2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma

Park, Joong-Won; Lee, June Sung; Suh, Kyung‐Suk; Chung, Jin Wook; Seong, Jinsil; Kim, Do Young; Kim, Ji Hoon; Kim, Hyeong Jun; Kim, Hwi Young; Park, Soo Young; Shim, Joo Hyeon; Lee, Jeong Hoon; Lim, Young‐Suk; Lim, Ho Yeong; Jang, Jeong Won; Jang, Jae Young; Jeon, Dae Won; Ko, Yang Seok; Kim, Kyung Sik; Kim, Joo Young; Kim, Seong Hoon; Kim, Jong Man; Yun, Yeong Cheol; Jeong, Dong Hwan; Cho, Jai Young; Lee, Kyung-Hun; Kim, Kyeong Min; Kim, So Yeon; Kim, Young Hwan; Lee, In Joon; Lee, Jeong Min; Lim, Hyeon Cheol; Cho, Sung Ki; Cheon, Ho Jong; Choi, Jun Il; Kay, Chul Seung; Kim, Misook; Kim, Tae Hyun; Park, Hee Chul; Bae, S. H.; Yoon, Sang Min; Yoon, Won Sup; Jang, Won Il; Klca, Korean Liver Canc Assoc; Ncc, Natl Canc Ctr

doi:10.3348/kjr.2015.16.3.465

Cited by 162 publications

(73 citation statements)

References 498 publications

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“…Surgical resection is the best management option, in patients with hepatocellular carcinoma (HCC), provided that the remnant liver function is adequate. 1 2 However, intrahepatic recurrence is a major cause of prognosis compromise in HCC, even after liver transplantation. 3 4 Hence, extensive studies have been performed to identify the risk factors that predict HCC recurrence.…”

Section: Introductionmentioning

confidence: 99%

A comparison of the risk factors of intrahepatic recurrence, early recurrencen, and multiple recurrences after resection for single nodular hepatocellular carcinoma

Shin

Lee

et al. 2015

Korean J Hepatobiliary Pancreat Surg

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Backgrounds/AimsIntrahepatic recurrence is one of the most important causes of compromised prognosis after surgical resection of hepatocellular carcinoma (HCC). This retrospective study was designed to identify and compare the risks of recurrence, early recurrence and multiple recurrences in a single patient population.MethodsA series of 92 consecutive patients, who received resection for single nodular HCC at our institute from January 2007 to December 2013, were enrolled in this study. The patients were divided into recurrent and non-recurrent groups; the recurrent group was further divided into subgroups by applying two criteria: early and late recurrence (with a cutoff of 18 months), and single and multiple (≥2) recurrence. The potential risk factors were compared using univariate and multivariate analyses. The subgroup analysis was performed to determine the effects of different cut-off values on the analysis.Results41 recurrences (44.6%) occurred during a mean follow-up of 42.4 months. The Child-Pugh score, and the portal vein invasion were found to be independent risk factors of recurrence, but differentiation was the only independent risk factor of early recurrence. The serum alpha-fetoprotein, tumor size, tumor necrosis, and hemorrhage were found to be the risk factors of multiple recurrences according to the univariate analysis, but lacked significance according to the multivariate analysis. When the cutoffs for early and multiple recurrences were changed to ≤10 months and >3 nodules, respectively, different risk factors were identified.ConclusionsOur results implicated that different factors can predict the recurrence, timing, and multiplicity of an HCC recurrence. Further studies should be conducted to prove the complex relationships between tumor burden, invasiveness, and underlying liver cirrhosis for initial tumors, and the timing and multiplicity of recurrent HCC.

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Section: Introductionmentioning

confidence: 99%

A comparison of the risk factors of intrahepatic recurrence, early recurrencen, and multiple recurrences after resection for single nodular hepatocellular carcinoma

Shin

Lee

et al. 2015

Korean J Hepatobiliary Pancreat Surg

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“…In 2003, Korea first established its own practice guidelines proposed by the Korean Liver Cancer Study Group (KLCSG) and the National Cancer Center (NCC). The newest version of the KLCSG-NCC Korea practice guidelines of 2014 includes modification of the noninvasive HCC diagnostic criteria ( 24 25 ), incorporating utilization of hepatocyte-specific contrast-enhanced MRI and diagnosis of subcentimeter HCC. These guidelines are based on results of many recent studies that show that the potential of hepatobiliary contrast agents in detection of small HCCs (< 2 cm), and differentiating HCCs from benign cirrhotic nodules ( 17 26 27 28 29 30 31 ).…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Diagnosis of Hepatocellular Carcinoma: Elaboration on Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guidelines Compared with Other Guidelines and Remaining Issues

2016

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Hepatocellular carcinoma (HCC) can be diagnosed based on characteristic findings of arterial-phase enhancement and portal/delayed "washout" in cirrhotic patients. Several countries and major academic societies have proposed varying specific diagnostic criteria for HCC, largely reflecting the variable HCC prevalence in different regions and ethnic groups, as well as different practice patterns. In 2014, a new version of Korean practice guidelines for management of HCC was released by the Korean Liver Cancer Study Group (KLCSG) and the National Cancer Center (NCC). According to the KLCSG-NCC Korea practice guidelines, if the typical hallmark of HCC (i.e., hypervascularity in the arterial phase with washout in the portal or 3 min-delayed phases) is identified in a nodule ≥ 1 cm in diameter on either dynamic CT, dynamic MRI, or MRI using hepatocyte-specific contrast agent in high-risk groups, a diagnosis of HCC is established. In addition, the KLCSG-NCC Korea practice guidelines provide criteria to diagnose HCC for subcentimeter hepatic nodules according to imaging findings and tumor marker, which has not been addressed in other guidelines such as Association for the Study of Liver Diseases and European Association for the Study of the Liver. In this review, we briefly review the new HCC diagnostic criteria endorsed by the 2014 KLCSG-NCC Korea practice guidelines, in comparison with other recent guidelines; we furthermore address several remaining issues in noninvasive diagnosis of HCC, including prerequisite of sonographic demonstration of nodules, discrepancy between transitional phase and delayed phase, and implementation of ancillary features for HCC diagnosis.

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“…In a study involving a group of patients with liver cancer classified according to the Japanese staging systems for HCC (3 rd edition) based on preoperative image findings, the presence of bile duct invasion upon preoperative imaging increased the T classification by 1 grade. 19 20 In early stage HCC, if bile duct invasion does not accompany microvascular invasion, it can result in undetected or hidden microvascular invasion. Among 3 early stage HCC patients with bile duct invasion, only 1 patient (T-stage 2) displayed concurrent microvascular invasion.…”

Section: Discussionmentioning

confidence: 99%

Bile duct invasion can be an independent prognostic factor in early stage hepatocellular carcinoma

Jang

Lee

Kim

et al. 2015

Korean J Hepatobiliary Pancreat Surg

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Backgrounds/AimsIn hepatocellular carcinoma (HCC), bile duct invasion occurs far more rarely than vascular invasion and is not well characterized. In addition, the pathologic finding of bile duct invasion is not considered an independent prognostic factor for HCC following surgery. In this study, we determined the characteristics of HCC with bile duct invasion, and assessed the clinical significance of bile duct invasion.MethodsWe retrospectively reviewed the medical records of 363 patients who underwent hepatic resection for HCC at Seoul National University Hospital (SNUH) from January 2009 to December 2011. Preoperative, operative, and pathological data were collected. The risk factors for recurrence and survival were analyzed. Subsequently, the patients were divided into 2 groups according to disease stage (American Joint Committee on Cancer/International Union Against Cancer 7th edition): early stage (T1 and 2) and advanced stage (T3 and 4) group; and risk factors in the sub-groups were analyzed.ResultsAmong 363 patients, 13 showed bile duct invasion on pathology. Patients with bile duct invasion had higher preoperative total bilirubin levels, greater microvascular invasion, and a higher death rate than those without bile duct invasion. In multivariate analysis, bile duct invasion was not an independent prognostic factor for survival for the entire cohort, but, was an independent prognostic factor for early stage.ConclusionsBile duct invasion accompanied microvascular invasion in most cases, and could be used as an independent prognostic factor for survival especially in early stage HCC (T1 and T2).

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2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma

Cited by 162 publications

References 498 publications

A comparison of the risk factors of intrahepatic recurrence, early recurrencen, and multiple recurrences after resection for single nodular hepatocellular carcinoma

A comparison of the risk factors of intrahepatic recurrence, early recurrencen, and multiple recurrences after resection for single nodular hepatocellular carcinoma

Noninvasive Diagnosis of Hepatocellular Carcinoma: Elaboration on Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guidelines Compared with Other Guidelines and Remaining Issues

Bile duct invasion can be an independent prognostic factor in early stage hepatocellular carcinoma

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