Journal of Liver Cancer

Recommendation and Guideline

Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association: Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi; J Liver Cancer. 2024;24(2):131-144. Published online August 30, 2024; DOI: https://doi.org/10.17998/jlc.2024.08.04

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Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the firstline treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and posttreatment management of patients.

Citations

Citations to this article as recorded by

Taiwan Academy of Tumor Ablation (TATA) consensus on hepatocellular carcinoma ablation
Ching-Wei Chang, Ming-Shun Wu, Wei-Yu Kao, Ming-Feng Chiang, Shih-Jer Hsu, Shen-Yung Wang, Chao-Hung Hung, Chih Horng Wu, San-Chi Chen, Yu-Ming Cheng, I-Cheng Lee, Yi-Chung Hsieh, Wei-Ting Chen, Chen-Chun Lin, Po-Chin Liang, Jen-I. Hwang, Shi-Ming Lin, Ka
Hepatology International.2026; 20(2): 240. CrossRef
Improved Detection of Small (<2 cm) Hepatocellular Carcinoma via Deep Learning-Based Synthetic CT Hepatic Arteriography: A Multi-Center External Validation Study
Jung Won Kwak, Sung Bum Cho, Ki Choon Sim, Jeong Woo Kim, In Young Choi, Yongwon Cho
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Med-X.2026;[Epub] CrossRef
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Maria F. F. Viana, Arthur A. Braga, Lucas B. Carvalho, Danilo C. M. S. Vasconcellos, Bianca C. M. R. Alexandrino, Felipe J. F. Coimbra
Journal of Liver Cancer.2026; 26(1): 157. CrossRef
Microwave ablation vs. liver resection for patients with hepatocellular carcinomas
Hyundam Gu, Yeonjoo Seo, Dong Jin Chung, Kwang Yeol Paik, Seung Kew Yoon, Jihye Lim
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Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea
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Frontiers in Surgery.2025;[Epub] CrossRef
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Case Reports

A case report of a patient presented with skin ulcer after treatment of lenvatinib: Serin Cha, Dong Woo Kim, Jung Wan Choe, Tae Hyung Kim, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Ja Seol Koo, Young Kul Jung, Hyung Joon Yim; J Liver Cancer. 2021;21(2):194-198. Published online September 30, 2021; DOI: https://doi.org/10.17998/jlc.2021.09.20

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7 Citations

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A 60-year-old man diagnosed with unresectable hepatocellular carcinoma (HCC) presented to the hospital with pain in the perineal region. He had been taking lenvatinib every day for 2 months after he was diagnosed with HCC with metastases to the lymph node, small bowel mesentery, and retroperitoneal space. Enhanced abdominal computed tomography revealed mild elevation in intensity in the perineal subcutaneous tissue with subcutaneous emphysema. The patient was diagnosed with Common Terminology Criteria for Adverse Events grade 3, skin ulceration of stage IV with full-thickness skin loss and tissue necrosis in the muscular layer. The patient was taken off the medication with prescription of antibiotics, and after 3 weeks, the skin has fully recovered. This is the first report of an HCC patient who presented with a skin ulceration of stage IV after lenvatinib treatment. We recommend stopping the medication immediately and changing to alternative treatments with appropriate supportive care.

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Soo Hyun Jeon, Woo Jin Lee, Chong Hyun Won, Sung Eun Chang, Mi Woo Lee, Joon Min Jung
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A Case of Simultaneous Resection of Recurrent Combined Hepatocellular Cholangiocarcinoma and Hypovascular Hepatocellular Carcinoma: Tae Hyung Kim, Soon Ho Um, Sang Jung Park, Seung Woon Park, Han Ah Lee, Yeon Seok Seo, Young Dong Yu, Dong-Sik Kim, Joo Young Kim; J Liver Cancer. 2017;17(1):94-99. Published online March 31, 2017; DOI: https://doi.org/10.17998/jlc.17.1.94

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Abstract PDF: Liver cancer is more complex to treat compared to cancers in other organs, since liver function should be considered. In addition, only a few patients can be applied curative treatment due to advanced stage at diagnosis. Therefore, early stage detection is important and has been increased through screening and surveillance programs using image modalities recently. However, it is still difficult to diagnose small or hypovascular hepatocellular carcinoma (HCC) even using advanced image modalties. In particular, hypovascular HCCs do not show arterial contrast enhancement which is a typical finding of HCC on computed tomography (CT) and magnetic resonance imaging (MRI). Those also account for a considerable portion of early HCC. We present 54 yearsold man who had recurrent hypervascular and hypovascular nodules on three phase CT and gadoxetic acid-enhanced MRI. The nodules were removed by surgical resection and confirmed as combined hepatocellular-cholangiocarcinoma and well differentiated HCC respectively.

A Case of Management for Hepatocellular Carcinoma with Lung Metastasis: Han Jo Jeon, Tae Hyung Kim, Soon Ho Um, Yeon Seok Seo, Hyun Seo Kim, Ki Joon Lim, Seung Woon Park, Han Ah Lee, Dong-Sik Kim; J Liver Cancer. 2016;16(2):129-133. Published online September 30, 2016; DOI: https://doi.org/10.17998/jlc.16.2.129

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Abstract PDF: Liver cancer is the 2nd most common cause of cancer related death in Korea. Especially, patients who present extrahepatic spread of hepatocellular carcinoma (HCC) have a shorter life expectancy (50% survival at 1 year and less than 4 months of median overall survival). Molecular target agent like sorafenib was usually mentioned as a treatment for them, but that was still not firmly established. We present a 75 year-old who had expanding nodular type of HCC. The mass was removed by resection and radiofrequency ablation. However, lung metastasis were revealed shortly after surgery. That lesions were treated with lenvatinib and systemic chemotherapy.

Clinical Outcome of Completely Ablated Hepatocellular Carcinoma in Single Session in Patients with Decompensated Liver Cirrhosis: Min Seon Park, Soon Ho Um, Ho Sang Ryu, Yeon Seok Seo, Sun Young Yim, Chang Ho Jung, Tae Hyung Kim, Dae Hoe Gu; J Liver Cancer. 2014;14(2):139-142. Published online September 30, 2014; DOI: https://doi.org/10.17998/jlc.14.2.139

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Abstract PDF: Most cases of hepatocellular carcinoma (HCC) occur in the Asia-Pacific region and in patients with underlying hepatitis B and C viral infection. Although surgical resection is the gold standard for treatment of HCC, only a few patients are surgical candidates because of their lack of hepatic reserve. Liver transplantation, which eradicates HCC and replaces damaged noncancerous hepatic parenchyma, is regarded as the best treatment for HCC in patients with decompensated liver cirrhosis. However, the shortage of donors limit its widespread use. Furthermore, the long waiting time for liver transplantation allow for tumor progression and reduce patient survival. Given this long wait, there is a reasonable clinical need in the meantime for minimally invasive methods to avoid progression of HCC in patients with decompensated liver cirrhosis. We herein offer our experiences of therapeutic efficacy and complications of the procedure and the changes in liver function before and after TACE and radiofrequency ablation in patients with HCC and decompensated liver cirrhosis, defined as a Child-Pugh-Turcotte score above 7. (J Liver Cancer 2014;14:139-142)

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