Backgrounds/Aims This study aimed to compare the outcomes of liver resection (LR) and transarterial chemoembolization (TACE) in patients with multinodular hepatocellular carcinoma (HCC) within the Milan criteria who were not eligible for liver transplantation.
Methods We retrospectively analyzed 483 patients with multinodular HCC within the Milan criteria, who underwent either LR or TACE as an initial therapy between 2013 and 2022. The overall survival (OS) in the entire population and recurrence-free survival (RFS) in patients who underwent LR and TACE and achieved a complete response were analyzed. Propensity score (PS) matching analysis was also used for a fair comparison of outcomes between the two groups.
Results Among the 483 patients, 107 (22.2%) and 376 (77.8%) underwent LR and TACE, respectively. The median size of the largest tumor was 2.0 cm, and 72.3% of the patients had two HCC lesions. The median OS and RFS were significantly longer in the LR group than in the TACE group (P<0.01 for both). In the multivariate analysis, TACE (adjusted hazard ratio [aHR], 1.81 and aHR, 2.41) and large tumor size (aHR, 1.43 and aHR, 1.44) were significantly associated with worse OS and RFS, respectively. The PS-matched analysis also demonstrated that the LR group had significantly longer OS and RFS than the TACE group (PS<0.05).
Conclusions In this study, LR showed better OS and RFS than TACE in patients with multinodular Barcelona Clinic Liver Cancer stage A HCC. Therefore, LR can be considered an effective treatment option for these patients.
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Background/Aim Hepatocellular carcinoma (HCC) tumor thrombi located in the first branch of the portal vein (Vp3) or in the main portal trunk (Vp4) are associated with poor prognosis. This study aimed to investigate the clinicopathological characteristics and risk factors for HCC recurrence and mortality following liver resection (LR) in patients with Vp3 or Vp4 HCC.
Methods The study included 64 patients who underwent LR for HCC with Vp3 or Vp4 portal vein tumor thrombosis (PVTT).
Results Fifty-eight patients (90.6%) had Vp3 PVTT, whereas the remaining six patients exhibited Vp4 PVTT. The median tumor size measured 8 cm, with approximately 36% of patients presented with multiple tumors. Fifty-four patients (84.4%) underwent open LR, whereas 10 patients underwent laparoscopic LR. In the Vp4 cases, combined LR and tumor thrombectomy were performed. The 3-year cumulative disease-free survival rate was 42.8% for the Vp3 group and 22.2% for the Vp4 group. The overall survival (OS) rate at 3 years was 47.9% for the Vp3 group and 60.0% for the Vp4 group. Intrahepatic metastasis has been identified as an important contributor to HCC recurrence. High hemoglobin levels are associated with high mortality.
Conclusion LR is a safe and effective treatment modality for selected patients with Vp3 or Vp4 HCC PVTT. This suggests that LR is a viable option for these patients, with favorable outcomes in terms of OS.
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.
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
J Liver Cancer. 2024;24(1):81-91. Published online January 19, 2024
Background/Aim Atezolizumab plus bevacizumab and lenvatinib are currently available as first-line therapy for the treatment of unresectable hepatocellular carcinoma (HCC). However, comparative efficacy studies are still limited. This study aimed to investigate the effectiveness of these treatments in HCC patients with portal vein tumor thrombosis (PVTT).
Methods We retrospectively included patients who received either atezolizumab plus bevacizumab or lenvatinib as first-line systemic therapy for HCC with PVTT. Primary endpoint was overall survival (OS), and secondary endpoints included progressionfree survival (PFS) and disease control rate (DCR) determined by response evaluation criteria in solid tumors, version 1.1.
Results A total of 52 patients were included: 30 received atezolizumab plus bevacizumab and 22 received lenvatinib. The median follow-up duration was 6.4 months (interquartile range, 3.9-9.8). The median OS was 10.8 months (95% confidence interval [CI], 5.7 to not estimated) with atezolizumab plus bevacizumab and 5.8 months (95% CI, 4.8 to not estimated) with lenvatinib (P=0.26 by log-rank test). There was no statistically significant difference in OS (adjusted hazard ratio [aHR], 0.71; 95% CI, 0.34-1.49; P=0.37). The median PFS was similar (P=0.63 by log-rank test), with 4.1 months (95% CI, 3.3-7.7) for atezolizumab plus bevacizumab and 4.3 months (95% CI, 2.6-5.8) for lenvatinib (aHR, 0.93; 95% CI, 0.51-1.69; P=0.80). HRs were similar after inverse probability treatment weighting. The DCRs were 23.3% and 18.2% in patients receiving atezolizumab plus bevacizumab and lenvatinib, respectively (P=0.74).
Conclusion The effectiveness of atezolizumab plus bevacizumab and lenvatinib was comparable for the treatment of HCC with PVTT.
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Background/Aim Radiotherapy (RT) is an effective local treatment for hepatocellular carcinoma (HCC). However, whether additional RT is safe and effective in patients with advanced HCC receiving atezolizumab plus bevacizumab remains unclear. This retrospective cohort study aimed to evaluate the feasibility of additional RT in these patients.
Methods Between March and October 2021, we retrospectively analyzed seven patients with advanced HCC who received RT during treatment with atezolizumab plus bevacizumab. The median prescribed RT dose was 35 Gy (range, 33–66). Freedom from local progression (FFLP), progression-free survival (PFS), and overall survival (OS) after RT were analyzed.
Results The median follow-up duration after RT was 14.2 months (range, 10.0–18.6). Of the seven patients, disease progression was noted in six (85.7%), the sites of disease progression were local in two (28.6%), intrahepatic in four (57.1%), and extrahepatic in four (57.1%). The median time of FFLP was not reached, and PFS and OS times were 4.0 (95% confidence interval [CI], 3.6–4.5) and 14.8% (95% CI, 12.5–17.2) months, respectively. The 1-year FFLP, PFS, and OS rates were 60% (95% CI, 43.8–76.2), 0%, and 85.7% (95% CI, 75.9–95.5), respectively. Grade 3 or higher hematologic adverse events (AEs) were not observed, but grade 3 nonhematologic AEs unrelated to RT were observed in one patient.
Conclusions The addition of RT may be feasible in patients with advanced HCC treated with atezolizumab plus bevacizumab. However, further studies are required to validate these findings.
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Background/Aim The profile of patients with hepatocellular carcinoma (HCC) has changed globally; the role of etiology in predicting prognosis of HCC patients remains unclear. We aimed to analyze the characteristics and prognosis of Korean patients with HCC according to disease etiology.
Methods This retrospective observational study included patients diagnosed with HCC between 2010 and 2014 in a single center in Korea. Patients with HCC aged <19 years old, had coinfection with other viral hepatitis, had missing follow-up data, were Barcelona Clinic Liver Cancer stage D, or died before 1 month were excluded.
Results A total of 1,595 patients with HCC were analyzed; they were classified into the hepatitis B virus (HBV) group (1,183 [74.2%]), hepatitis C virus (HCV) group (146 [9.2%]), and non-B non-C (NBNC) group (266 [16.7%]). The median overall survival of all patients was 74 months. The survival rates at 1, 3, and 5 years were 78.8%, 62.0% and 54.9% in the HBV group; 86.0%, 64.0%, and 48.6% in the HCV group; and 78.4%, 56.5%, and 45.9% in the NBNC group, respectively. NBNC-HCC has a poorer prognosis than other causes of HCC. Survival was significantly longer in the HBV group with early-stage HCC than in the NBNC group. Furthermore, survival was shorter in patients with early-stage HCC and diabetes mellitus (DM) than in those without DM.
Conclusions The etiology of HCC affected clinical characteristics and prognosis to some extent. NBNC-HCC patients showed shorter overall survival than viral-related HCC patients. Additionally, the presence of DM is an additional important prognostic factor in patients with early-stage HCC.
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Background/Aim We aimed to investigate the efficacy and safety of stereotactic body radiation therapy (SBRT) in elderly patients with small hepatocellular carcinomas (HCC).
Methods Eighty-three patients (89 lesions) with HCC who underwent SBRT between January 2012 and December 2018 were reviewed in this retrospective observational study. The key inclusion criteria were as follows: 1) age ≥75 years, 2) contraindications for hepatic resection or percutaneous ablative therapies, 3) no macroscopic vascular invasion, and 4) no extrahepatic metastasis.
Results The patients were 75-90 years of age, and 49 (59.0%) of them were male. Most patients (94.0%) had an Eastern Cooperative Oncology Group performance status of 0 or 1. Seventy-four patients (89.2%) had Child-Pugh class A hepatic function before SBRT. The median tumor size was 1.6 cm (range, 0.7-3.5). The overall median follow-up period was 34.8 months (range, 7.3-99.3). The 5-year local tumor control rate was 90.1%. The 3-year and 5-year overall survival rate was 57.1% and 40.7%, respectively. Acute toxicity grade ≥3 was observed in three patients (3.6%) with elevated serum hepatic enzymes; however, no patient experienced a worsening of the Child-Pugh score to ≥2 after SBRT. None of the patients developed late toxicity (grade ≥3).
Conclusions SBRT is a safe treatment option with a high local control rate in elderly patients with small HCC who are not eligible for other curative treatments.
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Background/Aims Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2015.
Methods Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative sample of patients newly diagnosed with HCC in Korea, were analyzed. A total of 1,558 patients with HCC registered in the KPLCR in 2015 were investigated.
Results The median age was 61.0 years (interquartile range, 54.0-70.0 years), and men accounted for 79.7% of the subjects. Hepatitis B virus infection was the most common underlying liver disease (58.1%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, stage 0, A, B, C, and D HCCs accounted for 14.2%, 31.5%, 7.6%, 39.0%, and 7.8% of patients, respectively. Transarterial therapy (32.1%) was the most commonly performed initial treatment, followed by surgical resection (23.2%), best supportive care (20.2%), and local ablation therapy (10.7%). Overall, 34.5% of patients were treated in accordance with the BCLC guidelines: 59.2% in stage 0/A, 48.4% in stage B, 18.1% in stage C, and 71.6% in stage D. The 1-, 3-, and 5-year OS rates were 67.1%, 50.9%, and 27.0%, respectively.
Conclusions In 2015, approximately 45% of Korean HCC cases were diagnosed at a very early or early stage, and 35% of patients underwent potentially curative initial treatment. BCLC guidance was followed in 34.5% of patients; in patients with stage B or C disease, there was relatively low adherence.
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Background/Aims Considering the high prevalence and mortality of hepatocellular carcinoma (HCC) in Korea, accurate statistics for HCC are important. We evaluated the characteristics of Korean patients with newly diagnosed HCC.
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Results At the time of HCC diagnosis, the median age was 60.0 years, with male predominance (79.6%). Hepatitis B virus infection was the most common etiology (59.1%). The rates of Barcelona Clinic Liver Cancer (BCLC) stages 0, A, B, C, and D at diagnosis were 3.9%, 36.9%, 12.5%, 39.4%, and 7.3%, respectively. The proportion of very early or early stage HCC at diagnosis (BCLC stage 0 or A) in the 2012-2014 cohort was significantly lower than that in the 2008-2011 cohort (40.8% vs. 48.3%, P<0.001). Transarterial therapy (37.5%) was the most commonly performed initial treatment, followed by surgical resection (19.8%), best supportive care (19.1%), and local ablation (10.6%). The median OS was 2.9 years, and the 1-, 3-, and 5-year OS rates were 67.7%, 49.3% and 41.9%, respectively. The OS rate of the 2012-2014 cohort was significantly higher than that of the 2008-2011 cohort (log-rank, P<0.001).
Conclusions The OS of HCC patients registered in the KPLCR between 2012 and 2014 significantly improved. Nevertheless, as about half of the HCC patients were diagnosed at an advanced stage, vigorous and optimized HCC screening strategies should be implemented.
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Jun Sik Yoon, Han Ah Lee, Jun Yong Park, Bo Hyun Kim, In Joon Lee, Young Eun Chon, Suk Kyun Hong, Dong Hyeon Lee, Hyun-Joo Kong, Young-Joo Won, Eunyang Kim, Jeong-Hoon Lee
J Liver Cancer. 2020;20(1):41-52. Published online March 31, 2020
Backgrounds/Aims Backgrounds/Aims: In Korea, hepatocellular carcinoma (HCC) is the sixth most common cancer and results in the second-highest cancer death rate among all cancers. We aimed to describe the characteristics of patients who were newly diagnosed with HCC in Korea between 2008 and 2011.
Methods The Korean Primary Liver Cancer Registry (KPLCR) is a random sample consisting of approximately 15% of patients with newly diagnosed primary liver cancer registered in the Korean Central Cancer Registry. We investigated the baseline characteristics, treatment modalities, and overall survival (OS) of patients with HCC registered in the KPLCR between 2008 and 2011.
Results A total of 6,083 patients were histologically or radiologically diagnosed with HCC. The hepatitis B virus was the predominant HCC etiology (72.0%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, stages 0, A, B, C, and D accounted for 8.6%, 39.7%, 11.5%, 33.8%, and 6.9%, respectively. Transarterial therapy (41.7%) was the most commonly performed initial treatment, followed by best supportive care (21.7%), surgical resection (16.7%), and local ablation therapies (10.6%). The overall rate of adherence to the BCLC treatment guideline was only 37.7%. The 1-, 3-, and 5-year OS rates were 65.6%, 46.2%, and 36.8%, respectively.
Conclusions Between 2008 and 2011, approximately half of patients with HCC (48.3%) were candidates for curative treatment (BCLC stage 0 or A), but one-third of patients (33.8%) had advanced HCC (BCLC stage C). Transarterial therapy was the most commonly conducted initial treatment and the 5-year OS rate was 36.8% in this period.
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Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma Josep M. Llovet, Roser Pinyol, Mark Yarchoan, Amit G. Singal, Thomas U. Marron, Myron Schwartz, Eli Pikarsky, Masatoshi Kudo, Richard S. Finn Nature Reviews Clinical Oncology.2024; 21(4): 294. CrossRef
Hepatocellular carcinoma incidence is decreasing in Korea but increasing in the very elderly Young Eun Chon, Seong Yong Park, Han Pyo Hong, Donghee Son, Jonghyun Lee, Eileen Yoon, Soon Sun Kim, Sang Bong Ahn, Soung Won Jeong, Dae Won Jun Clinical and Molecular Hepatology.2023; 29(1): 120. 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
Surgical resection versus ablation for early hepatocellular carcinoma: The debate is still open Bo Hyun Kim Clinical and Molecular Hepatology.2022; 28(2): 174. CrossRef
Cause of death and cause-specific mortality for primary liver cancer in South Korea: A nationwide population-based study in hepatitis B virus-endemic area Bo Hyun Kim, Dahhay Lee, Kyu-Won Jung, Young-Joo Won, Hyunsoon Cho Clinical and Molecular Hepatology.2022; 28(2): 242. CrossRef
Impact of expanding hepatitis B treatment guidelines: A modelling and economic impact analysis Young‐Suk Lim, Sang Hoon Ahn, Jae‐Jun Shim, Homie Razavi, Devin Razavi‐Shearer, Dong Hyun Sinn Alimentary Pharmacology & Therapeutics.2022; 56(3): 519. CrossRef
Surveillance for hepatocellular carcinoma: It is time to move forward Bo Hyun Kim, Yuri Cho, Joong-Won Park Clinical and Molecular Hepatology.2022; 28(4): 810. CrossRef
Therapeutic Decision Making in Hepatocellular Carcinoma According to Age and Child–Pugh Class: A Nationwide Cohort Analysis in South Korea Sunmin Park, Chai Hong Rim, Young Kul Jung, Won Sup Yoon, Alessandro Granito Canadian Journal of Gastroenterology and Hepatology.2021; 2021: 1. CrossRef
Outcome of Immune Checkpoint Inhibitor and Molecular Target Agent Combination for Advanced Hepatocellular Carcinoma: Beyond Sorafenib Era Nae-Yun Heo The Korean Journal of Gastroenterology.2021; 77(3): 145. CrossRef
Rare Case of Pyogenic Brain Abscess after Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma: Case Report and Literature Review Jun-Ho Myeong, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim Journal of Liver Cancer.2021; 21(1): 81. CrossRef
Hepatocellular Carcinoma in Korea: an Analysis of the 2015 Korean Nationwide Cancer Registry Jun Sik Yoon, Han Ah Lee, Hwi Young Kim, Dong Hyun Sinn, Dong Ho Lee, Suk Kyun Hong, Ju-Yeon Cho, Jonggi Choi, Young Chang, Hyun-Joo Kong, Eunyang Kim, Young-Joo Won, Jeong-Hoon Lee Journal of Liver Cancer.2021; 21(1): 58. CrossRef
Glucose Variability and Risk of Hepatocellular Carcinoma in Patients with Diabetes: A Nationwide Population-Based Study Jeong-Ju Yoo, Eun Ju Cho, Kyungdo Han, Soo Seong Heo, Bo-Yeon Kim, Dong Wook Shin, Su Jong Yu Cancer Epidemiology, Biomarkers & Prevention.2021; 30(5): 974. CrossRef
Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein improves diagnostic accuracy for hepatocellular carcinoma Han Ah Lee, Yoo Ra Lee, Young-Sun Lee, Young Kul Jung, Ji Hoon Kim, Hyunggin An, Hyung Joon Yim, Yoon Tae Jeen, Jong Eun Yeon, Kwan Soo Byun, Yeon Seok Seo World Journal of Gastroenterology.2021; 27(28): 4687. CrossRef
Hepatocellular Carcinoma in Korea between 2012 and 2014: an Analysis of Data from the Korean Nationwide Cancer Registry Young Eun Chon, Han Ah Lee, Jun Sik Yoon, Jun Yong Park, Bo Hyun Kim, In Joon Lee, Suk Kyun Hong, Dong Hyeon Lee, Hyun-Joo Kong, Eunyang Kim, Young-Joo Won, Jeong-Hoon Lee Journal of Liver Cancer.2020; 20(2): 135. CrossRef
Efficacy of Local Treatments for Hepatocellular Carcinoma Involving the Inferior Vena Cava and/or Right Atrium Han Ah Lee, Chai Hong Rim Journal of Hepatocellular Carcinoma.2020; Volume 7: 435. CrossRef
Recurrence of hepatocellular carcinoma (HCC) after hepatic resection is quite common. Peritoneal
recurrence has been considered incurable status and related to poor prognosis. Although
peritoneal metastasectomy is a therapeutic option for some selected patients with a few
peritoneal metastasis, the indication and therapeutic effect has not been clear. We report a
case of a 61-year-old man achieving complete remission of recurrent peritoneal metastasis after
repeated surgical resection by a multidisciplinary approach. Peritoneal metastasectomy might
be a therapeutic option for selected patients with localized oligonodular peritoneal metastasis.
Hepatocellular carcinoma is the third leading cause of cancer related mortality worldwide.
Only 30% of patients are eligible for curative surgical resection at diagnosis. For patients with
advanced hepatocellular carcinoma with accompanying portal vein tumor thrombosis, Sorafenib
is recommended as first-line treatment. However, survival gain from sorafenib is unsatisfactory,
and there is no standard therapy for patients who are intolerable or refractory to sorafenib. Here
we report a case of a 52-year-old man who initially achieved partial response after sorafenib
treatment, but eventually showed disease progression and was treated subsequently with
transarterial chemoembolization (TACE). Multinodular recurrence occurred, but he was treated
with repeated TACE, and has survived for 4 years so far.
Background/Aims Transarterial chemoembolization (TACE) is the standard locoregional
treatment in patients with unresectable hepatocellular carcinoma (HCC). Angiogenesis and
inflammation play important roles in tumor growth in HCC. In this study, we evaluated the
associations between the levels of growth factors and inflammatory markers and clinical
prognosis in patients with unresectable HCC treated with TACE. Methods The clinical outcomes of 58 HCC patients treated with TACE at the Catholic Medical
Centers from January, 2012 to February 2015 were evaluated. Baseline levels of the growth
factors vascular endothelial growth factor, fibroblast growth factor, platelet-derived growth
factor, and hepatocyte growth factor and the inflammatory cytokines interleukin (IL)-17 and
high sensitivity C-reactive protein (hs-CRP) were compared with the treatment outcomes. The
primary endpoint was time to progression (TTP); the secondary endpoint was overall survival
(OS). Results During the 20.8 months of follow-up, TTP was significantly delayed in patients with
low levels of hs-CRP (≤0.15) and IL-17 (≤0.94) and a maximal tumor diameter ≤5 cm (P =0.010,
P =0.015, and 0.048, respectively). Patients with HCC with low hs-CRP and IL-17 levels had
a longer survival than that of those with high hs-CRP levels and IL-17 (35.1 vs. 22.5 months,
P =0.000; 41 vs. 21.8 months, P =0.000, respectively). However, any baseline growth factors
were not significantly correlated with TTP and OS. Conclusions Elevated IL-17 and hs-CRP may be predictive of a poor outcome in patients
with HCC treated with TACE. A better understanding of this relationship will require further
investigation of the immune mechanisms underlying tumor progression.
Background/Aims Given the high incidence and mortality rate of hepatocellular carcinoma
(HCC), ensuring high quality of registry data is important for the improvement of health
service. Registries by voluntary reporting often lack case completeness and may cause
selection bias. A statutory Korean Central Cancer Registry (KCCR) has case completeness and
provides accurate information on HCC incidence, but provides limited information about HCC
characteristics. Methods The Korean Liver Cancer Study Group (KLCSG) and the KCCR jointly built a
nationwide cohort of patients who were diagnosed with HCC between 2003 and 2005. Out
of 31,521 new HCC cases that were registered at the KCCR between 2003 and 2005, 4,630 case s (14.7% of total HCC cases) were randomly selected and abstracted from 32 hospitals
nationwide, and followed up until December 2011. After excluding 110 patients who met the
exclusion criteria, a total of 4,520 HCC patients were analyzed. Results Mean age at the diagnosis of HCC was 57.1±10.8 years, and males comprised 81.0%.
Hepatitis B was the predominant etiology (72%), and hepatitis C comprised 12%. Stage
at diagnosis was 10%, 43%, 28%, 11% and 8% for modified International Union Against
Cancer (mUICC) stages I, II, III, IV-A and IV-B, respectively. Initial treatment modalities
were transarterial therapy in 53%, surgical resection in 10%, local ablation in 7%, and liver
transplantation in 1%. The median survival was 1.4 years, and the 1-, 3-, and 5-year survival rates were 56%, 35% and 27%, respectively. Age, gender, Child-Pugh class, etiology, tumor
stage at diagnosis, and treatment modality were factors independently related to survival. Conclusions About half of HCC patients are diagnosed at advanced stages in Korea. Curativeintent
treatments are rarely applied to patients. This data provides unbiased information
about the characteristics and outcome of HCC patients in Korea. (J Liver Cancer 2014;14:97-
107)
Citations
Citations to this article as recorded by
Hepatocellular Carcinoma in Korea between 2012 and 2014: an Analysis of Data from the Korean Nationwide Cancer Registry Young Eun Chon, Han Ah Lee, Jun Sik Yoon, Jun Yong Park, Bo Hyun Kim, In Joon Lee, Suk Kyun Hong, Dong Hyeon Lee, Hyun-Joo Kong, Eunyang Kim, Young-Joo Won, Jeong-Hoon Lee Journal of Liver Cancer.2020; 20(2): 135. CrossRef
Subclassification of Barcelona Clinic Liver Cancer B and C hepatocellular carcinoma: A cohort study of the multicenter registry database Sangheun Lee, Beom Kyung Kim, Kijun Song, Jun Yong Park, Sang Hoon Ahn, Seung Up Kim, Kwang‐Hyub Han, Do Young Kim Journal of Gastroenterology and Hepatology.2016; 31(4): 842. CrossRef
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.