Journal of Liver Cancer

Case Report

Durable complete response after discontinuation of atezolizumab-bevacizumab therapy in patients with hepatocellular carcinoma with portal vein tumor thrombosis: the first report: Pramod Kumar, Pradeep Krishna, Rohit Maidur, Naveen Chandrashekhar, Suresh Raghavaiah; Received June 14, 2024 Accepted September 26, 2024 Published online November 5, 2024; DOI: https://doi.org/10.17998/jlc.2024.09.26 [Accepted]

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Abstract PDF: Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is associated with a dismal prognosis. Atezolizumab plus bevacizumab (atezo-bev) is the recommended palliative treatment, and approximately 10% of the patients may experience a complete response (CR), according to the mRECIST criteria. The treatment duration is until disease progression or unacceptable side effects occur. Long-term continuation can cause potential toxicities and a substantial financial burden, making early treatment discontinuation a viable option. This report describes durable CR after discontinuing atezo-bev treatment in three patients with HCC and PVTT.

Review Article

Disease modifiers and novel markers in hepatitis B virus-related hepatocellular carcinoma: Lung-Yi Mak; J Liver Cancer. 2024;24(2):145-154. Published online August 5, 2024; DOI: https://doi.org/10.17998/jlc.2024.08.03

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Abstract PDF: Chronic hepatitis B (CHB) infection is responsible for 40% of the global burden of hepatocellular carcinoma (HCC) with a high case fatality rate. The risk of HCC differs among CHB subjects owing to differences in host and viral factors. Modifiable risk factors include viral load, use of antiviral therapy, co-infection with other hepatotropic viruses, concomitant metabolic dysfunctionassociated steatotic liver disease or diabetes mellitus, environmental exposure, and medication use. Detecting HCC at early stage improves survival, and current practice recommends HCC surveillance among individuals with cirrhosis, family history of HCC, or above an age cut-off. Ultrasonography with or without serum alpha feto-protein (AFP) every 6 months is widely accepted strategy for HCC surveillance. Novel tumor-specific markers, when combined with AFP, improve diagnostic accuracy than AFP alone to detect HCC at an early stage. To predict the risk of HCC, a number of clinical risk scores have been developed but none of them are clinically implemented nor endorsed by clinical practice guidelines. Biomarkers that reflect viral transcriptional activity and degree of liver fibrosis can potentially stratify the risk of HCC, especially among subjects who are already on antiviral therapy. Ongoing exploration of these novel biomarkers is required to confirm their performance characteristics, replicability and practicability.

Original Article

Incidence and Clinical Features of Hepatitis C Virus-associated Hepatocellular Carcinoma Patients without Liver Cirrhosis in Hepatitis B Virus-endemic Area: Jongbeom Shin, Jung Hwan Yu, Young-Joo Jin, Jin-Woo Lee; J Liver Cancer. 2021;21(1):34-44. Published online March 31, 2021; DOI: https://doi.org/10.17998/jlc.21.1.34

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Abstract PDF

Background
/objective: Hepatitis C virus (HCV)-associated hepatocellular carcinoma (HCC) is rarely observed in patients without liver cirrhosis (LC). We evaluated the incidence and clinical feature of HCV-associated HCC patients with or without LC.
Methods
The medical records of 1,516 patients diagnosed as having primary HCC at our hospital between January 2005 and December 2017 were retrospectively reviewed. Of these, 154 (10.2%) HCV-associated HCC patients were analyzed. LC was diagnosed histologically or clinically.
Results
Seventeen (11.0%) of the 154 patients had non-cirrhotic HCC, and all were of Child-Turcotte-Pugh (CTP) class A, Among the 17 patients, 88.2% were male, all had nodular type HCC, and only 2 (11.8%) were under HCC surveillance. Median overall survival (OS) of HCV-associated HCC patients with and without LC was 15 months and 37 months, respectively. Cumulative OS rates were not different between non-cirrhotic patients and cirrhotic patients with CTP class A (P=0.229). Cumulative OS rates were significantly higher in non-cirrhotic patients than in cirrhotic patients of CTP class B (P<0.001) or C (P<0.001). Multivariate analyses showed serum AST (hazard ratio [HR] 1.01, P=0.003) and AFP levels (HR 1.01, P=0.016), antiviral therapy (HR 0.25, P=0.022), and LC of CTP class B (HR, 5.24, P=0.006) or C (HR 21.79, P<0.001) were significantly associated with prognosis in HCV-associated HCC patients.
Conclusions
HCC in a non-cirrhotic liver was found in 11% of HCV-associated HCC patients. OSs of HCV-associated HCC patients were better in those of CTP A, regardless of LC than in those with LC of CTP class B or C.

Citations

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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
Diagnostic performance of CT/MRI LI-RADS v2018 in non-cirrhotic hepatitis C virus infection
Jennie J. Cao, Andy Shon, Luke Yoon, Aya Kamaya, Justin R. Tse
Abdominal Radiology.2024;[Epub] CrossRef

Review Article

Clinical Application of Liver Stiffness Measurement for Assessing the Risk of Hepatocellular Carcinoma: Jeong-Ju Yoo, Eun-Ae Jung, Sang Gyune Kim; J Liver Cancer. 2019;19(1):12-18. Published online March 31, 2019; DOI: https://doi.org/10.17998/jlc.19.1.12

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1 Citation

Abstract PDF

The most significant risk factor for hepatocellular carcinoma (HCC) is the presence of cirrhosis or advanced fibrosis of the liver. Liver biopsy was traditionally considered the gold standard for assessing the liver fibrosis burden. Recently, non-invasive methods, particularly transient elastography (TE), have proven effective at measuring fibrosis and determining cirrhosis. Clinical application of TE ranges from measuring fibrosis to predicting long-term prognosis and treatment response. Here, we focus on recent studies on the prognostic value of TE for predicting HCC.

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Metabolic dysfunction associated fatty liver disease and the risk of hepatocellular carcinoma
Byeong Geun Song, Sung Chul Choi, Myung Ji Goh, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Seung Woon Paik
JHEP Reports.2023; : 100810. CrossRef

Original Article

Methionine Adenosyltransferase 1: A Proteomic Surrogate Marker of Early Hepatocellular Carcinoma in Cirrhotic Patients: Lee, Joo Ho , Jun, Mi Jung , Shim, Ju Hyun , Song, Gi Won , Tak, Eunyoung , Oh, Bora , Yu, Eunsil , Choi, Sang Woon , An, Jihyun , Lee, Danbi , Kim, Kang Mo , Lim, Young Suk , Lee, Han Chu , Chung, Young Hwa , Lee, Yung Sang; J Liver Cancer. 2018;18(1):33-43. Published online March 31, 2018; DOI: https://doi.org/10.17998/jlc.18.1.33

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Abstract PDF: Background/Aims
Because there is a lack of effective biomarkers, we aimed to discover proteomic candidate markers for hepatocellular carcinoma (HCC) in cirrhotic patients at the highest-risk of HCC, and to validate the markers. Methods: We collected tumor tissue from 5 cirrhotics with HCC, and from 5 cirrhotics without HCC, who underwent liver resection or transplantation. These tissue samples were analyzed by 2-dimensional difference gel electrophoresis coupled with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and potential markers were validated at the transcriptional and translational levels. We also performed western blot assays using other blood samples from 10 cirrhotics with HCC and 10 without HCC. Results: Among the 66 distinguishable spots on 2-D gel images, we identified 15 proteins overexpressed more than 1.5 fold in terms of volume ratio in the tumors. Ten of the over-expressed proteins were identified by MALDI-TOF MS; of those, only methionine adenosyltransferase 1 (MAT1), a protein specific for liver, and acyl-CoA dehydrogenase were significantly up-regulated in tumors in further immunoblotting analyses (Ps<0.05). There was no between-pair difference in MAT1 mRNA measured by real-time polymerase chain reaction (P=0.96). However, in western blots of serum samples, distinct MAT1 bands were observed in all 10 HCC patients, but in only 2 of the non-HCC patients. Conclusions: MAT1 is a potential marker for surveillance in cirrhotic patients with and without prior HCC.

Case Reports

3 Cases of Portal Vein Thrombosis in Hepatocellular Carcinoma and Liver Cirrhosis Treated with Anticoagulation: Byung Moo Ahn, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Heon Young Lee; J Liver Cancer. 2015;15(1):57-63. Published online March 31, 2015; DOI: https://doi.org/10.17998/jlc.15.1.57

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1 Citation

Abstract PDF

The reported prevalence of PVT is in the range of 0.6-15.8% in patient with liver cirrhosis or portal hypertension. If the patient has hepatocellular carcinoma, thrombus is likely to be malignant thrombus. Malignancy, frequently of hepatic origin, is responsible for 21-24% of over all cases. The overall mortality rate of chronic PVT has been reported to be less than 10%, but is increased to 26% when associated with hepatocellular carcinoma and cirrhosis. However, no treatment guideline has been established on anticoagulant therapy for PVT in patients with concomitant hepatocellular carcinoma and cirrhosis. Because actually it is not easy to distinguish between malignant thrombus and benign thrombus in clinical aspect, PVT in hepatocellular carcinoma are still debatable whether or not treatment when it diagnosed. We present 3 cases of portal vein thrombosis successfully treated with anticoagulation in hepatocellular carcinoma and liver cirrhosis, and we include a literature review.

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Evaluation of Low-Molecular-Weight Heparin for Treatment of Portal Vein Thrombosis in Liver Cirrhosis Patients
Ji Min Han, Youngil Koh, Sung Hwan Kim, Sung Yun Suh, Yoon Sook Cho, Jeong-Hoon Lee, Su Jong Yu, Jung-Hwan Yoon, Hye Sun Gwak
Medicina.2023; 59(2): 292. CrossRef

Clinical Outcome of Completely Ablated Hepatocellular Carcinoma in Single Session in Patients with Decompensated Liver Cirrhosis: Min Seon Park, Soon Ho Um, Ho Sang Ryu, Yeon Seok Seo, Sun Young Yim, Chang Ho Jung, Tae Hyung Kim, Dae Hoe Gu; J Liver Cancer. 2014;14(2):139-142. Published online September 30, 2014; DOI: https://doi.org/10.17998/jlc.14.2.139

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Abstract PDF: Most cases of hepatocellular carcinoma (HCC) occur in the Asia-Pacific region and in patients with underlying hepatitis B and C viral infection. Although surgical resection is the gold standard for treatment of HCC, only a few patients are surgical candidates because of their lack of hepatic reserve. Liver transplantation, which eradicates HCC and replaces damaged noncancerous hepatic parenchyma, is regarded as the best treatment for HCC in patients with decompensated liver cirrhosis. However, the shortage of donors limit its widespread use. Furthermore, the long waiting time for liver transplantation allow for tumor progression and reduce patient survival. Given this long wait, there is a reasonable clinical need in the meantime for minimally invasive methods to avoid progression of HCC in patients with decompensated liver cirrhosis. We herein offer our experiences of therapeutic efficacy and complications of the procedure and the changes in liver function before and after TACE and radiofrequency ablation in patients with HCC and decompensated liver cirrhosis, defined as a Child-Pugh-Turcotte score above 7. (J Liver Cancer 2014;14:139-142)

A Case of Positive Tumor Marker Response after Intra-arterial Deferoxamine Infusion Therapy in a Hepatocellular Carcinoma Patient with Decompensated Liver Function: Hyun Ju Kim, Wonseok Kang, Mi Na Kim, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han; J Liver Cancer. 2014;14(2):127-130. Published online September 30, 2014; DOI: https://doi.org/10.17998/jlc.14.2.127

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Abstract PDF: Treatment of hepatocellular carcinoma is often very challenging when the underlying liver function is decompensated. Recent experimental and clinical studies showed that some chelating agents, including deferoxamine, display anti-proliferative actions against tumor cells, thereby exhibiting anti-cancer effect in certain cancers, including hepatocellular carcinoma. Based on previous studies, we herein offer our experience of positive tumor marker response after intra-arterial deferoxamine infusion in a patient presenting with advanced hepatocellular carcinoma with decompensated hepatic function. Validation of the efficacy of intra-arterial deferoxamine therapy in the setting of advanced hepatocellular carcinoma with underlying decompensated hepatic function is warranted. (J Liver Cancer 2014;14:127-130)

Original Article

Cirrhosis in Surgically Resected Hepatitis C-Associated Hepatocellular Carcinoma in a Hepatitis B Endemic Area: Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Jae-Won Joh, Seung Woon Paik, Byung Chul Yoo, Cheol Keun Park; J Liver Cancer. 2014;14(2):108-114. Published online September 30, 2014; DOI: https://doi.org/10.17998/jlc.14.2.108

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Abstract PDF: Background/Aims
Cirrhosis has generally been considered a prerequisite for hepatitis C virus (HCV)-infected livers to develop hepatocellular carcinoma (HCC), but HCCs that arise in absence of cirrhosis has been reported. We assessed the prevalence and significance of cirrhosis in HCV-related HCC patients who underwent surgical resection.
Methods
A total of 78 HCC patients (65 male [83.3%]; mean age, 64.2 ± 8.6 years) were evaluated for the presence of cirrhosis. Cirrhosis was assessed based on histology, aspartate aminotransferase-to-platelet ratio index (APRI) as well as clinical criteria, such as ascites, varices, thrombocytopenia, splenomegaly, and radiographic configuration of cirrhosis.
Results
Based on histology, cirrhosis, septal fibrosis, periportal fibrosis and no fibrosis was noticed in 33.3%, 60.3%, 5.1% and 1.3% of patients, respectively. The clinical criteria of cirrhosis were present in 76.9% of patients. APRI > 1.0 was seen in 47.4% of patients. There was no evidence of cirrhosis in 18 patients (23.1%), either by histology or clinically. Cirrhosis by histology was an independent factor for overall survival [hazard ratio: 3.87 (95% CI: 1.24 – 12.00), P=0.019].
Conclusions
Quite proportion of HCC patients had no evidence of cirrhosis, either by histology or clinically. Careful follow-up for HCC may be necessary even for non-cirrhotic HCVinfected Korean patients. (J Liver Cancer 2014;14:108-114)

Case Report

Metastatic Liver Cancer Mimicking Hepatocellular Carcinoma in Alcoholic Cirrhosis: Hee Yeon Kim, Chang Wook Kim, Chang Don Lee, Su Lim Lee, Yoo Dong Won, Ye Il Kim; Journal of the Korean Liver Cancer Study Group. 2014;14(1):41-45. Published online March 31, 2014; DOI: https://doi.org/10.17998/jlc.14.1.41

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Abstract PDF: A 50-year-old male patient visited for further evaluation of arterial enhancing nodules in cirrhotic liver. Computed tomography (CT) scan revealed vaguely nodular, arterial phaseenhancing nodules at segment 8 of the liver with cirrhotic background. Magnetic resonance imaging (MRI) showed four small nodules with early work-up enhancement in arterial phase and rapid washout. Angiography showed hypervascular nodular stains. Hepatocellular carcinoma (HCC) was diagnosed according to the noninvasive diagnostic criteria for HCC. A positron emission tomography (PET) scan was done for staging work-up, and increased uptake was noted in rectum. Subsequently, sigmoidoscopy revealed an ulceroinfiltrative lesion encircling the lumen of the rectosigmoid junction. Laparoscopic low anterior resection with wedge resection of liver was done, suspecting concurrent primary tumors of the rectum and liver. Pathologic examination demonstrated moderately differentiated adenocarcinoma in both rectum and liver, suggesting metastatic rectal carcinoma. The present case indicates that metastatic carcinoma as well as HCC should be considered in the differential diagnosis of irregularly enhancing small nodules even in high-risk patient group for HCC.

Original Articles

Sorafenib Combined with Transarterial-Chemoembolization in Child-Pugh Class B Patients with Hepatocellular Carcinoma: Jong Sik Lee, Sun Young Moon, Kyung Ann Lee, Jae Ki Min, Sung Jin Jeon, In Ae Kim, Kang Hoon Lee, Won Hyeok Choe, Jeong Han Kim, So Young Kwon; Journal of the Korean Liver Cancer Study Group. 2014;14(1):31-36. Published online March 31, 2014; DOI: https://doi.org/10.17998/jlc.14.1.31

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Abstract PDF: Background/Aims
The aim of the study is to investigate efficacy and safety of sorafenib combined with transarterial chemoembolization (TACE) in Child-Pugh (CP) class-B patients with hepatocellular carcinoma (HCC).
Methods
A total of 12 CP class-B patients who were initially treated with sorafenib combined with TACE were retrospectively reviewed. At 14 days after the first TACE, patients were continuously treated with sorafenib until unacceptable adverse events (AEs) or diseaseprogression. Consecutive TACEs were also performed, if patients were tolerable.
Results
Of 12 patients, 8, 3 and 1 patients had CP-score 7, 8, and 9, respectively. The median overall survival was 85 days. Patients underwent median 2 sessions of TACE (range 1-4) and the median duration of sorafenib was 48days (range, 12-92 days). Three patients refused repeated TACEs and 4 patients required delay of the consecutive TACE due to AEs of sorafenib. Six patients required transient or permanent discontinuation of sorafenib, due to its AEs (grade 1/2 AEs, 2 patients; grade 3/4 AEs, 4 patients). High CP score (score 8/9 vs. 7) was tended to be association with interruption of sorafenib (P=0.061) and requirement of refusal/ delay of consecutive TACE (P=0.081).
Conclusions
Sorafenib combined with TACE were frequently interrupted or delayed in CP class-B patients, mostly because of its side effects, even though there were not serious. Our experiences suggest that combination with sorafenib and TACE might interface with each other due to its side effects in CP class-B patients, especially patients with CP score 8/9 liver cirrhosis.

Hepatic Venous Pressure Gradient and Associated Factors in Survival Prediction in Patients with Liver Cirrhosis and Early and Very Early Hepatocellular Carcinoma: Tae Yeob Kim, Moon Young Kim, Jae Young Jang, Ki Tae Suk, Soung Won Jeong, Dong Joon Kim, Joo Hyun Sohn, Soon Koo Baik; Journal of the Korean Liver Cancer Study Group. 2014;14(1):23-30. Published online March 31, 2014; DOI: https://doi.org/10.17998/jlc.14.1.23

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Abstract PDF: Background/Aims
To analyze the usefulness of hepatic venous pressure gradient (HVPG) in survival prediction in cirrhotic patients with early and very early hepatocellular carcinoma (HCC).
Methods
We consecutively collected data of 45 stable cirrhotic patients (male 41, median age 57.2 years, BCLC A 29) with early-stage HCC undergoing HVPG measurement. Prognostic accuracy of HVPG was analyzed by the area under curve (AUC). Survival curves and the associated factors of HVPG status were obtained using Kaplan-Meier method and logistic regression analysis, respectively.
Results
The AUC value for prediction of survival by HVPG were 0.754 (95% CI, 0.603-0.870, P=0.006). The cut-off value of HVPG to predict death was 12 mmHg. Among the 45 patients, 11 patients (24.4%) died: 11 of 28 patients in the high HVPG group and none of 17 patients in the low HVPG group during followup period (P=0.003). The survival rate with high HVPG group was higher than those of low HVPG group (log rank P=0.008). In Child-Turcott-Pugh (CTP) class, the survival rate with CTP A class was higher than that with CTP B class (log rank P<0.001). The only associated factor with HVPG ≥12 mmHg in CTP A class and early-stage HCC was the presence of medium or large sized esophageal varices (odds ratio 66.8, 95% CI, 1.3-3530.4, P=0.038).
Conclusions
HVPG ≥12 mmHg may be suggested a predictor of survival in cirrhotic patients with early-stage HCC. In CTP A class, the presence of medium or large sized esophageal varices were associated with high HVPG.

Case Report

A Case of Primary Parasternal Abscess in a Cirrhotic and Diabetic Patient with Hepatocellular Carcinoma: Ji Young Lee, Joo Hyun Sohn, Tae Yeob Kim, Jung Hoon Lee, Ki Sul Chang, Hye Young Lee, Hyo Young Lee; Journal of the Korean Liver Cancer Study Group. 2013;13(2):164-168. Published online September 30, 2013; DOI: https://doi.org/10.17998/jlc.13.2.164

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Abstract PDF: Parasternal abscess is usually related to cardiac surgery, trauma or IV drug use and curable with antibiotics and surgical drainage. Sternal metastasis or primary parasternal abscess in a patient with hepatocellular carcinoma (HCC) is much rare and the differentiation between two diseases is occasionally difficult. Herein, we report a patient with HCC, diabetes mellitus and a spontaneously occurred parasternal abscess that is initially confused with a sternal metastasis. A-57-year-old man was admitted due to a slowly growing parasternal mass for 2 months. Two years prior to the admission, he had been diagnosed with small (1.6 cm) HCC in segment VII related to chronic hepatitis Band liver cirrhosis and treated with radiofrequency thermal ablation (RFTA). One year after RFTA, small (1.7 cm) HCC recurred in segment I and then he received TACE twiceat interval of 2 months. Eight months after that, multinodular HCCs newly developed in segment V and VIII (TNM stage IIIA) and two times of additional TACE were given. Thereafter he complained of gradually protruding mass with focal redness and mild tenderness on the sternum. But he denied any febrile and chilling sensation. Dynamic CT scans showed an enhanced parasternal lesion with bone destruction, while a bone scan displayed an increased uptake in the same site, resulting in an indistinguishable lesion between an abscess and a sternal metastasis of HCC. An excisional biopsy was performed on the lesion and revealed an abscess with sternal osteomyelitis rather than sternal metastasis. It was cured with surgical excision and antibiotics without complications.

Original Articles

The Comparison of Overall Survival between Child C with Early Stage HCC and Child A with Advanced Stage HCC: Eui Ju Park, Jae Young Jang, Soung Won Jeong, Jin Woo Choo, Jin Nyoung Kim, Soon Ha Kwon, Byoung Moo Lee, Sae Hwan Lee, Sang Gyune Kim, Sang-Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim; Journal of the Korean Liver Cancer Study Group. 2013;13(2):136-144. Published online September 30, 2013; DOI: https://doi.org/10.17998/jlc.13.2.136

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Abstract PDF: Background/Aims
The prognosis of hepatocellular carcinoma (HCC) is affected by stage as well as liver function. We analyzed the survival outcome of early stage HCC in Child class C patients and advanced HCC in Child class A patients.
Methods
Among 453 HCC patients with good performance status, Group A included 33 consecutive Child class C patients with early stage (I, II) HCC, and Group B included 45 consecutive Child class A patients with advanced stage (III, IV) HCC. We investigated the clinical characteristics, cirrhotic complications, and prognostic factors related with survival in each group, and compared overall survival between two groups.
Results
Age, prothrombin time, total bilirubin and Model for End-Stage Liver Disease (MELD) scores were significantly higher in Group A. Male sex, platelet count, albumin, sodium (Na), hepatitis B virus, alpha fetoprotein (AFP) and portal vein thrombosis were significantly higher in Group B. Complications of cirrhosis such as variceal bleeding, ascites, and hepatic encephalopathy were increased in Group A (P<0.05). Patients with an elevated AFP (>400 ng/mL) tended to exhibit poor survival as it increased in Group A (P=0.084). MELD scores>15 (Hazard ratio[HR] 17.84, 95% confidence interval [CI] 3.70-85.93, P<0.001), stage IV (HR:3.27, 95% CI 1.10-9.75, P=0.033), and absence of HCC treatment (HR: 3.70, 95% CI 1.06-12.50, P=0.040) were independent poor prognostic factors in Group B. Median overall survival was 24.6 months (95% CI 10.6-38.4) for Group A and 13.5 months (95% CI 4.6-22.3) for Group B (P=0.278). In the HCC treatment group, there were no significant differences of median overall survival between Group A and Group B, respectively (27.1 vs. 15.7 months, P=0.338). In patients with conservative treatment, Group A and Group B had a significantly different median overall survival of 13.6 and 2.5 months, respectively (P=0.012). In patients of Group B, median overall survival was significantly higher in patients who received treatment of HCC compared to those who did not, respectively (15.7 vs. 2.5 months, P<0.001).
Conclusions
Overall median survival was not different between both groups. However, in Child class A patients with advanced stage HCCs, the cumulative median survival was higher in patients who received treatment of HCC compared to those who did not. Therefore, advanced stage HCC patients with good liver function should be considered for HCC treatments.

Epidemiologic Changes in Hepatocellular Carcinoma: A 10-year Single Center Experience in Gangneung, Korea: Young Don Kim, Woo Sung Jang, Jang Hoon Kwon, Jong Sam Hong, Gab Jin Cheon; Journal of the Korean Liver Cancer Study Group. 2013;13(2):123-129. Published online September 30, 2013; DOI: https://doi.org/10.17998/jlc.13.2.123

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Abstract PDF: Background/Aims
Hepatocellular carcinoma (HCC) is common cause of liver related death in Korea, and the importance of alcohol as an etiology of chronic liver disease including cirrhosis is emphasized recently. We investigated the epidemiologic changes of HCC during last 10 years in single tertiary center in Gangneung, Korea.
Methods
We retrospectively reviewed the medical records of admitted patients diagnosed as HCC in year 2002 and 2012 respectively, and their clinical characteristics were compared.
Results
A total of 214 patients were enrolled. Mean age was 60.1 years and 179 (83.6%) was male. Number of patient with cirrhosis was 160 (74.8%) and with viral hepatitis was 164 (74.8%). Chronic hepatitis B (CHB) was the most common cause of HCC patients with liver cirrhosis (61.9%), and alcohol was 14.4%. The possible curative group (by BCLC stage 0 or A) was only 36.4% (n=78), and had not decreased during the study periods (36.3 % vs. 36.6%, P=0.144), and other clinical variables also had no statistical differences.
Conclusions
The clinical characteristics of HCC including clinical stage at the time of diagnosis were not changed over the last 10 year period, and CHB was still the most common etiology of HCC in Gangneung, Korea.

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