Journal of Liver Cancer

Original Article

Effect of direct-acting antivirals for hepatitis C virus-related hepatocellular carcinoma recurrence and death after curative treatment: Young-Hwan Ahn, Heirim Lee, Ji Eun Han, Hyo Jung Cho, Jae Youn Cheong, Bumhee Park, Soon Sun Kim; J Liver Cancer. 2022;22(2):125-135. Published online June 28, 2022; DOI: https://doi.org/10.17998/jlc.2022.05.24

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Background/Aim
There has been a long-standing debate about the association of directacting antiviral (DAA) therapy and hepatocellular carcinoma (HCC) recurrence. This study aimed to investigate the association between DAA therapy and HCC recurrence after curative therapy.
Methods
We retrospectively enrolled 1,021 patients with HCV-related (hepatitis C virus) HCC who underwent radiofrequency ablation (RFA), liver resection, or both as the first treatment modality from January 2007 to December 2016 and without a history of HCV therapy before HCC treatment from a nationwide database. The effect of HCV treatment on HCC recurrence and all-cause mortality was also investigated.
Results
Among the 1,021 patients, 77 (7.5%) were treated with DAA, 14 (1.4%) were treated with interferon-based therapy, and 930 (91.1%) did not receive HCV therapy. DAA therapy was an independent prognostic factor for lower HCC recurrence rate (hazard ratio [HR], 0.04; 95% confidence interval [CI], 0.006-0.289; P=0.001 for landmarks at 6 months after HCC treatment and HR, 0.05; 95% CI, 0.007-0.354; P=0.003 for landmarks at 1 year). Furthermore, DAA therapy was associated with lower all-cause mortality (HR, 0.049; 95% CI, 0.007-0.349; P=0.003 for landmarks at 6 months and HR, 0.063; 95% CI, 0.009-0.451; P=0.006 for landmarks at 1 year).
Conclusions
DAA therapy after curative HCC treatment can decrease HCC recurrence and all-cause mortality compared to interferon-based therapy or no antiviral therapy. Therefore, clinicians should consider administering DAA therapy after curative HCC treatment in patients with HCV-related HCC.

Citations

Citations to this article as recorded by

Comparison of Surgical Resection and Radiofrequency Ablation in Elderly Patients with Hepatocellular Carcinoma
Jun Il Kim, Jayoun Lee, Gi Hong Choi, Min Woo Lee, Dong Ah Park, Jeong-Ju Yoo
Digestive Diseases and Sciences.2024; 69(3): 1055. CrossRef
Analyzing risk factors and developing a stratification system for hepatocellular carcinoma recurrence after interferon-free direct-acting antiviral therapy in chronic hepatitis C patients
Chih-Hsuan Luan, Pin-Shuo Su, Chi-Jen Chu, Chung-Chi Lin, Chien-Wei Su, Jiing-Chyuan Luo, I-Cheng Lee, Chen-Ta Chi, Shou-Dong Lee, Yuan-Jen Wang, Fa-Yauh Lee, Yi-Hsiang Huang, Ming-Chih Hou
Journal of the Chinese Medical Association.2024; 87(4): 357. CrossRef
Addition of Kidney Dysfunction Type to MELD-Na for the Prediction of Survival in Cirrhotic Patients Awaiting Liver Transplantation in Comparison with MELD 3.0 with Albumin
Kyeong-Min Yeom, Jong-In Chang, Jeong-Ju Yoo, Ji Eun Moon, Dong Hyun Sinn, Young Seok Kim, Sang Gyune Kim
Diagnostics.2023; 14(1): 39. CrossRef
Is direct-acting antiviral treatment beneficial or harmful for patients with hepatitis C virus-related hepatocellular carcinoma?
Hye Won Lee
Journal of Liver Cancer.2022; 22(2): 91. CrossRef

Case Report

Infiltrative hepatocellular carcinoma with multiple lung metastasis completely cured using nivolumab: a case report: Ji Eun Han, Hyo Jung Cho, Soon Sun Kim, Jae Youn Cheong; J Liver Cancer. 2021;21(2):169-176. Published online September 30, 2021; DOI: https://doi.org/10.17998/jlc.2021.08.26

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Abstract PDF

The current Food and Drug Administration-approved systemic treatments for advanced hepatocellular carcinoma (HCC) include multikinase inhibitors (tyrosine kinase inhibitor [TKI]) and immune checkpoint inhibitors (ICIs). Among ICIs, nivolumab is used as secondline therapy for advanced HCC after sorafenib failure or patient intolerance. In this case, a patient with infiltrative HCC and portal vein tumor thrombosis was treated with hepatic arterial infusion chemotherapy (HAIC) and radiation therapy. New lung metastasis developed after HAICs; thus, lenvatinib treatment was initiated. However, the disease progressed. Thereafter, sorafenib treatment was initiated but he developed intolerance, with grade 3 sorafenib-related diarrhea. Subsequently, nivolumab was administered as rescue therapy. He demonstrated a partial response to nivolumab after the third treatment and viable HCCs in the lungs and liver completely disappeared after the 24th treatment. These findings suggest that nivolumab could be used as an effective rescue therapy for advanced HCC progression after TKI treatment.

Citations

Citations to this article as recorded by

Intermediate-stage (BCLC stage B) infiltrative hepatocellular carcinoma: safety and efficacy of chemoembolization
Seong Ho Kim, Jin Hyoung Kim, Gun Ha Kim, Ji Hoon Kim, Heung-Kyu Ko, Hee Ho Chu, Ji Hoon Shin, Dong Il Gwon, Gi-Young Ko, Hyun-Ki Yoon, Shakir Aljerdah, Nayoung Kim
European Radiology.2023; 33(12): 8736. CrossRef

Original Article

Effect of PTEN Polymorphism on the Development of Hepatitis B Virus-associated Hepatocellular Carcinoma: Soon Sun Kim, Jung Woo Eun, Hyo Jung Cho, Hyun-Young Lee, Chul Won Seo, Gil Ho Lee, So Young Yoon, Choong Kyun Noh, Sung Won Cho, Jae Youn Cheong; J Liver Cancer. 2019;19(1):46-54. Published online March 31, 2019; DOI: https://doi.org/10.17998/jlc.19.1.46

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Abstract PDF

Background/Aim
s: Phosphatase and tensin homolog (PTEN) is a known tumor suppressor gene that is downregulated in hepatocellular carcinoma (HCC). Here, we investigated the association between single nucleotide polymorphisms (SNPs) of PTEN and HCC development in patients with hepatitis B virus (HBV) infection.
Methods
Six SNPs of PTEN at positions rs1234221, rs1903860, rs1234220, rs1903858, rs2299941, and rs17431184 were analyzed in a development population (417 chronic HBV carriers without HCC and 281 chronic HBV carriers with HCC). PTEN rs1903858, rs1903860, and rs2299941 SNPs were further assessed for the development of HCC in a validation population of 200 patients with HBV-related liver cirrhosis.
Results
In the development population, PTEN rs1903860 C allele, rs1903858 G allele, and rs2299941 G allele were associated with a low risk of HCC. The haplotype A-T-A-A-A was associated with an increased risk of HCC (recessive model; odds ratio=2.277, 95% confidence interval [CI] =1.144-4.532, P=0.019). In the validation population, PTEN rs2299941 G allele was the only significant protective genetic polymorphism related to HCC development after adjustment for age and sex (hazard ratio=0.582, 95% CI =0.353-0.962, P=0.035).
Conclusions
These findings suggest that genetic polymorphisms in PTEN may affect HCC development in patients with chronic HBV infection.

Citations

Citations to this article as recorded by

Association of genetic variations in phosphatase and tensin homolog (PTEN) gene with polycystic ovary syndrome in South Indian women: a case control study
Swapna Siddamalla, Suresh Govatati, Veena Kunjumol Venu, Nagendram Erram, Mamata Deenadayal, Sisinthy Shivaji, Manjula Bhanoori
Archives of Gynecology and Obstetrics.2020; 302(4): 1033. CrossRef

Case Reports

A Case of Hepatocellular Carcinoma with Bile Duct Invasion: Seung Min Bang, Hye Won Chung, Jae Youn Cheong, Chung Ryul Lee, Kun Hoon Song, Kwang Hyub Han, Chae Yoon Cheon, Young Myoung Moon, Sung Il Park, Do Yun Lee, Jong Tae Lee; Journal of the Korean Liver Cancer Study Group. 2001;1(1):85-88. Published online June 30, 2001

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Abstract PDF: A 52 year-old female patient with liver cirrhosis admitted due to icteric skin color for 3 weeks. Four months ago, she had been diagnosed as hepatocellular carcinoma(HCC), and treated with transarterial chemoembolization(TACE) at another hospital. Physical findings revealed that she had icteric sclera without ascites or palpable hepatosplenomegaly. Total bilirubin was 6.0mg/dL, ALT/AST was 117/111 IU/L. Computed tomography showed 3cm sized nodular mass involving left lateral segment of the liver and left intrahepatic bile duct. Endoscopic retrograde cholangiopancreatography(ERCP) revealed filling defect of left intrahepaitc duct and common hepatic duct, suggesting left intrahepatic duct and common hepatic duct invasion of HCC. After endoscopic retrograde biliary drainage(ERBD) with stent insertion, total bilirubin was decreased and clinical symptoms were improved. She was treated with TACE using adriamycin after ERBD. Thereafter, she was prescribed oral 5-fluorouracil and treated with external radiotherapy(4,500cGy). Five months later after the treatment, CT scan showed decrease in tumor size, and jaundice was improved as well.

A Case of Hepatocellular Carcinoma with Dramatic Therapeutic Response in Stage Ⅳa (T4N0M0): Hye Won Chung, Jae Youn Cheong, Kun Hoon Song, Kwang Hyub Han, Young Myoung Moon, Byoung Ro Kim, Jin Sil Seong, Myoung Jin Kim, Do Yun Lee, Young Nyun Park; Journal of the Korean Liver Cancer Study Group. 2001;1(1):89-92. Published online June 30, 2001

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Abstract PDF: A 52 year-old-female patient was admitted due to right upper quadrant abdominal pain and right shoulder pain for 1 month. She had no history of previous medical problem before admission. At admission, physical findings revealed that she had 2 FB palpable hepatomegaly and others were not remarkable. Laboratory findings revealed that HBsAg and HBeAG were positive enhanced at arterial phase involving entire right lobe and S4, and thrombus at main portal vein. Clinically she was diagnosed advanced hepatocellular carcinoma(HCC) and TNM stage was T4N0M0, stage Ⅳa. She was treated with transarterial chemoembolization(TACE) for 2 cycles and radiation therapy. After TACE and radiation therapy, the tumor size decreased and the main portal vein thrombus was disappeared. Then, she underwent extended right lobectomy of the liver. Pathology of operative specimen revealed well-encapsulated HCC at Edmonsons grade Ⅱ, near total necrosis. Normal liver tissue showed sinusoidal congestion, mild periportal fibrosis, and veno-occlusive disease. Two years after the operation, there had been no sign of recurrence and follow-up CT scan showed sign of recurrence at S2. He underwent percutaneous Holmium injection 3 times and TACE 4 times, and so far he survived for 6 years and 10 months. He is currently under observation at out patient department.

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