Publications by authors named "Young Eun Chon"
Changes in antiviral treatment rate for hepatitis B virus before hepatocellular carcinoma diagnosis: a nationwide Korean study.
Eur J Gastroenterol Hepatol
October 2025
Background And Aims: Antiviral treatment (AVT) reduces hepatitis B virus (HBV) reactivation and hepatocsellular carcinoma (HCC) development; however, the impact of AVT timing - before versus after HCC diagnosis - on prognosis remains unclear. This study aimed to evaluate the current status, changes, and clinical outcomes of AVT before HCC diagnosis in Korea.
Methods: Data were extracted from the Korean National Health Insurance Service for patients newly diagnosed with HBV-related HCC from 2008 to 2018.
This survey aimed to collect expert opinions from multidisciplinary specialists involved in the management of hepatocellular carcinoma (HCC) in Korea regarding real-world criteria for systemic therapy indications. In response to discrepancies between national reimbursement policies and clinical decision-making, members of the Korean Liver Cancer Association and Korean Association for the Study of the Liver participated in a web-based survey from February 4 to 14, 2025. A total of 89 respondents, primarily experienced clinicians, provided their views on major clinical scenarios including infiltrative HCC, bilobar multifocal disease, huge tumors, vascular invasion, extrahepatic metastasis, and transarterial chemoembolization (TACE) refractoriness.
View Article and Find Full Text PDFClinical Course and Prognosis of Long-Term Survivors of Hepatocellular Carcinoma.
Aliment Pharmacol Ther
April 2025
Background And Aims: This study investigated the long-term prognosis and clinical course of patients who survived for more than 5 years after hepatocellular carcinoma (HCC) diagnosis.
Methods: This retrospective cohort study used data from the Korean National Health Insurance Service database. A total of 35,348 subjects newly diagnosed with HCC between January 2008 and December 2010 were followed up until December 2018.
Background And Aims: This study aims to develop and validate a machine learning (ML) model predicting hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients after the first 5 years of entecavir (ETV) or tenofovir (TFV) therapy.
Methods: CHB patients treated with ETV/TFV for > 5 years and not diagnosed with HCC during the first 5 years of therapy were selected from two hospitals. We used 36 variables, including baseline characteristics (age, sex, cirrhosis, and type of antiviral agent) and laboratory values (at baseline, at 5 years, and changes between 5 years) for model development.
Backgrounds/aims: This meta-analysis examined whether preoperative vibration-controlled transient elastography (VCTE) can predict postoperative complications and recurrence in patients undergoing hepatic resection for hepatocellular carcinoma (HCC).
Methods: A systematic literature search was conducted using Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases. Out of 431 individual studies, thirteen published between 2008 and 2022 were included.
Background/aims: Opinions differ regarding vibration-controlled transient elastography and magnetic resonance elastography (VCTE/MRE) cut-offs for diagnosing advanced fibrosis (AF) in patients with non-alcoholic fatty liver disease (NAFLD). We investigated the diagnostic performance and optimal cut-off values of VCTE and MRE for diagnosing AF.
Methods: Literature databases, including Medline, EMBASE, Cochrane Library, and KoreaMed, were used to identify relevant studies published up to June 13, 2023.
Article Synopsis
- The study evaluates the effectiveness of vibration-controlled transient elastography (VCTE) in diagnosing liver fibrosis in autoimmune liver diseases like primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC).
- A meta-analysis of 14 studies involving 1,098 patients showed that VCTE performs well for fibrosis staging, with strong area under the curve (sAUC) values for different stages of fibrosis across all three diseases.
- The findings suggest that VCTE is a reliable non-invasive tool for assessing and monitoring liver fibrosis in patients with autoimmune liver diseases.
Article Synopsis
- Despite advancements in hepatitis C therapy, hepatocellular carcinoma (HCC) can still occur after patients achieve sustained viral response (SVR), prompting a study on the predictive capabilities of vibration-controlled transient elastography (VCTE) and fibrosis 4-index (FIB-4) for HCC development post-SVR.
- The meta-analysis included 27 studies with a total of 169,911 patients, assessing the tests' performance in predicting HCC using pooled estimates of sensitivity, specificity, and area under the curve (AUC).
- The results indicated that both VCTE and FIB-4 have good predictive capabilities for HCC development after SVR, with optimal cut-off values identified for risk assessment, highlighting
Prevalence of clinically significant liver fibrosis in the general population: A systematic review and meta-analysis.
Clin Mol Hepatol
September 2024
Article Synopsis
- Researchers aimed to determine the prevalence of clinically significant liver fibrosis in the general population using noninvasive tests (NITs).
- They analyzed data from four major databases and included 45 studies, finding the prevalence rates of advanced liver fibrosis to be 2.3% and significant liver fibrosis to be 7.3%.
- The highest prevalence rates were observed in the American region, indicating a need for further research to identify at-risk individuals in the general population.
Article Synopsis
- - The Fibrosis-4 index (FIB-4) is a noninvasive test used to assess advanced liver fibrosis (AF) in patients with nonalcoholic fatty liver disease (NAFLD), though its effectiveness in those with type 2 diabetes mellitus (T2DM) is debated due to high AF rates in this group.
- - A meta-analysis of 12 studies involving 5,624 NAFLD patients with T2DM revealed that FIB-4 has moderate sensitivity and specificity, particularly showing better performance at high cutoffs (high specificity but lower sensitivity).
- - While FIB-4 can be useful for diagnosing AF, the current evidence is limited and varied, suggesting a need for more research to
Backgrounds/aims: Accurate diagnosis of significant liver fibrosis in patients with chronic hepatitis B (CHB) is crucial when determining whether to initiate antiviral treatment (AVT). We conduct a meta-analysis to assess the diagnostic performance of vibration-controlled transient elastography (VCTE) for significant liver fibrosis in AVT-naïve CHB patients with serum alanine transaminase (ALT) levels within 5-fold the upper limit of normal (ULN).
Methods: The Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases were searched to identify studies that compared the performance of VCTE and liver biopsy (reference standard) when diagnosing significant liver fibrosis (≥F2) in AVT-naïve CHB patients with ALT within 5-fold the ULN.
Backgrounds/aims: Liver stiffness measurement (LSM) using vibration-controlled transient elastography (VCTE) can assess fibrotic burden in chronic liver diseases. The systematic review and meta-analysis was conducted to determine whether LSM using VCTE can predict the risk of development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients.
Methods: A systematic literature search of the Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases (from January 2010 to June 2023) was conducted.
Background: It is unclear whether direct-acting antivirals (DAAs) treatment improves the disease burden in hepatitis C virus (HCV) infection. This study aimed to investigate the effect of DAA treatment on the reduction of disease burden in patients with HCV infection using individual participant data.
Methods: This nationwide multicentre retrospective cohort study recruited patients with HCV infection from 29 tertiary institutions in South Korea.
Article Synopsis
- - The study investigates the outcomes of second-line systemic treatments (sorafenib and lenvatinib) for advanced hepatocellular carcinoma (HCC) after patients experience disease progression on the recommended first-line therapy, atezolizumab plus bevacizumab (ATE+BEV).
- - Out of 126 patients analyzed, results showed that although the objective response rate was similar for both treatment groups, lenvatinib significantly outperformed sorafenib in disease control rates and progression-free survival (PFS).
- - Overall survival (OS) was similar between the two treatments, indicating that while lenvatinib may improve disease management post-ATE+BEV, further research is needed for better treatment strategies.
Liver transplantation is a highly complex and challenging field of clinical practice. Although it was originally developed in western countries, it has been further advanced in Asian countries through the use of living donor liver transplantation. This method of transplantation is the only available option in many countries in the Asia-Pacific region due to the lack of deceased organ donation.
View Article and Find Full Text PDFArticle Synopsis
- The study explores mortality rates and causes of death in patients with chronic hepatitis B (CHB) from two distinct cohorts in South Korea over a ten-year period.
- It found that while overall mortality was relatively low at 1.54 per 100 person-years, the majority of deaths in non-cirrhotic patients (70%) were due to non-liver-related causes, particularly extrahepatic malignancies.
- Notably, mortality due to hepatocellular carcinoma (HCC) showed a decline, but deaths from extrahepatic malignancies increased, highlighting a shift in the leading causes of death in CHB patients during the antiviral treatment era.
Guidelines vary on alpha-fetoprotein (AFP) testing for hepatocellular carcinoma (HCC) screening. This study aims to reassess AFP's role in HCC surveillance, utilizing a comprehensive, recent, nationwide cohort. Utilizing the National Health Claims Database from the Korean National Health Insurance Service, this research included data from 185,316 HCC patients registered between 2008 and 2018.
View Article and Find Full Text PDFImpact of anthropometric parameters on outcomes in Asians with metabolic dysfunction-associated fatty liver disease.
J Cachexia Sarcopenia Muscle
December 2023
Background: We examined the incidence and predictors of clinical outcomes in metabolic dysfunction-associated fatty liver disease (MAFLD), focusing on anthropometric parameters.
Methods: Adult patients with MAFLD were identified in nationwide databases and a hospital cohort. Primary endpoints were atherosclerotic cardiovascular disease (ASCVD) and advanced fibrosis.
Considering the lower risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients receiving long-term potent antiviral therapy, models predicting HCC after 5 years of therapy are needed. We conducted a multicenter retrospective cohort study to construct and validate a model predicting HCC after 5 years of entecavir (ETV) or tenofovir (TFV) therapy for CHB. The endpoint was HCC after 5 years of ETV/TFV therapy.
View Article and Find Full Text PDFArticle Synopsis
- Machine learning (ML) algorithms have been developed to enhance the predictive accuracy for hepatocellular carcinoma (HCC) risk among patients with chronic hepatitis B (CHB) receiving antiviral therapy (AVT).
- A study used a training cohort of 960 patients to create an ML model predicting HCC development within 5 years, which was subsequently validated with a separate group of 1937 patients.
- The new ML model outperformed existing risk prediction models, achieving a higher area under the receiver-operating characteristic curve (AUC) and demonstrating significant differences in HCC development among identified risk groups.
Background/aims: Regression of liver fibrosis during antiviral therapy in chronic hepatitis B (CHB) patients has been demonstrated, but data on the influence of long-term treatment with tenofovir disoproxil fumarate (TDF) on liver stiffness (LS) measured by transient elastography are scarce. We aimed to investigate the changes in LS values during the 144-week TDF therapy in treatment-naïve CHB patients.
Methods: This prospective observational study was conducted from April 2015 to July 2020 at CHA Bundang Medical Center.