Journal of Liver Cancer

Original Article

Prediction of Post-resection Prognosis Using the ADV Score for Huge Hepatocellular Carcinomas ≥13 cm: Shin Hwang, Ki-Hun Kim, Deok-Bog Moon, Chul-Soo Ahn, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park; J Liver Cancer. 2021;21(1):45-57. Published online March 31, 2021; DOI: https://doi.org/10.17998/jlc.21.1.45

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Background/Aims
Multiplication of α-fetoprotein, des-γ-carboxy prothrombin, and tumor volume (ADV score) is a surrogate marker for post-resection prognosis of hepatocellular carcinoma (HCC). This study aimed to validate the predictive power of the ADV score-based prognostic prediction model for patients with solitary huge HCC.
Methods
Of 3,018 patients, 100 patients who underwent hepatic resection for solitary HCC ≥13 cm between 2008 and 2012 were selected.
Results
The median tumor diameter and tumor volume were 15.0 cm and 886 mL, respectively. Tumor recurrence and overall survival (OS) rates were 70.7% and 66.0% at one year and 84.9% and 34.0% at five years, respectively. Microvascular invasion (MVI) was the only independent risk factor for disease-free survival (DFS) and OS. DFS and OS, stratified by ADV score with 1-log intervals, showed significant prognostic contrasts (P=0.007 and P=0.017, respectively). DFS and OS, stratified by ADV score with a cut-off of 8-log, showed significant prognostic contrasts (P=0.014 and P=0.042, respectively). The combination of MVI and ADV score with a cut-off of 8-log also showed significant prognostic contrasts in DFS (P<0.001) and OS (P=0.001) considering the number of risk factors. Prognostic contrast was enhanced after combining the MVI and ADV score.
Conclusions
The prognostic prediction model with the ADV score could reliably predict the risk of tumor recurrence and long-term patient survival outcomes in patients with solitary huge HCCs ≥13 cm. The results of this study suggest that our prognostic prediction models can be used to guide surgical treatment and post-resection follow-up for patients with huge HCCs.

Citations

Citations to this article as recorded by

ADV score plus FDG-PET as preoperative predictors of post-resection prognosis in patients with hepatocellular carcinoma ≥10 cm: a retrospective cohort validation study
I-Ji Jeong, Shin Hwang, Byung-Gon Nah, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Ki-Hun Kim, Woo-Hyoung Kang, Young-in Yoon
International Journal of Surgery.2026;[Epub] CrossRef
Five-year complete remission of super-giant hepatocellular carcinoma with hepatectomy followed by sorafenib plus camrelizumab: A case report
Xiao-Qin Zheng, Li-Bo Sun, Wen-Jie Jin, Hui Liu, Wen-Yan Song, Hui Xu, Ju-Shan Wu, Xiao-Jun Wang, Chun-Yan Gou, Hui-Guo Ding
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Limited survival benefit of preoperative transarterial chemoembolization in huge hepatocellular carcinoma due to the prognostic impact of satellite nodules: a retrospective cohort study
Byeong-Gon Na, Shin Hwang, Chul-Soo Ahn, Ki-Hun Kim, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Sang Hoon Kim, Sung-Gyu Lee
Annals of Surgical Treatment and Research.2025; 109(3): 194. CrossRef
Early identification of hepatocellular carcinoma patients at high-risk of recurrence using the ADV score: a multicenter retrospective study
Shuya Cao, Zheyu Zhou, Chaobo Chen, Wenwen Li, Jinsong Liu, Jiawei Xu, Chunlong Zhao, Yihang Yuan, Zhenggang Xu, Huaiyu Wu, Guwei Ji, Xiaoliang Xu, Ke Wang
World Journal of Surgical Oncology.2024;[Epub] CrossRef
ADV score is a reliable surrogate biomarker of hepatocellular carcinoma in liver resection and transplantation
Shin Hwang, Dong-Hwan Jung, Gi-Won Song
Annals of Liver Transplantation.2023; 3(2): 86. CrossRef

Case Report

A Case of Massive HCC Treated with Surgical Resection: Shin Young Lee, Hee Bok Chae, Dong Hee Ryu, Il Hun Bae, Rohyun Sung; Journal of the Korean Liver Cancer Study Group. 2009;9(1):59-62. Published online June 30, 2009

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Abstract PDF: A 59-year-old male patient visited ER complaining of persistent pain in his right upper quadrant abdomen. He had suffered from end stage renal disease secondary to long-term hypertension and had been under the maintenance hemodialysis for 13 years. Half a month ago, he recognized a mass at his epigastric area. He did not have any history of liver disease in his lifetime. Physical exams revealed that he had a tender and hard mass on his right upper quadrant and epigastric area. Total bilirubin was 0.6 mg/dL, AST/ALT was 59/75 IU/L, and AFP was 105,740 ng/mL. Computed tomography showed the huge liver mass in the left lobe and its size was estimated about 16cm. The regional lymph node was also found in the porta hepatis area. He received complete resection of the hepatoma and was discharged. We concerned about high probability of recurrence because of the pre-operative AFP level and vascular invasion in the pathologic specimen.

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