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JLC : Journal of Liver Cancer

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5 "Long-term survival"
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Case Report
Successful Surgical Cases for Advanced Hepatocellular Carcinoma
Hyung-Il Seo, Sang-Jae Park, Sung Wha Hong, Seong Hoon Kim, Soon-Ae Lee, Joon Il Choi, Hyun Bum Kim, Eun Kyung Hong, Joong-Won Park, Chang-Min Kim
Journal of the Korean Liver Cancer Study Group. 2006;6(1):32-37.   Published online June 30, 2006
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  • 2 Downloads
AbstractAbstract PDF
Advanced hepatocellular carcinoma (HCC) suggests a significantly high risk of recurrence, and the role of hepatic resection for advanced HCC is unclear. We will describe two cases of advanced HCC treated by hepatic resection. The two patients had liver tumors greater than 10 cm in diameter, with good liver function, and without tumor invasion to the main portal vein. The hepatic resection types were 5, 6 segmentectomy and hemihepatectomy. The lengths of surgical margins were 4.5 cm and 3.0 cm, each. In one patient, tumor invasion to resected diaphragm was detected in the 1st operation specimen. This patient received the second and third operation due to local recurrence. All these patients survived over 3 years without tumor recurrence. The hepatic resection for large HCC and repeated resection for local recurrence in selected cases can put in the way of long-term survival and cure.
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Review Articles
A Review of Prognostic Factors Influencing the Longterm Survival of Patients with Hepatocellular Carcinoma
Young Min Park
Journal of the Korean Liver Cancer Study Group. 2001;1(1):1-11.   Published online June 30, 2001
  • 1,936 Views
  • 21 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is a leading cause of cancer death in Korea, a highest endemic area of hepatitis B virus infection throughout the world. Because of the delayed diagnosis and decompensated cirrhosis, the current situation for the longterm survival of HCC patients is not optimistic, but still pessimistic. However, recently, HCC screening became a popular health program especially for a high risk group, so that the detection rate of small-size HCC is increasing, and also the various available therapeutic methods such as hepatic resection, percutaneous ethanol injection therapy (PEIT), and radiofrequency therapy (RFT) are all effective for the early stage of localized HCC. In epidemiological viewpoint, HCC shows a heterogeneous pattern in natural course and in survival. These heterogeneity is correlated with various factors, including age at the diagnosis, sex, tumor stage at the diagnosis, the presence of cirrhosis and hepatic failure, a kind of treatment protocol, and various biological features, including tumor growth pattern, differentiation grade, proliferating activity, tumor cell type, vascular invasion, alpha-fetoprotein, etc. To help the assessment of clinical situation and the prediction of clinical course of individual patients with HCC, this review will introduce various prognostic factors in relation to the survival of HCC patients.
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Analysis of 38 Long-Term Survivors after Liver Resections for Hepatocellular Carcinoma
Seong Woo Hong , Hyuck Sang Lee, Yang Won Nah
Journal of the Korean Liver Cancer Study Group. 2001;1(1):12-19.   Published online June 30, 2001
  • 663 Views
  • 6 Downloads
AbstractAbstract PDF
Background/Aims
This study was conducted to develop an optimal strategy to achieve a long-term survival after liver resection for hepatocellular carcinoma. Methods: Between July 1975 and March 1995, 109 patients who underwent liver resection for hepatocellular carcinoma at Inje University Seoul Paik Hospital were analyzed retrospectively. Results: Thirty-eight patients (34.9%) survived longer than 5 years after operation. Prognostic factors of statistical significance were the diagnostic clue, ICG R15, TNM stage, extent of tumor, intrahepatic metastasis, portal vein thrombosis, serosal interval. For 63 cases with no intrahepatic metastasis, there was no survival difference between the lobectomy group and the segmentectomy/subsegmentectomy group (36.8% vs. 50.0%). In the subset of patients with satellite nodules confined to one single segment of the liver, 66.7% of the those who underwent lobectomy lived longer than 5 years while only 17.6% of the patients who had a lesser resection survived long-term(p=0.025). Conclusion: For the achievement of a long-term survival in patients with hepatocellular carcinoma, a systematic segmentectomy/subsegmentectomy is adequate for those with no intrahepatic metastasis, while the presence of satellite nodules in one segment calls for a standard hepatic lobectomy.
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Case Reports
A Case of Young Adult with Hepatocellular Carcinoma Treated by Chemoembolization: Still Alive for 8 Years
Jae Ryang Juhn, Young Kil Choi
Journal of the Korean Liver Cancer Study Group. 2001;1(1):51-55.   Published online June 30, 2001
  • 740 Views
  • 3 Downloads
AbstractAbstract PDF
A 30 year-old-male patient with hepatocellular carcinoma was treated with TACE 6 times and has been still alive for 8 years. He had suffered from chronic hepatitis B which led to cirrhotic liver and esophageal varix(grade Ⅲ). He underwent a splenectomy due to thrombocytopenia. Child-Pugh class of this patient was A and shoed moderate high AFP ( 350 ng/ml and over). A small hypoechoic mass(2cm) was detected in S 8 of the liver by ultrasonography. The mass was hypodense and displayed nodular enhancement on CT. The tumor was hypervascular and was supplied by anterior superior branch of the right hepatic artery. Superselective catheterization and chemoembolization were successfully done with 2 cc of Lipiodol. The hepatic tumor was disappeared after 5 cycles of TACE and he has been lost for 3 years until the recent visit. AFP increased again and a small newly developed mass medial to the previous mass was supplied by the right inferior phrenic artery. Thus, superselective TACE was performed again and Lipiodol was well accumulated. The patient has been well for 8 years.
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A Long-Term Survival Case of Hepatocellular Carcinoma with Adrenal Gland Recurrence
Hee-Bok Chae, Seon Mee Park, Sei Jin Youn
Journal of the Korean Liver Cancer Study Group. 2001;1(1):56-59.   Published online June 30, 2001
  • 755 Views
  • 13 Downloads
AbstractAbstract PDF
A 59 year-old-male patient with liver cirrhosis was admitted due to altered mentality for 1 day. Thirty-seven months ago, he was diagnosed as hepatocellular carcinoma. At the time of the initial diagnosis, physical findings were normal. Biochemical tests showed as AST (86 IU/L), ALT (68 IU/L), bilirubin (0.5 mg/dL) and AFP (268 ng/ml). Abdomen CT showed a 5 cm-sized mass at S 6. He was trated with preoperative TACE and posterior segmentectomy 1 month after TACE. The excised liver specimen showed that most of the tumor was dead due to previous TACE, the growth pattern was trabecular, and the Edmondsons differentiation grade was Ⅲ/Ⅳ. At 18 months after the operation, the CT scan showed the right adrenal gland metastasis and he was treated with hot saline injection to the adrenal gland metastasis. From 22 months to 24 months after the operation, he was treated with both external radiotherapy (total does 3000 cGy) and subcutaneous injection of interferon ( 3 million units, 3 times a week). At 28 months after the operation, TACE was done via right adrenal artery. At 33 months after the operation, the final CT showed that adrenal gland mass was growing much larger against all of these treatment modalities. Following that he suffered from spontaneous bacterial peritonitis and two episodes of hepatic encephalopathy. At 37 months after the operation, he expired due to deep encephalopathy and massive esophageal variceal bleeding. In conclusion, we report this patient as a long-term survival case after the recurrence of hepatocellular carcinoma at right adrenal gland.
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