71. 依據 IMbrave050 Phase III clinical trial，下列何者為 High Risk features？
(1) Surgical resection: 3 tumors, the largest one 4.5cm, no vascular invasion,
Grade 2 tumor differentiation
(2) Radiofrequency ablation (RFA): Single tumor, 2.5cm
(3) Surgical resection: single tumor, 4cm, no vascular invasion, Grade 3 tumor
differentiation
(4) Surgical resection: single tumor, 6cm, no vascular invasion, Grade 2 tumor
differentiation
(A) (3)＋(4)
(B) (1)＋(3)
(C) (1)＋(4)
(D) (1)＋(2)＋(3)＋(4)

(E) (2)＋(3)＋(4)

67. 關於中期肝癌 TACE unsuitable 的範圍，2020 APPLE Expert Consensus Statement 與 2023 AASLD Practice Guidance 比較，其中包括下列何種共同項目？(1) ＞ 50% liver involvement(2) Infiltrative type(3) Bilobar extensive HCC(4) Extranodular growth type HCC(5) Poorly differentiated HCC(A) (2)＋(3)(B) (1)＋(2)＋(3)(C) (2)＋(3)＋(4)＋(5)(D) (2)＋(3)＋(5)(E) (1)＋(2)＋(3)＋(4)＋(5)

68. 依據 2023 AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma，下列何者敘述正確？(1) AASLD advises against the combination of systemic therapy withtransarterial therapies for BCLC Stage B HCC outside of a clinical trial setting(2) Patients with BCLC Stage B HCC should be treated with transarterialchemoembolization(3) AASLD advises radioembolization as an alternative therapy tochemoembolization in patients with BCLC Stage B HCC(4) Patients with Child-Turcotte-Pugh class C cirrhosis should be enrolled insurveillance programs(A) (3)＋(4)(B) (1)＋(2)(C) (3)(D) (1)＋(2)＋(3)(E) (1)＋(2)＋(3)＋(4)

69. 依據 2023 AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma，下列何者敘述正確？(1) AASLD does not advise use of statins, aspirin, and metformin solely toreduce HCC risk(2) AASLD recommends against routine use of HCC surveillance in patientswith NAFLD who have advanced fibrosis but without cirrhosis(3) AASLD advises repeat short-interval ultrasound and AFP in approximately3-6 months for patients with a ＜1 cm lesion on abdominal ultrasound(4) In patients with an LI-RADS-4 observation, AASLD advises repeatcross-sectional imaging in 3–6 months(A) (3)＋(4)(B) (1)＋(2)(C) (3)(D) (1)＋(2)＋(3)(E) (1)＋(2)＋(3)＋(4)

70. 依據 2023 AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma，下列何者敘述正確？(1) Patients with HCC beyond BCLC Stage 0 should undergo non-contrast CTof the chest to evaluate for metastatic disease(2) AASLD advises use of the BCLC system(3) Routine postoperative surveillance should be performed to detectrecurrence using contrast-enhanced multiphasic CT or MRI every 3–6months for all patients with HCC following liver resection(4) AASLD recommends against routine use of HCC surveillance in patientswith HCV infection post-SVR with advanced fibrosis but without cirrhosis(A) (3)＋(4)(B) (1)＋(2)(C) (3)(D) (1)＋(2)＋(3)(E) (1)＋(2)＋(3)＋(4)

72. 關於 HCC systemic therapy，依據 phase 3 clinical trials 的結果，下列敘述何者正確？(1) Atezolizumab + Bevacizumab 在一線 systemic therapy，objective responserate (ORR) ＞30%(2) Himalaya trial 受試者，viral HCC 比例＞70%(3) Tremelimumab (300 mg, one dose) plus durvalumab (1500 mg every 4weeks; STRIDE)的 ORR 為 25%(4) Median progression-free survival (PFS)，lenvatinib 不亞於 Atezolizumab +Bevacizumab(A) (1)(B) (1)＋(2)＋(4)(C) (1)＋(3)＋(4)(D) (1)＋(2)＋(3)＋(4)(E) (1)＋(4)

73. 依據 2023 AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma，下列何者敘述正確？(1) Patients with advanced HCC who have Child-Turcotte-Pugh A cirrhosisshould be offered atezolizumab plus bevacizumab or durvalumab plustremelimumab as preferred first-line therapy options(2) Patients with recent GI bleeding within 6 months and those with high-riskstigmata for bleeding on EGD should have varices adequately treated priorto atezolizumab plus bevacizumab initiation, or these patients may beconsidered for durvalumab plus tremelimumab(3) AASLD advises sorafenib or lenvatinib as preferred agents after first-linedurvalumab plus tremelimumab if patients are not eligible for clinical trials(4) Well-selected patients with Child-Turcotte-Pugh B cirrhosis may be offeredsorafenib, lenvatinib, or single-agent anti-PD1 or anti-PDL1 ICI therapy(A) (3)＋(4)(B) (1)＋(2)＋(4)(C) (3)(D) (1)＋(2)＋(3)(E) (1)＋(2)＋(3)＋(4)

74. 關於 Liver Imaging Reporting and Data System (LI-RADS) system，下列敘述何者錯誤？(1) AASLD advises multidisciplinary discussion to determine optimal follow-upfor patients with LI-RADS -3 observations(2) Biopsy should be performed for patients with LR-M observations(3) LI-RADS -5 lesions have a 95%–99% probability of being HCC(4) LI-RADS -3 observations have a ∼30% probability of HCC(5) AASLD advises continued surveillance with repeat CT or MRI in 3–6 monthsfor LI-RAD-2 lesions(A) (1)(B) (2)(C) (1)＋(2)(D) (1)＋(4)＋(5)(E) (1)＋(5)

75. 關於 HCC surveillance test 用於 early HCC detection，下列何者正確？(1) Ultrasound + AFP: sensitivity 約 61%，specificity 約 92%(2) AASLD recommends HCC surveillance using a combination of liverultrasound and AFP(3) GALAD: sensitivity 約 54-72%，specificity 約 90%(4) AFP-L3%: sensitivity 約 50%，specificity 約 80%(5) PIKVA-II: sensitivity 約 40%，specificity 約 81%(A) (1)＋(2)＋(3)(B) (1)＋(2)＋(3)＋(5)(C) (1)＋(2)＋(3)＋(4)(D) (1)＋(2)(E) (1)＋(2)＋(3)＋(4)＋(5)

76. 關於 HCC systemic therapy 的敘述下列何者正確？(1) Systemic chemotherapy with doxorubicin or FOLFOX did not demonstratesurvival benefits(2) Lenvatinib targets VEGFR1-3; fibroblast growth factor receptor (FGFR1-4);platelet-derived growth factor receptor α, RET, and KIT(3) Cabozantinib is a MET, VEGFR2 and RET inhibitor approved for thyroid,renal cancer and HCC(4) Ramucirumab is a monoclonal antibody targeting VEGFR 2(5) Atezolizumab plus cabozantinib showed a superiority to sorafenib in median progression-free survival (PFS)(A) (1)＋(2)(B) (1)＋(2)＋(3)(C) (2)＋(3)＋(4)(D) (1)＋(2)＋(3)＋(5)(E) (1)＋(2)＋(3)＋(4)＋(5)

77. 依據 BCLC 2022 update，下列何者正確？(1) For solitary HCC, the presence of CSPH (defined by a hepatic venouspressure gradient [HVPG] ＞ 10 mmHg) is the key consideration to decidetreatment option(2) BCLC A is defined as solitary HCC irrespective of size or as a multifocalHCC up to 3 nodules (none of them ＞ 3 cm), without macrovascular invasion, extrahepatic spread or cancer-related symptoms(3) The 2022 version of the BCLC staging system does not recommendresection for multinodular HCC within Milan criteria(4) MW (microwave) achieves more extensive tumour necrosis than RF(radiofrequency) and is potentially the best option for those patients withHCC ＞ 4 cm(A) (1)(B) (1)＋(2)(C) (2)＋(3)(D) (1)＋(2)＋(3)(E) (1)＋(2)＋(3)＋(4)