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Recommendation and Guideline
Transarterial chemoembolization for hepatocellular carcinoma: 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association
Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim
J Liver Cancer. 2023;23(2):241-261.   Published online July 14, 2023
DOI: https://doi.org/10.17998/jlc.2023.05.22
  • 2,806 Views
  • 164 Downloads
  • 5 Citations
AbstractAbstract PDF
Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

Citations

Citations to this article as recorded by  
  • Liver resection in selective hepatocellular carcinoma with Vp3 or Vp4 portal vein tumor thrombosis improves prognosis
    Manuel Lim, Jongman Kim, Jinsoo Rhu, Gyu-Seong Choi, Jae-Won Joh
    Journal of Liver Cancer.2024; 24(1): 102.     CrossRef
  • A refined prediction model for survival in hepatocellular carcinoma patients treated with transarterial chemoembolization
    Hae Lim Lee, Seok Hwan Kim, Hee Yeon Kim, Sung Won Lee, Myeong Jun Song
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Clinical outcomes of transarterial chemoembolization in Child–Turcotte Pugh class A patients with a single small (≤3 cm) hepatocellular carcinoma
    Jungnam Lee, Young‐Joo Jin, Seung Kak Shin, Jung Hyun Kwon, Sang Gyune Kim, Jung Hwan Yu, Jin‐Woo Lee, Oh Sang Kwon, Soon Woo Nahm, Young Seok Kim
    Journal of Gastroenterology and Hepatology.2024;[Epub]     CrossRef
  • Recent Hepatocellular Carcinoma Managements in Korea: Focus on the Updated Guidelines in 2022
    Yuri Cho, Bo Hyun Kim, Young-Suk Lim
    Digestive Disease Interventions.2024;[Epub]     CrossRef
  • Implications of the first edition of the Korean expert consensus-based practice recommendations for transarterial chemoembolization in the management of hepatocellular carcinoma
    Jin Wook Chung
    Journal of Liver Cancer.2023; 23(2): 235.     CrossRef
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Guideline
2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma
J Liver Cancer. 2023;23(1):1-120.   Published online December 9, 2022
DOI: https://doi.org/10.17998/jlc.2022.11.07
  • 9,655 Views
  • 333 Downloads
  • 34 Citations
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.

Citations

Citations to this article as recorded by  
  • Contrast-enhanced US for HCC: Finally out from the waiting list?
    Richard G. Barr, Luigi Bolondi
    Hepatology.2024; 79(2): 267.     CrossRef
  • The Epidemiology of Hepatitis B Virus Infection in Korea: 15-Year Analysis
    Log Young Kim, Jeong-Ju Yoo, Young Chang, Hoongil Jo, Young Youn Cho, Sangheun Lee, Dong Hyeon Lee, Jae Young Jang
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Potential role of Fibrosis‐4 score in hepatocellular carcinoma screening: The Kangbuk Samsung Health Study
    Sujeong Shin, Won Sohn, Yoosoo Chang, Yoosun Cho, Min‐Jung Kwon, Sarah H. Wild, Christopher D. Byrne, Seungho Ryu
    Hepatology Research.2024; 54(6): 551.     CrossRef
  • Research Progress of lncRNA-ATB/miR-141-3p/GP73 Ax-is-Mediated EMT Promoting TACE Refractoriness
    棋 耿
    Advances in Clinical Medicine.2024; 14(01): 903.     CrossRef
  • Response to atezolizumab plus bevacizumab specific for lung and lymph node metastases affects survival of patients with HCC
    Jiwon Yang, Jonggi Choi, Won‐Mook Choi, Kang Mo Kim, Han Chu Lee, Ju Hyun Shim
    Liver International.2024; 44(4): 907.     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
  • Management Consensus Guidelines for Hepatocellular Carcinoma: 2023 Update on Surveillance, Diagnosis, Systemic Treatment, and Posttreatment Monitoring by the Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan
    Wei Teng, Hung-Wei Wang, Shi-Ming Lin
    Liver Cancer.2024; : 1.     CrossRef
  • Complications of immunotherapy in advanced hepatocellular carcinoma
    Young-Gi Song, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
    Journal of Liver Cancer.2024; 24(1): 9.     CrossRef
  • Liver resection in selective hepatocellular carcinoma with Vp3 or Vp4 portal vein tumor thrombosis improves prognosis
    Manuel Lim, Jongman Kim, Jinsoo Rhu, Gyu-Seong Choi, Jae-Won Joh
    Journal of Liver Cancer.2024; 24(1): 102.     CrossRef
  • Comparison of atezolizumab plus bevacizumab and lenvatinib for hepatocellular carcinoma with portal vein tumor thrombosis
    Jeayeon Park, Yun Bin Lee, Yunmi Ko, Youngsu Park, Hyunjae Shin, Moon Haeng Hur, Min Kyung Park, Dae-Won Lee, Eun Ju Cho, Kyung-Hun Lee, Jeong-Hoon Lee, Su Jong Yu, Tae-Yong Kim, Yoon Jun Kim, Tae-You Kim, Jung-Hwan Yoon
    Journal of Liver Cancer.2024; 24(1): 81.     CrossRef
  • Programmed Death 1 and Cytotoxic T-Lymphocyte-Associated Protein 4 Gene Expression in Peripheral Blood Mononuclear Cells Can Serve as Prognostic Biomarkers for Hepatocellular Carcinoma
    Ji Ah Lee, Hei-Gwon Choi, Hyuk Soo Eun, Jiyoon Bu, Tae Min Jang, Jeongdong Lee, Chae Yeon Son, Min Seok Kim, Woo Sun Rou, Seok Hyun Kim, Byung Seok Lee, Ha Neul Kim, Tae Hee Lee, Hong Jae Jeon
    Cancers.2024; 16(8): 1493.     CrossRef
  • Risk of Hepatocellular Carcinoma by Steatotic Liver Disease and Its Newly Proposed Subclassification
    Byeong Geun Song, Aryoung Kim, Myung Ji Goh, Wonseok Kang, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Dong Hyun Sinn
    Liver Cancer.2024; : 1.     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
  • Consistent efficacy of hepatic artery infusion chemotherapy irrespective of PD‑L1 positivity in unresectable hepatocellular carcinoma
    Ji Kim, Young Kim, Hee-Chul Nam, Chang-Wook Kim, Jae-Sung Yoo, Ji Han, Jeong Jang, Jong Choi, Seung Yoon, Ho Jong Chun, Jung Oh, Suho Kim, Sung Lee, Pil Sung
    Oncology Letters.2024;[Epub]     CrossRef
  • Risk of Bleeding in Hepatocellular Carcinoma Patients Treated with Atezolizumab/Bevacizumab: A Systematic Review and Meta-Analysis
    Young-Gi Song, Kyeong-Min Yeom, Eun Ae Jung, Sang Gyune Kim, Young Seok Kim, Jeong-Ju Yoo
    Liver Cancer.2024; : 1.     CrossRef
  • Trends in alcohol use and alcoholic liver disease in South Korea: a nationwide cohort study
    Jeong-Ju Yoo, Dong Hyeon Lee, Young Chang, Hoongil Jo, Young Youn Cho, Sangheun Lee, Log Young Kim, Jae Young Jang
    BMC Public Health.2024;[Epub]     CrossRef
  • Fatal intratumoral hemorrhage in a patient with hepatocellular carcinoma following successful treatment with atezolizumab/bevacizumab: A case report
    Kyeong-Hoon Park, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
    World Journal of Clinical Cases.2024; 12(22): 5177.     CrossRef
  • Diagnostic performance of the 2022 KLCA-NCC criteria for hepatocellular carcinoma on magnetic resonance imaging with extracellular contrast and hepatobiliary agents: comparison with the 2018 KLCA-NCC criteria
    Ja Kyung Yoon, Sunyoung Lee, Jeong Ah Hwang, Ji Eun Lee, Seung-seob Kim, Myeong-Jin Kim
    Journal of Liver Cancer.2023; 23(1): 157.     CrossRef
  • Radiologic features of hepatocellular carcinoma related to prognosis
    Shin Hye Hwang, Hyungjin Rhee
    Journal of Liver Cancer.2023; 23(1): 143.     CrossRef
  • Current status of ultrasonography in national cancer surveillance program for hepatocellular carcinoma in South Korea: a large-scale multicenter study
    Sun Hong Yoo, Soon Sun Kim, Sang Gyune Kim, Jung Hyun Kwon, Han-Ah Lee, Yeon Seok Seo, Young Kul Jung, Hyung Joon Yim, Do Seon Song, Seong Hee Kang, Moon Young Kim, Young-Hwan Ahn, Jieun Han, Young Seok Kim, Young Chang, Soung Won Jeong, Jae Young Jang, J
    Journal of Liver Cancer.2023; 23(1): 189.     CrossRef
  • Smoking Increases the Risk of Hepatocellular Carcinoma and Cardiovascular Disease in Patients with Metabolic-Associated Fatty Liver Disease
    Jeong-Ju Yoo, Man Young Park, Eun Ju Cho, Su Jong Yu, Sang Gyune Kim, Yoon Jun Kim, Young Seok Kim, Jung-Hwan Yoon
    Journal of Clinical Medicine.2023; 12(9): 3336.     CrossRef
  • Transarterial Chemoembolization for Hepatocellular Carcinoma: 2023 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association
    Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim
    Korean Journal of Radiology.2023; 24(7): 606.     CrossRef
  • Transarterial chemoembolization for hepatocellular carcinoma: 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association
    Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim
    Journal of Liver Cancer.2023; 23(2): 241.     CrossRef
  • Transarterial chemoembolization for hepatocellular carcinoma: 2023 Expert consensus-based practical recommendations of the Korean Liver Cancer Association
    Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim
    Clinical and Molecular Hepatology.2023; 29(3): 521.     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
  • 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
  • Diagnosis of hepatocellular carcinoma using Sonazoid: a comprehensive review
    Woo Kyoung Jeong
    Journal of Liver Cancer.2023; 23(2): 272.     CrossRef
  • The Current Evidence of Intensity-Modulated Radiotherapy for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
    Won Il Jang, Sunmi Jo, Ji Eun Moon, Sun Hyun Bae, Hee Chul Park
    Cancers.2023; 15(20): 4914.     CrossRef
  • Clinical outcome of surgical resection for multifocal T2-T3 hepatocellular carcinoma up to 3 nodules: a comparative analysis with a single nodule
    Sehyeon Yu, Hye-Sung Jo, Young-Dong Yu, Yoo jin Choi, Dong-Sik Kim
    Journal of Liver Cancer.2023; 23(2): 377.     CrossRef
  • Sonazoid contrast-enhanced ultrasonography for the diagnosis of hepatocellular carcinoma: strengths and shortcomings
    Sung Won Lee, Min Kyu Kang, Xiang Zhang
    Journal of Liver Cancer.2023; 23(2): 238.     CrossRef
  • Sequential regorafenib or nivolumab therapy in recurrent hepatocellular carcinoma with sorafenib failure in liver transplant patients does not improve prognosis
    Jieun Kwon, Jongman Kim, Jinsoo Rhu, Gyu-Seong Choi, Jae-Won Joh
    Annals of Liver Transplantation.2023; 3(2): 104.     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
  • Regular Alpha-Fetoprotein Tests Boost Curative Treatment and Survival for Hepatocellular Carcinoma Patients in an Endemic Area
    Joo Hyun Oh, Jonghyun Lee, Eileen L. Yoon, Soung Won Jeong, Soon Sun Kim, Young Eun Chon, Sang Bong Ahn, Dae Won Jun
    Cancers.2023; 16(1): 150.     CrossRef
  • Adjuvant and neoadjuvant therapies for hepatocellular carcinoma
    Arndt Vogel, Robert C. Grant, Tim Meyer, Gonzalo Sapisochin, Grainne M. O’Kane, Anna Saborowski
    Hepatology.2023;[Epub]     CrossRef
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Review Articles
Differences in radiotherapy application according to regional disease characteristics of hepatocellular carcinoma
Chai Hong Rim
J Liver Cancer. 2021;21(2):113-123.   Published online August 11, 2021
DOI: https://doi.org/10.17998/jlc.2021.05.26
  • 5,880 Views
  • 107 Downloads
  • 2 Citations
AbstractAbstract PDF
There are differences in opinion regarding the application of external beam radiotherapy in the treatment of hepatocellular carcinoma. Some major guidelines state that external beam radiotherapy is yet to attain a sufficient level of evidence. However, caution should be exercised when attempting to understand the clinical need for external beam radiotherapy solely based on the level of evidence. Previously, external beam radiotherapy had low applicability in the treatment of hepatocellular carcinoma before computed tomography-based planning was popularized. Modern external beam radiotherapy can selectively target tumor cells while sparing normal liver tissues. Recent technologies such as stereotactic body radiotherapy have enabled more precise treatment. The characteristics of hepatocellular carcinoma differ significantly according to the regional etiology. The main cause of hepatocellular carcinoma is the hepatitis B virus. It is commonly diagnosed as a locally advanced tumor but with relatively preserved hepatic function. The majority of these hepatocellular carcinoma cases are found in the East Asian population. Hepatocellular carcinoma caused by hepatitis C virus or other benign hepatitis tends to be diagnosed as a less locally aggressive tumor but with deteriorated liver function. The Western world and Japan tend to have patients with such causes. External beam radiotherapy has been more commonly performed for the former, although the use of external beam radiotherapy in the latter might have more concerns with regard to hepatic toxicity. This review discusses the above subjects along with perspectives regarding external beam radiotherapy in recent guidelines.

Citations

Citations to this article as recorded by  
  • Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: Meta-Analysis and International Stereotactic Radiosurgery Society Practice Guidelines
    Sun Hyun Bae, Seok-Joo Chun, Joo-Hyun Chung, Eunji Kim, Jin-Kyu Kang, Won Il Jang, Ji Eun Moon, Isaure Roquette, Xavier Mirabel, Tomoki Kimura, Masayuki Ueno, Ting-Shi Su, Alison C. Tree, Matthias Guckenberger, Simon S. Lo, Marta Scorsetti, Ben J. Slotman
    International Journal of Radiation Oncology*Biology*Physics.2024; 118(2): 337.     CrossRef
  • Will the collaboration of surgery and external radiotherapy open new avenues for hepatocellular carcinoma with portal vein thrombosis?
    Jung Wan Choe, Hye Yoon Lee, Chai Hong Rim
    World Journal of Gastroenterology.2022; 28(7): 704.     CrossRef
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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
  • 4,590 Views
  • 167 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  
  • Concurrent nivolumab and external beam radiation therapy for hepatocellular carcinoma with macrovascular invasion: A phase II 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.2024; 6(4): 100991.     CrossRef
  • 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
  • Differences in radiotherapy application according to regional disease characteristics of hepatocellular carcinoma
    Chai Hong Rim
    Journal of Liver Cancer.2021; 21(2): 113.     CrossRef
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Original Article
Noninvasive Diagnostic Criteria of the Revised 2014 the Korean Liver Cancer Study Group and the National Cancer Center Guideline for Subcentimetersized Hepatocellular Carcinoma: Is It Too Strict?
Kim, Nam Joong , Sinn, Dong Hyun , Kang, Wonseok , Paik, Yong Han , Choi, Moon Seok , Lee, Joon Hyeok , Koh, Kwang Cheol , Paik, Seung Woon , Gwak, Geum Youn
J Liver Cancer. 2018;18(1):44-50.   Published online March 31, 2018
DOI: https://doi.org/10.17998/jlc.18.1.44
  • 2,089 Views
  • 33 Downloads
  • 1 Citation
AbstractAbstract PDF
Background/Aims
Noninvasive diagnostic criteria for hepatocellular carcinoma (HCC) differ between guidelines, especially for subcentimeter-sized nodules. This study aimed to analyze clinical and radiological characteristics of subcentimeter-sized HCC, and assess the validity of noninvasive diagnostic criteria of the revised 2014 the Korean Liver Cancer Study Group and the National Cancer Center (KLCSG-NCC) guideline for subcentimeter-sized HCC. Methods: A total of 33 consecutive patients (median age, 58.6 years; men, 60.6%; hepatitis B virus-infected, 87.9%) who were diagnosed with HCC between January 2009 and December 2013 and had a maximum tumor diameter less than 1 cm were retrospectively included. Results: Among 33 subcentimeter-sized HCC cases, 6 cases were histologically proven and the remaining 27 patients were diagnosed by radiologically and/or serologically. Initial detection modality was dynamic contrast-enhanced computed tomography (CT) (66.7%, 22/33) or dynamic contrast-enhanced magnetic resonance imaging (MRI) (33.3% 11/33). No case was identified by surveillance ultrasonography. Typical radiological feature of HCC, which is arterial enhancement with delayed washout, was present in 51.7% (15/29 patients) in dynamic contrast-enhanced CT, and 90.9% (30/33 patients) in dynamic contrast-enhanced MRI. When these 33 cases were re-assessed by the revised 2014 KLCSG-NCC guideline, no one has fulfilled the noninvasive diagnostic criteria. Conclusions: None of the cases that were diagnosed as subcentimeter-sized HCC including histologically confirmed cases did not fulfill the noninvasive diagnostic criteria of the revised 2014 KLCSG-NCC guideline. Refinement of the current noninvasive diagnostic criteria for subcentimeter-sized HCC may be required.

Citations

Citations to this article as recorded by  
  • Clinical practice guideline and real-life practice in hepatocellular carcinoma: A Korean perspective
    Myung Ji Goh, Dong Hyun Sinn, Jong Man Kim, Min Woo Lee, Dong Ho Hyun, Jeong Il Yu, Jung Yong Hong, Moon Seok Choi
    Clinical and Molecular Hepatology.2023; 29(2): 197.     CrossRef
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Review Articles
Surgical Perspectives of Hepatocellular Carcinoma beyond the Barcelona Clinical Liver Cancer Guideline; Focusing on Liver Transplantation
Nam-Joon Yi, Gwang-Woong Lee, Kyoung-Suk Suh
J Liver Cancer. 2015;15(1):4-10.   Published online March 31, 2015
DOI: https://doi.org/10.17998/jlc.15.1.4
  • 960 Views
  • 16 Downloads
AbstractAbstract PDF
The management of hepatocellular carcinoma (HCC) is decided according to the evidence base recommendations generated by international societies especially by Barcelona clinical liver cancer (BCLC) guideline. However, the BCLC guideline based on studies of the Western countries, has not been well matched to real life cohort in Korea. In Western countries, a deceased donor liver transplantation has been well allocated to the HCC patients with preserved liver function. Patients with mild to moderate portal hypertension and certain BCLC B patients could be eligible for hepatic resection if a chance for 50% survival rate at 5 years is perceived. If liver transplantation (LT) is back up for liver resection in those patients as a salvage therapy, widening indication of liver resection could be much easily acceptable. On the other hands, new selection criteria of HCC beyond Milan criteria considering tumor biology, has been provided in the field of LT resulting in more than 50% survival rate at 5 years. Herein, surgical perspectives beyond the BCLC recommendation for LT for HCC would be reviewed in the respect of Korean surgeon’s view in this article.
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Directions for Future Hepatocellular Carcinoma Treatment Guidelines; Surgeon’s Perspective: Extension of Surgical Indication
Dong-Sik Kim
Journal of the Korean Liver Cancer Study Group. 2013;13(1):14-17.   Published online February 28, 2013
DOI: https://doi.org/10.17998/jlc.13.1.14
  • 1,037 Views
  • 5 Downloads
AbstractAbstract PDF
Since the second edition of practice guidelines for management of hepatocellular carcinoma in 2009, several other organizations have added newer versions of guidelines. It must be a good opportunity to review trends in changes of recent guidelines focusing on surgical filed. At the same time, issues that have been suggested or discussed so far regarding Korean guidelines will be discussed.
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Response Evaluation Assessment in HCC: Modified RECIST
So Yeon Kim
Journal of the Korean Liver Cancer Study Group. 2011;11(2):111-115.   Published online September 30, 2011
  • 722 Views
  • 25 Downloads
AbstractAbstract PDF
The accurate evaluation of response to treatment is a key aspect in cancer therapy, because an objective response may become a surrogate marker of improver survival. For cytotoxic drugs, tumor response evaluation according to the World Health Organization (WHO) criteria or the Response Evaluation Criteria in Solid Tumors (RECIST) guideline offers simple approaches based on the size of the lesions. However, considering the nature of locoregional therapy or new cytostatic agent for hepatocellular carcinoma (HCC), which do not decrease the size of the tumor but induce tumor necrosis, original WHO or RECIST criteria will not reflect clinical benefit exactly. Recently, modified RECIST assessment is proposed by AASLD-JNCI guidelines. Given that complete necrosis was well correlated with better survival, modified RECIST criteria consider changes in tumor viability, which can be measured as the area of arterial enhancement, with maintaining overall response assessment similar to RECIST. The proposed modified RECIST assessment is expected to provide a reliable method for assessing tumor response in HCC clinical trials.
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Changes of Hepatocellular Carcinoma Guidelines during the Last Ten-Year Period
Do Seon Song, Si Hyun Bae
Journal of the Korean Liver Cancer Study Group. 2011;11(2):136-143.   Published online September 30, 2011
  • 623 Views
  • 1 Download
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is the third most common cause of cancer death in the world. There has been many advances in diagnosis of HCC during the last ten-year period, especially imaging techniques. The Korean Liver cancer study group (KLCSG), European Association for the Study of the Liver (EASL), American Association for the Study of Liver disease (AASLD) and Asian-Pacific Association for the Study of Liver (APASL) have made and changed HCC guidelines with advances of imaging technique and results of research on HCC. We reviewed the changes of imaging guidelines in HCC diagnosis according to the advances of imaging. In addition, further studies will be needed to solve the controversies in diagnosis of HCC smaller than 1 cm in size.
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Practice Guidelines for Management of Hepatocellular Carcinoma: Global Discrepancies and Solution of Local Ablation
Hong Soo Kim
Journal of the Korean Liver Cancer Study Group. 2011;11(1):6-11.   Published online February 28, 2011
  • 509 Views
  • 1 Download
AbstractAbstract PDF
A curative modality for hepatocellular carcinoma was a resection or a liver transplantation in a past decades, but nowadays local ablation therapy like a percutaneous alcohol injection or a radiofrequency ablation is comparable with a surgical resection. So a local ablation therapy is considered as a curative modality. Recently early detection of a small hepatocellular carcinoma is becoming easy due to use a suveillance ultrasonography and computed tomography in a high risk patients. Grobally, an indication for local ablation therapy is a small hepatocellular carcinoma less than 3 cm in diameter and have a well-reserved liver function. But patients who met above indication is also controlled by a liver transplantation or a surgical resection. So we should pay attention to a difference between treatment guidelines and a strengths and weaknesses of local ablation therapy.
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Gobal Discrepancy of Practical Guidelines for Management of Hepatocellular Carcinoma-Resection and Transplanation
Kwang-Woong Lee
Journal of the Korean Liver Cancer Study Group. 2011;11(1):18-22.   Published online February 28, 2011
  • 518 Views
  • 3 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) usually appears in the setting of underlying liver disease. Therefore, HCC should be managed in multidisciplinary settings. Under these circumstances, several practice guidelines were introduced around the world. Clinically useful practice guidelines should be based on evidences, but socio-economic and medical status of the country should be considered as well. In this review, 6 well-known global practical guidelines (BCLC-AASLD, NCCN, 2 from Japan, APASL, Korean) were compared in terms of resection and liver transplantation (LT). BCLC-AASLD from Europe and the United States stressed more on LT for the patients within Milan criteria. However, the guidelines from the Asia had more extended indication of liver resection. The number of living donor LT in Korea is the highest in the world. Under this circumstance, indication of LT for HCC in Korea is inevitably being expanded. Compared to other guidelines, therefore, Korean guideline allowed a limited expansion of indication for HCC into patients with Child A and/or living donor LT with outside Milan HCC. However, to make more practical guidelines, high quality evidence from Korea and validation study of current Korean guideline are needed.
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2009 Treatment Guideline for Hepatocellular Carcinoma: Surgical Resection and Liver Transplantation
Sung Hoon Kim, Kyung Sik Kim
Journal of the Korean Liver Cancer Study Group. 2010;10(1):6-10.   Published online June 30, 2010
  • 525 Views
  • 4 Downloads
AbstractAbstract PDF
The effort we are trying to set up the treatment guideline for hepatocellular carcinoma has produced various guidelines after drawing a conclusion from Barcelona EASL meeting in 2000. Especially in Korea, the Korean Liver Cancer Study Group and the National Cancer Center have collaborated on making treatment guideline for hepatocellular carcinoma in the early stage of setting up the guideline, 2003, and it was a great help to treatment, study and education. However, a need of revision had been raised due to many changes in the latest treatments and an accumulation of international and domestic experience. After the proposal of amending the treatment guideline for Hepatocellular carcinoma in the Cancer Control Forum of the National Cancer Control Planning Board on October 17th, 2008, “2009 Guideline” has been reported in the Conference of the Korean Liver Cancer Study Group held on June 27th, 2009. When revising the guideline, there are some suggestions of continuous modification to reflect evidence based medical knowledge, and recently there are some debates about the drawback of the surgical field which was not handled in EASL and AASLD Guidelines. Therefore, it will broaden your understanding of liver surgical resection and liver transplantation and it will also be a place for the discussion of disputable issues.
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JLC : Journal of Liver Cancer