kai-Wen Huang, H
Liver Cancer.2025; 14(5): 651. CrossRef
Practical consensus multi-specialty guidelines on image-guided ablation for hepatocellular carcinoma
David S. Lu
Journal of Liver Cancer.2024; 24(2): 120. CrossRef

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

5,048 Views
83 Downloads
5 Citations

Abstract PDF Supplementary Material

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

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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

Cure can be achieved by conversion to microwave ablation following atezolizumab-bevacizumab therapy in unresectable hepatocellular carcinoma: Rene John D. Febro, Engelbert Simon S. Perillo, Akemi A. Kimura, Stephen N. Wong; J Liver Cancer. 2024;24(2):234-242. Published online June 3, 2024; DOI: https://doi.org/10.17998/jlc.2024.05.23

7,210 Views
149 Downloads
1 Citation

Abstract PDF

Backgrounds/Aims
Atezolizumab/bevacizumab is the recommended first-line systemic therapy for unresectable hepatocellular carcinoma (uHCC) and may facilitate curative conversion through resection and locoregional therapies. However, there have been very few reports on curative conversion using microwave ablation (MWA). This study aimed to determine the curative conversion rate with MWA using atezolizumab-bevacizumab as the first-line treatment in patients with uHCC, and to compare the characteristics and survival of patients with and without curative conversion.
Methods
Consecutive patients with uHCC who were started on atezolizumab-bevacizumab from May 2021 to December 2023 in a single tertiary center were included. Objective response rate (ORR) and disease control rate (DCR) were based on the Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) criteria.
Results
Twenty consecutive patients with uHCC (60% advanced-stage) were included, 90% exceeding the up-to-7 criteria. The ORR and DCR were 35% and 60%, 35% and 55% using RECIST and mRECIST, respectively. Five patients (25%) underwent successful curative conversion with MWA (four advanced and one intermediate stage) despite a median HCC size of 6.1 cm (range, 2.4-7.3). Two of these patients were tumor and drug-free 132-133 weeks from the 1st atezolizumab-bevacizumab dose. Patients who underwent curative conversion had significantly longer survival than those who did not (P=0.024). Other factors associated with survival were male sex, Child-Pugh class A, and an objective response.
Conclusions
Despite the relatively large tumor size, successful curative conversion with MWA was achieved with first-line atezolizumab-bevacizumab in uHCC. However, data from prospective multicenter trials are required to determine whether this strategy is universally applicable.

Citations

Citations to this article as recorded by

Curative Treatment after Immunotherapy Leads to Excellent Outcomes in Patients with Hepatocellular Carcinoma
Gwang Hyeon Choi, Hyun-Seok Kim, Michael Luu, Alexander Kuo, Walid S. Ayoub, Hirsh Trivedi, Yun Wang, Aarshi Vipani, Pin-Jung Chen, Steven A. Miles, Emily A. Kaymen, Andrew Hendifar, Tsuyoshi Todo, Todd V. Brennan, Georgios Voidonikolas, Steven A. Wisel,
Liver Cancer.2025; : 1. CrossRef

Additional nodules detected using EOB-MRI in patients with resectable single hepatocellular carcinoma: an implication for active treatment strategy: Na Reum Kim, Seoung Yoon Rho, Jonathan Navarro, Chansik An, Dai Hoon Han, Jin Sub Choi, Myeong-Jin Kim, Gi Hong Choi; J Liver Cancer. 2024;24(1):92-101. Published online February 14, 2024; DOI: https://doi.org/10.17998/jlc.2024.01.25

4,419 Views
110 Downloads
1 Citation

Abstract PDF

Background/Aim
Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOBMRI) further enhances the identification of additional hepatic nodules compared with computed tomography (CT) alone; however, the optimal treatment for such additional nodules remains unclear. We investigated the long-term oncological effect of aggressive treatment strategies for additional lesions identified using EOB-MRI in patients with hepatocellular carcinoma (HCC).
Methods
Data from 522 patients diagnosed with solitary HCC using CT between January 2008 and December 2012 were retrospectively reviewed. Propensity score-matched (PSM) analysis was used to compare the oncologic outcomes between patients with solitary HCC and those with additional nodules on EOB-MRI after aggressive treatment (resection or radiofrequency ablation [RFA]).
Results
Among the 383 patients included, 59 had additional nodules identified using EOB-MRI. Compared with patients with solitary HCC, those with additional nodules on EOB-MRI had elevated total bilirubin, aspartate transaminase, and alanine transaminase; had a lower platelet count, higher MELD score, and highly associated with liver cirrhosis (P<0.05). Regarding long-term outcomes, 59 patients with solitary HCC and those with additional nodules after PSM were compared. Disease-free survival (DFS) and overall survival (OS) were comparable between the two groups (DFS, 60.4 vs. 44.3 months, P=0.071; OS, 82.8 vs. 84.8 months, P=0.986).
Conclusion
The aggressive treatment approach, either resection or RFA, for patients with additional nodules identified on EOBMRI was associated with long-term survival comparable with that for solitary HCC. However, further studies are required to confirm these findings.

Citations

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Differential Infiltration of T-Cell Populations in Tumor and Liver Tissues Predicts Recurrence-Free Survival in Surgically Resected Hepatocellular Carcinoma
Eun Ji Jang, Ho Joong Choi, Young Kyoung You, Deok Hwa Seo, Mi Hyun Kwon, Keungmo Yang, Jaejun Lee, Jeong Won Jang, Seung Kew Yoon, Ji Won Han, Pil Soo Sung
Cancers.2025; 17(9): 1548. CrossRef

Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study: Kazuya Kariyama, Kazuhiro Nouso, Atsushi Hiraoka, Hidenori Toyoda, Toshifumi Tada, Kunihiko Tsuji, Toru Ishikawa, Takeshi Hatanaka, Ei Itobayashi, Koichi Takaguchi, Akemi Tsutsui, Atsushi Naganuma, Satoshi Yasuda, Satoru Kakizaki, Akiko Wakuta, Shohei Shiota, Masatoshi Kudo, Takashi Kumada; J Liver Cancer. 2024;24(1):71-80. Published online November 6, 2023; DOI: https://doi.org/10.17998/jlc.2023.09.11

5,531 Views
192 Downloads
4 Citations

Abstract PDF

Background/Aim
The aim of this study was to compare the therapeutic efficacy of ablation and surgery in solitary hepatocellular carcinoma (HCC) measuring ≤5 cm with a large HCC cohort database.
Methods
The study included consecutive 2,067 patients with solitary HCC who were treated with either ablation (n=1,248) or surgery (n=819). Th e patients were divided into three groups based on the tumor size and compared the outcomes of the two therapies using propensity score matching.
Results
No significant difference in recurrence-free survival (RFS) or overall survival (OS) was found between surgery and ablation groups for tumors measuring ≤2 cm or >2 cm but ≤3 cm. For tumors measuring >3 cm but ≤5 cm, RFS was significantly better with surgery than with ablation (3.6 and 2.0 years, respectively, P=0.0297). However, no significant difference in OS was found between surgery and ablation in this group (6.7 and 6.0 years, respectively, P=0.668).
Conclusion
The study suggests that surgery and ablation can be equally used as a treatment for solitary HCC no more than 3 cm in diameter. For HCCs measuring 3-5 cm, the OS was not different between therapies; thus, ablation and less invasive therapy can be considered a treatment option; however, special caution should be taken to prevent recurrence.

Citations

Citations to this article as recorded by

Asian Conference on Tumor Ablation Guidelines for Hepatocellular Carcinoma
Shuichiro Shiina, Ryosuke Tateishi, Joon Il Choi, So Yeon Kim, Zhiqiang Meng, Lujun Shen, Sheng-Nan Lu, Jen-I. Hwang, Maki Tobari, Hitoshi Maruyama, Terguunbileg Batsaikhan, Qing Deng, Lariza Marie Canseco, Yoshinari Asaoka, Shi-Ming Lin, Kai-Wen Huang, H
Liver Cancer.2025; 14(5): 651. CrossRef
Reply to the Letter regarding “Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study”
Kazuhiro Nouso, Kazuya Kariyama
Journal of Liver Cancer.2024; 24(1): 5. CrossRef
Radiofrequency for hepatocellular carcinoma larger than 3 cm: potential for applications in daily practice
Ji Hoon Kim, Pil Soo Sung
Journal of Liver Cancer.2024; 24(1): 1. CrossRef
Letter regarding “Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study”
Jongman Kim
Journal of Liver Cancer.2024; 24(1): 3. CrossRef

Review Article

Management of early-stage hepatocellular carcinoma: challenges and strategies for optimal outcomes: Jae Hyun Yoon, Sung Kyu Choi; J Liver Cancer. 2023;23(2):300-315. Published online September 21, 2023; DOI: https://doi.org/10.17998/jlc.2023.08.27

15,107 Views
310 Downloads
19 Citations

Abstract PDF

Although hepatocellular carcinoma (HCC) is associated with a poor prognosis, management of early-stage HCC is often successful with highly efficacious treatment modalities such as liver transplantation, surgical resection, and radiofrequency ablation. However, unfavorable clinical outcomes have been observed under certain circumstances, even after efficient treatment. Factors that predict unsuitable results after treatment include tumor markers, inflammatory markers, imaging findings reflecting tumor biology, specific outcome indicators for each treatment modality, liver functional reserve, and the technical feasibility of the treatment modalities. Various strategies may overcome these challenges, including the application of reinforced treatment indication criteria with predictive markers reflecting tumor biology, compensation for technical issues with up-to-date technologies, modification of treatment modalities, downstaging with locoregional therapies (such as transarterial chemotherapy or radiotherapy), and recently introduced combination immunotherapies. In this review, we discuss the challenges to achieving optimal outcomes in the management of early-stage HCC and suggest strategies to overcome these obstacles.

Citations

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Current advances in nanoparticle-based approaches for the hepatocellular carcinoma treatment
Sathishbabu Paranthaman, Umme Hani, Riyaz Ali M. Osmani, Rohit R. Bhosale, Nazima Haider
Clinics and Research in Hepatology and Gastroenterology.2025; 49(1): 102508. CrossRef
Therapeutic potential of kakkatin derivatives against hepatocellular carcinoma
Sahiba Chahal, Vikram Patial
World Journal of Clinical Oncology.2025;[Epub] CrossRef
Sequential combination with ropeginterferon alfa-2b and anti-PD-1 treatment as adjuvant therapy in HBV-related HCC: a phase 1 dose escalation trial
Albert Qin, Ming-Chih Ho, Chan-Yen Tsai, Chun-Jen Liu, Pei-Jer Chen
Hepatology International.2025; 19(3): 547. CrossRef
Advancing Cancer Treatment: A Review of Immune Checkpoint Inhibitors and Combination Strategies
Valencia Mc Neil, Seung Won Lee
Cancers.2025; 17(9): 1408. CrossRef
Comparison of initial treatments for resectable hepatocellular carcinoma within Milan criteria: an observational study based on a nationwide survey
Sang Jin Kim, Woo Kyoung Jeong, Hyung-Joon Han, Gyu-Seong Choi, Kyun-Hwan Kim, Jongman Kim
Annals of Surgical Treatment and Research.2025; 108(5): 279. CrossRef
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Haodong Liu, Shijie Liang, Chunting Peng, Jiawei Yang, Zheng Yang, Wuning Mo
Biochemical Genetics.2025;[Epub] CrossRef
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Ramanpreet Singh, Mina S. Makary
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Pre- and postoperative predictors of extrahepatic recurrence after curative resection for hepatocellular carcinoma
Chang Hun Lee, Yun Chae Lee, Seung Young Seo, Ga Ram You, Hoon Gil Jo, Sung Bum Cho, Eun Young Cho, In Hee Kim, Sung Kyu Choi, Jae Hyun Yoon
BMC Cancer.2025;[Epub] CrossRef
Diosgenin potentiates the anticancer effect of doxorubicin and volasertib via regulating polo-like kinase 1 and triggering apoptosis in hepatocellular carcinoma cells
Eman H. Yousef, Mohamed E. El-Mesery, Maha R. Habeeb, Laila A. Eissa
Naunyn-Schmiedeberg's Archives of Pharmacology.2024; 397(7): 4883. CrossRef
Comparison of Surgical Resection and Radiofrequency Ablation in Elderly Patients with Hepatocellular Carcinoma
Jun Il Kim, Jayoun Lee, Gi Hong Choi, Min Woo Lee, Dong Ah Park, Jeong-Ju Yoo
Digestive Diseases and Sciences.2024; 69(3): 1055. CrossRef
Radiofrequency for hepatocellular carcinoma larger than 3 cm: potential for applications in daily practice
Ji Hoon Kim, Pil Soo Sung
Journal of Liver Cancer.2024; 24(1): 1. CrossRef
Hepatocellular carcinoma outcomes and potential implications for surveillance in elderly patients
Aryoung Kim, Goeun Park, Myung Ji Goh, Byeong Geun Song, Wonseok Kang, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Dong Hyun Sinn
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Deok Seo, Ji Park, Hee Jung, Min Kang, Byung Kang, Dong Lee, Jae Lee, Seung Yoon, Jeong Jang, Jae Ahn, Pil Sung
Oncology Letters.2024;[Epub] CrossRef
Heavy smoking increases early mortality risk in patients with hepatocellular carcinoma after curative treatment
Jaejun Lee, Jong Young Choi, Soon Kyu Lee
Journal of Liver Cancer.2024; 24(2): 253. CrossRef
Superselective ablative chemo-ethanol embolization for recurrent single hepatocellular carcinoma: a 6-month outcome analysis
Jae Hwan Lee, Kun Yung Kim, Chong-ho Lee, Minuk Kim, Chang Jin Yoon
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Stage dependent microbial dynamics in hepatocellular carcinoma and adjacent normal liver tissues
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Efficacy of Transarterial Chemoembolization (TACE) for Early-Stage Hepatocellular Carcinoma
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Medicina.2023; 59(12): 2174. CrossRef

Original Article

The efficacy of treatment for hepatocellular carcinoma in elderly patients: Han Ah Lee, Sangheun Lee, Hae Lim Lee, Jeong Eun Song, Dong Hyeon Lee, Sojung Han, Ju Hyun Shim, Bo Hyun Kim, Jong Young Choi, Hyunchul Rhim, Do Young Kim; J Liver Cancer. 2023;23(2):362-376. Published online September 14, 2023; DOI: https://doi.org/10.17998/jlc.2023.08.03

5,288 Views
149 Downloads
4 Citations

Abstract PDF Supplementary Material

Background/Aim
Despite the increasing proportion of elderly patients with hepatocellular carcinoma (HCC) over time, treatment efficacy in this population is not well established.
Methods
Data collected from the Korean Primary Liver Cancer Registry, a representative cohort of patients newly diagnosed with HCC in Korea between 2008 and 2017, were analyzed. Overall survival (OS) according to tumor stage and treatment modality was compared between elderly and non-elderly patients with HCC.
Results
Among 15,186 study patients, 5,829 (38.4%) were elderly. A larger proportion of elderly patients did not receive any treatment for HCC than non-elderly patients (25.2% vs. 16.7%). However, OS was significantly better in elderly patients who received treatment compared to those who did not (median, 38.6 vs. 22.3 months; P<0.001). In early-stage HCC, surgery yielded significantly lower OS in elderly patients compared to non-elderly patients (median, 97.4 vs. 138.0 months; P<0.001), however, local ablation (median, 82.2 vs. 105.5 months) and transarterial therapy (median, 42.6 vs. 56.9 months) each provided comparable OS between the two groups after inverse probability of treatment weighting (IPTW) analysis (all P>0.05). After IPTW, in intermediate-stage HCC, surgery (median, 66.0 vs. 90.3 months) and transarterial therapy (median, 36.5 vs. 37.2 months), and in advanced-stage HCC, transarterial (median, 25.3 vs. 26.3 months) and systemic therapy (median, 25.3 vs. 26.3 months) yielded comparable OS between the elderly and non-elderly HCC patients (all P>0.05).
Conclusions
Personalized treatments tailored to individual patients can improve the prognosis of elderly patients with HCC to a level comparable to that of non-elderly patients.

Citations

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Management of hepatocellular carcinoma in elderly and adolescent/young adult populations
Han Ah Lee
Journal of Liver Cancer.2025; 25(1): 52. CrossRef
Immunological Landscape and Molecular Therapeutic Targets of the Tumor Microenvironment in Hepatocellular Carcinoma
Yusra Zarlashat, Abdul Ghaffar, Flora Guerra, Anna Picca
International Journal of Molecular Sciences.2025; 26(16): 7836. CrossRef
Efficacy and Safety of Surgical Resection in Elderly Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
Jin-Soo Lee, Dong Ah Park, Seungeun Ryoo, Jungeun Park, Gi Hong Choi, Jeong-Ju Yoo
Gut and Liver.2024; 18(4): 695. CrossRef
Achieving Sufficient Therapeutic Outcomes of Surgery in Elderly Hepatocellular Carcinoma Patients through Appropriate Selection
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Gut and Liver.2024; 18(4): 556. CrossRef

Case Report

Complete response to local therapy for advanced hepatocellular carcinoma with lung metastasis: a case report: Daeun Kim, Seiyeon Park, Won Sohn, Hyun Pyo Hong, Byung Ik Kim; J Liver Cancer. 2022;22(1):51-56. Published online January 27, 2022; DOI: https://doi.org/10.17998/jlc.2021.12.28

6,671 Views
126 Downloads
2 Citations

Abstract PDF

The concept of oligometastasis is widely accepted for various types of solid tumors; accordingly, better outcomes can be anticipated with aggressive local interventions. The treatment of advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis is systemic therapy. However, treatment responses to systemic therapy are poor. Recently, a small number of metastatic cancers (oligometastasis) have been controlled by local therapy rather than systemic therapy. Our study reports a case of a 66-year-old male patient with advanced HCC with lung metastasis, which was treated with local therapy. There were less than four metastases in the lungs, which were treated with wedge resection, radiofrequency, and radiation therapy. He repeatedly underwent local therapy for lung oligometastasis and locoregional therapy for intrahepatic HCC rather than systemic therapy; control by local therapy was possible as his liver function was preserved with Child-Turcotte-Pugh class A.

Citations

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A classification model for resectability in hepatocellular carcinoma patients
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Original Articles

The effect of nucleos(t)ide analogues on clinical outcomes of patients treated with transarterial chemoembolization and radiofrequency ablation for hepatitis B virus-related hepatocellular carcinoma: Jae Min Park, Won Hyeok Choe, Jeong Han Kim, So Young Kwon, Byung Chul Yoo; J Liver Cancer. 2021;21(2):155-162. Published online September 30, 2021; DOI: https://doi.org/10.17998/jlc.2021.09.22

6,058 Views
105 Downloads
3 Citations

Abstract PDF Supplementary Material

Background/Aims
Because hepatitis B virus (HBV) replication has been known to play an important role in cancer recurrence after curative treatment of HBV-related hepatocellular carcinoma (HCC), we examined whether treatment based on nucleos(t)ide analogues (NAs) might decrease the recurrence rate and improve patient survival.
Methods
The retrospective cohort study enrolled 73 patients with chronic hepatitis B who were treated with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) with curative intent for HCC. Among those, 30 and 43 patients were treated with tenofovir disoproxil fumarate (TDF) and entecavir (ETV), respectively.
Results
Of the 73 patients, 51 experienced HCC recurrence, and 14 patients were dead during a follow-up of 73±34 months. Multivariate analyses showed that tumor size (hazard ratio [HR], 1.590; 95% confidence-interval [CI], 1.106-2.285; P=0.012) and Child-Pugh class B (vs. class A/non cirrhosis; HR, 5.794; 95% CI, 2.311-14.523; P=0.001) was significantly associated with HCC recurrence, and Child-Pugh class B (HR, 7.357; 95% CI, 2.100-25.777; P=0.002) was an independent unfavorable prognostic factor for survival. During NAs therapy, TDF was superior to ETV for complete viral response at 1 year after the date of combination of TACE and RFA (P=0.016). However, the risks of HCC recurrence and survival were not significantly different between those treated with TDF versus ETV.
Conclusions
TDF was superior to ETV for achieving complete viral response. However, the recurrence and mortality after TACE and RFA for HBV-related HCC were not significantly different between patients treated with TDF versus ETV.

Citations

Citations to this article as recorded by

Enhanced prognosis of HCC patients undergoing radical treatments with tenofovir versus entecavir: A meta-analysis based on propensity score matching studies
Qingyan Kong, Mengshi Yi, Fei Teng, Zheyu Chen
Asian Journal of Surgery.2024; 47(1): 55. CrossRef
Tenofovir versus entecavir on the prognosis of hepatitis B virus-related hepatocellular carcinoma: a systematic review and meta-analysis
Hui Liu, Cheng-Long Han, Bao-Wen Tian, Zi-Niu Ding, Ya-Fei Yang, Yun-Long Ma, Chun-Cheng Yang, Guang-Xiao Meng, Jun-Shuai Xue, Dong-Xu Wang, Zhao-Ru Dong, Zhi-Qiang Chen, Jian-Guo Hong, Tao Li
Expert Review of Gastroenterology & Hepatology.2023; 17(6): 623. 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

Transarterial chemoembolization using drug-eluting bead compared with radiofrequency ablation for treatment of single small hepatocellular carcinoma: a pilot non-randomized trial: Tae Hoon Kim, Na Hye Kim, Jin Dong Kim, Young Nam Kim, Yu Jin Kim, Eun Jung Kim, Ki Deok Yoo, Choong Heon Ryu, Ha Hun Song, Hyun Kim; J Liver Cancer. 2021;21(2):146-154. Published online August 11, 2021; DOI: https://doi.org/10.17998/jlc.2021.05.20

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5 Citations

Abstract PDF Supplementary Material

Background/Aims
Surgical resection, transplantation, and radiofrequency ablation (RFA) are generally accepted as amenable treatments for small hepatocellular carcinoma (HCC). Recently drug-eluting beads (DEB) which had several treatment advantages were introduced for transarterial chemoembolization (TACE). The aim of this study was to evaluate feasibility and safety of DEB-TACE compared with RFA for the treatment of single small HCC.
Methods
In this pilot non-randomized trial, we assessed retrospective data of 40 patients who underwent DEB-TACE (n=21) or RFA (n=19) for single small (≤3 centimeter in greatest dimension) HCC. The primary outcomes were tumor response and time to recurrence. The secondary outcome was treatment-related complications.
Results
Complete response rate to DEB-TACE and RFA after first follow-up assessment was 90.5% and 94.7%, respectively (P=1.000). During mean follow-up of 87.6 months (95% confidence interval: 74.4-102), 7 patients experienced local recurrence. The 6- and 12-month cumulative local recurrence rate was 5.0% and 21.8% in DEB-TACE vs. 11.1% and 17.0% in RFA group (P=0.877). A total 14 distant intrahepatic recurrences were developed and 12- and 24-month cumulative distant intrahepatic recurrence rate was 20.6% and 42.7% in DEBTACE vs. 17.2% and 36.3% in RFA group (P=0.844). Two patients experienced gangrenous cholecystitis after DEB-TACE requiring cholecystectomy as treatment-related adverse event.
Conclusions
Tumor response and recurrence rate after single session of DEB-TACE or RFA were similar. DEB-TACE could be applied selectively in patients with a single small HCC if the other therapeutic modality is unfeasible.

Citations

Citations to this article as recorded by

Controlled release of doxorubicin from bio-resolvable drug-eluting bead of GelMA-SPMA graft copolymer for embolotherapy of liver cancer
Jeewon Do, Suguna Perumal, Jaewon Seo, Seonmin Lee, Shin Geun Park, Jiwon Ko, Ji Hoon Shin, Kyu-Pyo Kim, Wonmok Lee
Journal of Drug Delivery Science and Technology.2025; 105: 106601. CrossRef
Incidence and Risk Factors of Acute Ischemic Cholecystitis after Transarterial Chemoembolization: Correlation with Cone Beam CT Findings
Jong Yeong Kim, Jung Suk Oh, Ho Jong Chun, Su Ho Kim
Journal of the Korean Society of Radiology.2024; 85(2): 363. CrossRef
Superselective ablative chemo-ethanol embolization for recurrent single hepatocellular carcinoma: a 6-month outcome analysis
Jae Hwan Lee, Kun Yung Kim, Chong-ho Lee, Minuk Kim, Chang Jin Yoon
Journal of Liver Cancer.2024; 24(2): 217. CrossRef
Drug-Eluting Bead Transarterial Chemoembolization Versus Radiofrequency Ablation as an Initial Treatment of Single Small (≤ 3 cm) Hepatocellular Carcinoma
Somin Lee, Yong Yeon Jeong, Byung Chan Lee, Sang Soo Shin, Suk Hee Heo, Hyoung Ook Kim, Chan Park, Won Gi Jeong
Journal of Korean Medical Science.2023;[Epub] CrossRef
Comparable Outcomes in Early Hepatocellular Carcinomas Treated with Trans-Arterial Chemoembolization and Radiofrequency Ablation
Benjamin Wei Rong Tay, Daniel Q. Huang, Muthiah Mark, Neo Wee Thong, Lee Guan Huei, Lim Seng Gee, Low How Cheng, Lee Yin Mei, Prem Thurairajah, Lim Jia Chen, Cheng Han Ng, Wen Hui Lim, Darren Jun Hao Tan, Da Costa Maureen, Kow Wei Chieh Alfred, Iyer Shrid
Biomedicines.2022; 10(10): 2361. CrossRef

Case Reports

Gallbladder Fistula Treated with N-Butyl-2-Cyanoacrylate after Radiofrequency Ablation in a Hepatocellular Carcinoma Patient: a Case Report: In Tae So, Byoung Kook Jang, Jae Seok Hwang, Young hwan Kim; J Liver Cancer. 2019;19(1):69-73. Published online March 31, 2019; DOI: https://doi.org/10.17998/jlc.19.1.69

5,212 Views
65 Downloads

Abstract PDF: Radiofrequency ablation (RFA) is a minimally invasive local therapy for hepatocellular carcinoma (HCC). Even though RFA is considered to be a safe treatment modality, a variety of complications have been reported. Recently, we encountered a case of refractory fistula between a liver abscess and the gallbladder after RFA. A 64-year-old woman diagnosed with HCC associated with chronic hepatitis B was treated by RFA. After RFA, she experienced abdominal pain, and abdominal computed tomography (CT) revealed a liver abscess complicated by a previous treatment of HCC, she was treated with intravenous antibiotics and percutaneous abscess drainage. Follow-up abdominal CT revealed a fistula between the liver abscess and gallbladder, which was successfully treated with percutaneous transcatheter n-butyl-2-cyanoacrylate (NBCA) embolization. We herein report the rare case of a refractory fistula between a liver abscess and the gallbladder after RFA in a patient treated with NBCA embolization.

Needle-tract Seeding of Hepatocellular Carcinoma at Chest Wall: A Report of Two Cases: Kim, Dae Jung , Kim, Gwangil; J Liver Cancer. 2018;18(1):63-66. Published online March 31, 2018; DOI: https://doi.org/10.17998/jlc.18.1.63

2,118 Views
29 Downloads

Abstract PDF: We report two cases of needle-tract seeding after cryoablation and radiofrequency ablation for hepatocellular carcinomas. The seeding nodule appeared 6 and 12 months on the follow-up computed tomographic scan, respectively. In both cases, the seeding nodules were solitary in the chest wall, and could be completely resected.

Review Article

The Role of Combination of Transarterial Chemoebolization and Radiofrequency Ablation for Hepatocellular Carcinoma Treatment: Byoung Kuk Jang; J Liver Cancer. 2017;17(1):15-18. Published online March 31, 2017; DOI: https://doi.org/10.17998/jlc.17.1.15

1,999 Views
32 Downloads

Abstract PDF: Recently, various combination therapies have been applied to the treatment of hepatocellular carcinoma (HCC). Among various treatment modalities, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) were combined to improve the therapeutic effect of RFA. The decrease of blood flow by TACE can increase the size of the ablation area by reducing heat loss during RFA. Based on these theoretical advantages, TACE and RFA combination therapy have been tried for the treatment of patients with HCC which is not feasible to be removed by surgery. However, TACE and RFA combination therapy has not been standardized by various protocols for each study. This review discusses the implications and role of this treatment, although there are several limitations to clearly demonstrate the indications and efficacy of TACE and RFA combination therapies.

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