Journal of Liver Cancer

Case Report

Metastatic papillary renal cell carcinoma with portal vein tumor thrombosis confirmed on blind liver biopsy: Hun Kim, Tae Hoon Roh, Jun Seop Lee, Min Seong Kim, Beom Kyung Kim; J Liver Cancer. 2024;24(1):113-117. Published online November 29, 2023; DOI: https://doi.org/10.17998/jlc.2023.11.05

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Abstract PDF: Portal vein tumor thrombosis (PVTT) is an uncommon condition in which tumor cells expand into the vessels, causing blood clot formation in the portal vein. PVTT is mainly associated with hepatocellular carcinoma, leading to an unfavorable prognosis; however, it can also develop in patients with other cancer types. Herein, we report a case of metastatic renal cell carcinoma diagnosed by a blind liver biopsy in a patient with dynamic computed tomography-confirmed portal vein thrombosis and cholangiopathy. This case illustrates the importance of systematic surveillance with routine laboratory tests and contrast-enhanced imaging studies on patients with cancer to detect potential liver infiltration of metastatic 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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Abstract PDF

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 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

Review Article

Is Transarterial Chemoembolization Only Treatment Option in Patients with Intermediate Stage of Hepatocellular Carcinoma?: in Perspectives of Surgery: Ji Young Lim, Minjong Lee, Tae Hun Kim; J Liver Cancer. 2020;20(2):113-119. Published online September 30, 2020; DOI: https://doi.org/10.17998/jlc.20.2.113

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Abstract PDF: In the Barcelona Clinic Liver Cancer staging system, intermediate stage hepatocellular carcinoma (HCC) is defined as large multinodular tumors without vascular invasion or extrahepatic spread in an asymptomatic patient with good performance status. Intermediate stage HCC includes various subgroups and it is characterized by extensive heterogeneity. Current guidelines recommend transarterial chemoembolization (TACE) as the standard treatment modality for patients with intermediate stage HCC. Although TACE provides improved survival benefits compared with supportive care for patients with intermediate stage HCC, all of them are not good candidates for TACE. TACE refractoriness is another obstacle to effective treatment of patients with intermediate stage HCC. Given that many studies recently reported improved survival in patients treated with hepatic resection over TACE, we reviewed the survival outcomes of TACE and hepatic resection as a treatment strategy of intermediate stage HCC.

Case Reports

A Case of Advanced Hepatocellular Carcinoma with Long-term Post-progression Survival under Repeated Transarterial Chemoembolization after Sorafenib Failure: Jihyun Lee, Hwi Young Kim, Yong Jin Jung, Tae Hun Kim, Kwon Yu; J Liver Cancer. 2017;17(1):82-87. Published online March 31, 2017; DOI: https://doi.org/10.17998/jlc.17.1.82

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Abstract PDF: 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.

A Resected Case of Early Hepatocellular Carcinoma: Sang-Jae Park, Joong-Won Park, Seong-Hun Kim, Soon-Ae Lee, Young-Hun Kim, Eun-Kyoung Hong, Chang-Min Kim; Journal of the Korean Liver Cancer Study Group. 2004;4(1):33-38. Published online June 30, 2004

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Abstract PDF: A 35 year-old male patient admitted due to epigastric pain for 1 month. He was heavy drinker and spider angioma was obserbed in physical examination. HBsAb, anti-HBs Ab and anti-HCV Ab were all negative and AFP level was normal. AST/ALT were elevated to 178 IU/L and 107 IU/L, respectively. At ultrasonography, CT and MRI, a 2 cm, hypervascular mass was detected in the segment Ⅵ. Segmentectomy of the segment Ⅵ was performed. Tumor size 1.7 cm in maximum diameter and the Edmondson and Steiners grade Ⅰ. High-grade dysplasia was present in the periphery of hepatocellular carcinoma (nodule-in-nodule). Microvascular invasion was not observed and background liver was cirrhotic. He was discharged 10 days after operation without any problem and there has been no evidence of recurrence for the 2 years postoperatively.

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