Asian consensus workshop report: Expert consensus guideline for the management of intermediate and advanced hepatocellular carcinoma in Asia

Kwang Hyub Han, Masatochi Kudo, Sheng Long Ye, Jong Young Choi, Roonni Tung Ping Poon, Jinsil Seong, Joong Won Park, Takafumi Ichida, Jin Wook Chung, Pierce Chow, Ann Lii Cheng

Research output: Contribution to journalArticle

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Abstract

Hepatocellular carcinoma (HCC) is a highly prevalent disease in many Asian countries, accounting for 80% of victims worldwide. Screening programs improve the detection of early HCC and have a positive impact on survival, but the majority of HCC patients in Asia still present with advanced stage disease. The treatment outcomes of HCC are affected by multiple variables, including liver function, performance status of the patient, and tumor stage. Therefore, it is not easy to apply a multidisciplinary therapeutic approach for optimal management. At present, limited numbers of HCC patients are eligible for curative therapies such as surgery or ablation in Asia. Therefore, most patients are eligible for only palliative treatments. For optimal management, the treatment choice is guided by staging systems and treatment guidelines. Numerous staging systems have been proposed and treatment guidelines vary by region. According to the Barcelona Clinic Liver Cancer (BCLC) guideline based on evidence from randomized clinical trials, only transarterial chemoembolization (TACE) is recommended for intermediate stage HCC and sorafenib for advanced stage HCC. However, treatment guidelines from Asian countries have adopted several other therapeutic modalities such as a surgical approach, hepatic arterial infusion chemotherapy, external radiation, and their combinations based on clinical experiences for intermediate and advanced stage HCC. Although TACE is the main therapeutic modality in the intermediate stage, overall therapeutic outcomes depend on the tumor size. In the advanced stage, the prognosis depends on the tumor status, e.g. major vessel invasion or extrahepatic spread. Thus, a new staging system representing prognoses suitable for Asian HCC patients and a corresponding optimal treatment algorithm should be further investigated using evidence-based data, which will finally bring about an Asian consensus for the management of intermediate and advanced stage HCC.

Original languageEnglish
Pages (from-to)158-164
Number of pages7
JournalOncology
Volume81
Issue numberSUPPL. 1
DOIs
Publication statusPublished - 2011 Dec 1

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Consensus Development Conferences
Hepatocellular Carcinoma
Guidelines
Therapeutics
Neoplasms
Liver
Liver Neoplasms
Palliative Care
Randomized Controlled Trials

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Han, Kwang Hyub ; Kudo, Masatochi ; Ye, Sheng Long ; Choi, Jong Young ; Poon, Roonni Tung Ping ; Seong, Jinsil ; Park, Joong Won ; Ichida, Takafumi ; Chung, Jin Wook ; Chow, Pierce ; Cheng, Ann Lii. / Asian consensus workshop report : Expert consensus guideline for the management of intermediate and advanced hepatocellular carcinoma in Asia. In: Oncology. 2011 ; Vol. 81, No. SUPPL. 1. pp. 158-164.
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abstract = "Hepatocellular carcinoma (HCC) is a highly prevalent disease in many Asian countries, accounting for 80{\%} of victims worldwide. Screening programs improve the detection of early HCC and have a positive impact on survival, but the majority of HCC patients in Asia still present with advanced stage disease. The treatment outcomes of HCC are affected by multiple variables, including liver function, performance status of the patient, and tumor stage. Therefore, it is not easy to apply a multidisciplinary therapeutic approach for optimal management. At present, limited numbers of HCC patients are eligible for curative therapies such as surgery or ablation in Asia. Therefore, most patients are eligible for only palliative treatments. For optimal management, the treatment choice is guided by staging systems and treatment guidelines. Numerous staging systems have been proposed and treatment guidelines vary by region. According to the Barcelona Clinic Liver Cancer (BCLC) guideline based on evidence from randomized clinical trials, only transarterial chemoembolization (TACE) is recommended for intermediate stage HCC and sorafenib for advanced stage HCC. However, treatment guidelines from Asian countries have adopted several other therapeutic modalities such as a surgical approach, hepatic arterial infusion chemotherapy, external radiation, and their combinations based on clinical experiences for intermediate and advanced stage HCC. Although TACE is the main therapeutic modality in the intermediate stage, overall therapeutic outcomes depend on the tumor size. In the advanced stage, the prognosis depends on the tumor status, e.g. major vessel invasion or extrahepatic spread. Thus, a new staging system representing prognoses suitable for Asian HCC patients and a corresponding optimal treatment algorithm should be further investigated using evidence-based data, which will finally bring about an Asian consensus for the management of intermediate and advanced stage HCC.",
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Han, KH, Kudo, M, Ye, SL, Choi, JY, Poon, RTP, Seong, J, Park, JW, Ichida, T, Chung, JW, Chow, P & Cheng, AL 2011, 'Asian consensus workshop report: Expert consensus guideline for the management of intermediate and advanced hepatocellular carcinoma in Asia', Oncology, vol. 81, no. SUPPL. 1, pp. 158-164. https://doi.org/10.1159/000333280

Asian consensus workshop report : Expert consensus guideline for the management of intermediate and advanced hepatocellular carcinoma in Asia. / Han, Kwang Hyub; Kudo, Masatochi; Ye, Sheng Long; Choi, Jong Young; Poon, Roonni Tung Ping; Seong, Jinsil; Park, Joong Won; Ichida, Takafumi; Chung, Jin Wook; Chow, Pierce; Cheng, Ann Lii.

In: Oncology, Vol. 81, No. SUPPL. 1, 01.12.2011, p. 158-164.

Research output: Contribution to journalArticle

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AU - Han, Kwang Hyub

AU - Kudo, Masatochi

AU - Ye, Sheng Long

AU - Choi, Jong Young

AU - Poon, Roonni Tung Ping

AU - Seong, Jinsil

AU - Park, Joong Won

AU - Ichida, Takafumi

AU - Chung, Jin Wook

AU - Chow, Pierce

AU - Cheng, Ann Lii

PY - 2011/12/1

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N2 - Hepatocellular carcinoma (HCC) is a highly prevalent disease in many Asian countries, accounting for 80% of victims worldwide. Screening programs improve the detection of early HCC and have a positive impact on survival, but the majority of HCC patients in Asia still present with advanced stage disease. The treatment outcomes of HCC are affected by multiple variables, including liver function, performance status of the patient, and tumor stage. Therefore, it is not easy to apply a multidisciplinary therapeutic approach for optimal management. At present, limited numbers of HCC patients are eligible for curative therapies such as surgery or ablation in Asia. Therefore, most patients are eligible for only palliative treatments. For optimal management, the treatment choice is guided by staging systems and treatment guidelines. Numerous staging systems have been proposed and treatment guidelines vary by region. According to the Barcelona Clinic Liver Cancer (BCLC) guideline based on evidence from randomized clinical trials, only transarterial chemoembolization (TACE) is recommended for intermediate stage HCC and sorafenib for advanced stage HCC. However, treatment guidelines from Asian countries have adopted several other therapeutic modalities such as a surgical approach, hepatic arterial infusion chemotherapy, external radiation, and their combinations based on clinical experiences for intermediate and advanced stage HCC. Although TACE is the main therapeutic modality in the intermediate stage, overall therapeutic outcomes depend on the tumor size. In the advanced stage, the prognosis depends on the tumor status, e.g. major vessel invasion or extrahepatic spread. Thus, a new staging system representing prognoses suitable for Asian HCC patients and a corresponding optimal treatment algorithm should be further investigated using evidence-based data, which will finally bring about an Asian consensus for the management of intermediate and advanced stage HCC.

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