Background/Aims Tenofovir disoproxil fumarate (TDF) is potentially nephrotoxic in chronic hepatitis B patients. Hepatocellular carcinoma (HCC) patients treated using transarterial chemoembolization (TACE) are at an increased risk of renal injury. The aim of this study was to determine whether TDF is associated with more renal adverse events than entecavir (ETV) in HCC patients treated with TACE.
Methods In this retrospective single-center study, we selected 53 HCC patients who were treated with TDF from January 2012 to July 2013 and had their first TACE procedure in the same period. These patients were matched by age and sex to patients treated with ETV.
Results There were no significant differences in baseline characteristics, including HCC factors, and nephrotoxic drug use, between the two groups. The median follow-up period was 17.0 and 20.0 months for the TDF and ETV groups, respectively. There was no difference during the follow-up period between the TDF and ETV groups in the increase in creatinine over 0.5 mg/dL (17.0% and 17.0%, P=1.00, respectively) and the decrease in eGFR over 25% (43.4% and 41.5%, P=0.84, respectively). Multivariate analysis revealed that Child-Pugh class over B (hazard ratio [HR], 7.30; 95% confidence interval [CI] 2.79-19.10; P<0.01) was associated with increase in creatinine, and Child-Pugh class over B (HR, 82.74; 95% CI 12.31-555.83; P<0.01) and Barcelona-Clinic Liver Cancer stage over B (HR, 14.93; 95% CI 1.60-139.51; P=0.02) were associated with decrease in eGFR.
Conclusions TDF has comparable safety to that of ETV for HCC patients undergoing TACE.
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Big Data Information under Proportional Hazard Mathematical Model in Analysis of Hepatitis B Virus Infection Data of Patients with Interventional Liver Cancer through Antiviral Therapy of Entecavir Yichi Zhang, Shuai Zhao, Han Ding, Xiaoling Song, Huijie Miao, Xuya Cui, Jian Wang, Bing Han, Enas Abdulhay Journal of Healthcare Engineering.2021; 2021: 1. CrossRef
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.
Kyung Woo Park, Young Seok Kim, Sang Gyune Kim, Soung Won Jeong, Jae Young Jang, Hong Soo Kim, Sae Hwan Lee, Boo Sung Kim, Jun Cheol Jeong, Min Hee Lee, Jae Myeong Lee, Hee Kyung Kim
J Liver Cancer. 2015;15(2):122-125. Published online September 30, 2015
For a small hepatocellular carcinoma (HCC), liver resection shows most favorable outcome in case which liver transplantation is not available, although it has also substantial recurrence
rate. Here, we report a case of recurred HCC with multiple intrahepatic metastasis at 5 months
after surgical resection for small HCC was done. A 55-year-old man with chronic HBV infection
received subsegmentectomy for HCC less than 2 cm. A follow-up computed tomography (CT)
at 5 months from operation revealed that there were multiple enhancing nodules in entire
remnant liver. Intra-arterial injections of adriamycin mixed lipiodol and gelfoam particles were
instituted through hepatic artery. We assume that poorly differentiated cellular feature would
be attributable to this kind of very early and aggressive recurrence of HCC. (J Liver Cancer
2015;15:122-125)
Recently, detection of an incidental hepatic tumor has rapidly increased with the introduction
of multi-modality imaging techniques. And then, it is very important to determine whether
these tumors are malignant or benign lesions. In some cases, differentiation from other hepatic
tumors such as focal nodular hyperplasia or hepatic adenoma and hepatocellular carcinoma
can be extremely difficult, both clinical and radiologic finding. Therefore, it is suggested that
combination of multi-modality imaging study than using only a single imaging test. Despite
advanced imaging studies such as computed tomography (CT), magnetic resonance imaging
(MRI), contrast enhanced ultrasonography, and positron emission tomography (PET) showed
a high sensitivity and specificity, role of liver biopsy is still remained to confirm the diagnosis.
The use of liver biopsy in the diagnosis of hypervascular hepatic tumors is controversial.
However if the tumors was shown rapid growth tendency and heterogeneous radiological
appearance, liver biopsy or surgical resection should be considered to provide final diagnosis
and prompt curative treatment. We report a case of a hepatocelluar carcinoma showing
similar radiologic characteristics to focal nodular hyperplasia in patients without high risk
factors of hepatocelluar carcinoma.
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
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.
Jeong-Yeop Song, Young Seok Kim, Jae Myeong Lee, Soo Ji Jin, Kyu Sung Choi, Yun Nah Lee, Sang Hyune Kim, Sung Won Jeong, Jae Young Jang, Sae Hwan Lee, Hong Soo Kim, Boo Sung Kim
Journal of the Korean Liver Cancer Study Group. 2013;13(1):65-69. Published online February 28, 2013
In Korea, hepatocellular carcinoma (HCC) is a fourth leading malignancy with poor prognosis of 5 year survival reaching
just 18.9%. The peak incidence is 6th decade and the incidence drops with decreasing age. However, young patients with
HCC are not uncommonly encountered in clinical practice, and notably, even though managements with all available
modalities are undertaken in these patients, the prognosis does not seem to be better. As such, many physicians feel that
the behavior of HCC in young patients takes a more aggressive course than that in old patients. From this perspective, we
performed a systemic review of previous literatures focusing on the question whether or not HCC in young patients is more
aggressive; it was found that young patients with HCC had presentation of more advanced stage, more preserved liver
function, but poor or equivocal survival rate. In the multivariate analysis, however, the poor outcome resulted not from young
age, but from advanced stage, which was supported by similar or better outcome when the prognosis was compared with
the same stage between young and old patients. Consequently, it could be inferred that an earlier detection of the tumor
through earlier starting point of surveillance might improve the prognosis of young patients with HCC. However, a matter
of cost-effectiveness should also be considered, which necessitates a further analysis on this issue.
Jong Kyu Park, Young Seok Kim, Sang Gyune Kim, Seung Won Jeong, Jae Young Jang, Hyun Jong Choi, Jong Ho Moon, Hong Soo Kim, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim
Journal of the Korean Liver Cancer Study Group. 2009;9(1):49-52. Published online June 30, 2009
Recent progress in imaging techniques has permitted the diagnosis of hepatocelluar carcinoma (HCC) at an early stage.
However, portal vein invasion is still found in 12.5~39.7%. HCC with tumor thrombosis of the portal vein has a poor
prognosis. Previous studies showed that the median survival time of patients with HCC with involving portal vein was 2.7~4
months if effective treatment was not administered. Thus, for such HCC with portal vain invasion, an effective therapy that
will maintain quality of life is required. We report a case of HCC with portal vein tumor thrombus treated by intra-arterial
chemotherapy.
Extrahepatic metastases of hepatocellular carcinoma (HCC) are now increasing due to prolonged survival.
Extrahepatic metastases of HCC frequently develop in patients with more advanced stage and sometimes occur
without intrahepatic recurrence. We report two cases bone metastasis of HCC without intrahepatic recurrence
after treatment.
Hepatitis B virus (HBV) reactivation is a well described complication in cancer patitient who receive cytotoxic
chemotherapy and may result in varying degree of liver damage. Liver damage due to HBV exacerbation is a
2-stage process. The initial stage occurs during intense cytotoxic therapy and is characterized by enhancing viral
replication, as reflected by increases in serum levels of HBV DNA, HBeAg, which presumably result in
widespread infection of hepatocytes. The second stage is related to restoration of immune function following
withdrawl of cytotoxic therapy, which cause rapid immune-mediated destruction of infected hepatocyte. Clinically,
this may lead to hepatitis, hepatic failure, and even death. We report a case of hepatic failure after chemotherapy
in patient with HBV-related hepatocelluar carcinoma.