73. 依據 BCLC 2022 update，BCLC B 下列何者錯誤？
(1) The treatment options include LT, TACE and systemic therapy.
(2) AFP higher than 1,000 ng/dl is currently applied as an exclusion criterion of
LT in BCLC B HCC.
(3) BCLC B patients with an AFP ＞1,000 ng/ml who experienced biochemical
response (at least a decrease to less than 500 ng/ml) to locoregional therapies have post-LT outcomes inferior to those reported for patients within Milan criteria.
(4) For patients to be candidates for TACE, increased bilirubin beyond 2 mg or
slight fluid retention requiring diuretic treatment are suboptimal survival after
TACE.
(A) (3)
(B) (2)
(C) (2)＋(3)
(D) (3)＋(4)

(E) (1)＋(3)

69. 關於 Liver Imaging Reporting and Data System (LI-RADS) system，下列敘述何者錯誤？(1) A LI-RADS 2 lesion has an average probability of HCC of 33%.(2) A LI-RADS 4 lesion has an average probability of HCC of 80%.(3) For LI-RADS M lesions, 42% had HCC and 57% had another tumor besides HCC.(4) 6%-15% of LI-RADS 3 lesions followed prospectively were diagnosed as HCC or other malignancy by 24 months.(5) Threshold growth (= size increase of a mass by ≥ 50% in ≤ 6 months) is a criterion for LI-RADS 4.(A) (1)＋(5)(B) (1)(C) (1)＋(4)(D) (1)＋(3)＋(5)(E) (1)＋(3)

70. 依據 2018 AASLD practice guidance，關於 HCC 診斷，下列敘述何者正確？(1) Diagnosis of HCC can be made by imaging in patients without cirrhosis, ifenhancement and washout are present.(2) Histological markers GPC3, HSP70, and GS can be assessed to distinguishhigh-grade dysplasia from HCC on histology if HCC cannot be diagnosed based on routine histology.(3) A lesion of ＞1 cm on ultrasound (US) should trigger recall procedures for the diagnosis of HCC.(4) If using AFP with US, then an AFP ＞20 ng/mL should trigger recall procedures for diagnosis of HCC.(A) (1)(B) (2)＋(3)(C) (1)＋(4)(D) (2)＋(3)＋(4)(E) (1)＋(2)＋(3)＋(4)

71. GALAD model 可以運用在 HCC 診斷，下列何者不屬於 GALAD model 的組成項目？(A) Gender(B) AFP and AFP-L3%(C) DCP (protein induced by vitamin K absence/antagonist-II)(D) Age(E) Alcohol

72. 依據 BCLC 2022 update，下列何者錯誤？(1) For solitary HCC, the presence of CSPH (defined by a hepatic venous pressure gradient [HVPG] ＞10 mmHg) is the key consideration to decide treatment option.(2) For BCLC A, multifocal disease still within the Milan criteria is better served by liver transplantation (LT).(3) For BCLC 0, LT is not considered.(4) BCLC A is defined as solitary HCC irrespective of size or as a multifocal HCC up to 3 nodules (none of them ＞3 cm), without macrovascular invasion, extrahepatic spread or cancer-related symptoms.(A) (3)(B) (2)(C) (2)＋(3)(D) (3)＋(4)(E) (2)＋(5)

74. 依據 2018 HCC EASL Clinical Practice Guidelines，TACE 的敘述下列何者正確？(1) Drug-eluting beads has shown similar benefit to conventional TACE.(2) Segmental or sub-segmental portal vein tumor invasions are absolute contraindications for TACE.(3) There is insufficient evidence to recommend scores that better select BCLC-B candidates for first TACE or for subsequent sessions.(4) Patients with biliary-enteric anastomosis or biliary stent are at higher risk ofhepatic abscess by TACE.(A) (1)＋(3)＋(4)(B) (1)＋(2)＋(3)(C) (2)＋(3)＋(4)(D) (1)＋(2)＋(3)＋(4)(E) (1)＋(4)

75. 關於 HCC systemic therapy 的敘述下列何者正確？(1) Systemic chemotherapy with doxorubicin or FOLFOX did not demonstrate survival 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 1-3.(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)

76. 依據 2018 AASLD Guidelines for the Treatment of Hepatocellular Carcinoma，下列何者敘述正確？(1) The AASLD suggests surveillance using ultrasound (US) with or withoutalpha-fetoprotein (AFP) every 6 months.(2) The AASLD suggests observation with follow-up imaging over treatment for patients with cirrhosis awaiting liver transplantation who develop T1 HCC.(3) The AASLD suggests that adults with Child-Pugh class A cirrhosis and resectable T1 or T2 HCC undergo resection over radiofrequency ablation.(4) The AASLD suggests bridging to transplant in patients listed for liver transplantation within OPTN T2 (Milan) criteria to decrease progression of disease and subsequent dropout from the waiting list.(A) (2)＋(3)＋(4)(B) (3)＋(4)(C) (3)(D) (1)＋(2)(E) (1)＋(2)＋(3)＋(4)

77. 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 response rate (ORR) ＞30%。(2) Himalaya trial 受試者，non-viral HCC 比例＞40%。(3) Tremelimumab (300 mg, one dose) plus durvalumab (1500 mg every 4 weeks; STRIDE)的 median progression-free survival (PFS)超越 sorafenib。(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)

78. 關於 HCC radioembolization (TARE) or Selective internal radiation therapy(SIRT)的敘述，下列何者正確？(1) “BCLC 2022 update” suggests that radioembolization is only for single lesion ≤8 cm.(2) Current data demonstrate benefit of TARE compared to sorafenib in patients with advanced HCC.(3) Compared to TACE, SIRT provides significantly longer time to progression and better tumor control, but it does not provide longer survival.(4) SIRT might prepare or select patients for surgery as it induces substantial hypertrophy in the liver lobe contralateral to the target.(A) (3)＋(4)(B) (1)＋(2)＋(3)(C) (2)＋(3)＋(4)(D) (1)＋(2)＋(3)＋(4)(E) (1)＋(3)＋(4)

79. 關於 Cholangiocarconoma(CCA)的敘述，下列何者正確？(1) Adjuvant chemotherapy with capecitabine for 6 months after surgical resection with curative intent is recommended for intrahepatic CCA, S-1 is an alternative option.(2) Liver transplantation is a potentially curative option for intrahepatic and perihilar CCA.(3) FOLFOX (folinic acid, fluorouracil and oxaliplatin) can be recommended as second- line standard of care chemotherapy.(4) Durvalumab plus Gemcitabine and Cisplatin significantly improved overall survival (OS) versus Gemcitabine plus Cisplatin for advanced biliary tract cancer.(5) Cirrhosis is one of the risk factors of intrahepatic CCA.(A) (2)＋(4)(B) (1)＋(2)＋(3)＋(4)(C) (2)＋(3)＋(4)(D) (1)＋(2)＋(3)＋(4)＋(5)(E) (1)＋(2)＋(4)