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Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Hong Kong perspective

Wai-Kay Seto|Man-Fung Yuen|Lung-Yi Mak|Rex Wan-Hin Hui|Tan-To Cheung|Victor Ho-Fun Lee
대한간학회 (The korean Association for the Study of the Liver)|2023.04|Clinical and Molecular Hepatology|제29권 제2호|pp. 217-229

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키워드

Hepatocellular carcinomaLiver transplantationHepatitis BImmunotherapyHepatectomy

초록

Hepatocellular carcinoma (HCC) is a major public health burden in Hong Kong, and chronic hepatitis B is the most common HCC etiology in our region. With the high case load, extensive local expertise on HCC has been accumulated. This article summarized local guidelines and real-life practice on HCC management in Hong Kong. For HCC surveillance, liver ultrasound and serum alpha-fetoprotein for periodic screening is recommended in viral hepatitis or cirrhotic patients, and this is adhered to in clinical practice. HCC diagnosis is not covered in local guidelines, yet our practice is in-line with regional guidelines, where diagnosis is usually achieved by cross-sectional imaging and without the need for histology. Our guidelines recommend using the Hong Kong Liver Cancer Staging for pre-treatment staging, yet we routinely use other widely-adopted systems such as the Barcelona Clinic Liver Cancer Staging and the Tumor-Node-Metastasis Staging as well. Our local guidelines have provided clear treatment algorithms for the whole range of HCC therapies, including resection, ablation, transplant, transarterial chemoembolization, transarterial radioembolization, stereotactic body radiation therapy, targeted therapy, and immunotherapy. Real-life treatment choices are largely in line with the guidelines, although treatment protocols are individualized, and availability of specific therapies can vary between centers. Overall, HCC guidelines in Hong Kong are tailored based on local expertise and our unique patient population. The guidelines are up-to-date and provide practical pathways to assist our routine practice. Regular updates of local guidelines are warranted to account for the rapidly evolving paradigm of HCC management.

Abstract

Hepatocellular carcinoma (HCC) is a major public health burden in Hong Kong, and chronic hepatitis B is the most common HCC etiology in our region. With the high case load, extensive local expertise on HCC has been accumulated. This article summarized local guidelines and real-life practice on HCC management in Hong Kong. For HCC surveillance, liver ultrasound and serum alpha-fetoprotein for periodic screening is recommended in viral hepatitis or cirrhotic patients, and this is adhered to in clinical practice. HCC diagnosis is not covered in local guidelines, yet our practice is in-line with regional guidelines, where diagnosis is usually achieved by cross-sectional imaging and without the need for histology. Our guidelines recommend using the Hong Kong Liver Cancer Staging for pre-treatment staging, yet we routinely use other widely-adopted systems such as the Barcelona Clinic Liver Cancer Staging and the Tumor-Node-Metastasis Staging as well. Our local guidelines have provided clear treatment algorithms for the whole range of HCC therapies, including resection, ablation, transplant, transarterial chemoembolization, transarterial radioembolization, stereotactic body radiation therapy, targeted therapy, and immunotherapy. Real-life treatment choices are largely in line with the guidelines, although treatment protocols are individualized, and availability of specific therapies can vary between centers. Overall, HCC guidelines in Hong Kong are tailored based on local expertise and our unique patient population. The guidelines are up-to-date and provide practical pathways to assist our routine practice. Regular updates of local guidelines are warranted to account for the rapidly evolving paradigm of HCC management.

참고문헌 (56)

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관련 논문AI추천

Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Taiwan perspectiveCheng-Maw Ho, Chih-Horng Wu, Chun-Jen Liu, Tsung-Hao Liu, Tung-Hung Su대한간학회 · Clinical and Molecular Hepatology2023 · 제29권 제2호Overview of Asian clinical practice guidelines for the management of hepatocellular carcinoma: An Asian perspective comparisonBo Hyun Kim, Joong-Won Park, Yuri Cho대한간학회 · Clinical and Molecular Hepatology2023 · 제29권 제2호Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Chinese perspectiveDiyang Xie, Jia Fan, Jian Zhou, Jieyi Shi, Qiang Gao대한간학회 · Clinical and Molecular Hepatology2023 · 제29권 제2호Clinical practice guideline and real-life practice in hepatocellular carcinoma: A Korean perspectiveDong Ho Hyun, Dong Hyun Sinn, Jeong Il Yu, Jong Man Kim, Jung Yong Hong, Min Woo Lee, Moon Seok Choi, Myung Ji Goh대한간학회 · Clinical and Molecular Hepatology2023 · 제29권 제2호Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Japanese perspectiveHideki Iwamoto, Hironori Koga, Hiroyuki Suzuki, Masahito Nakano, Shigeo Shimose, Takumi Kawaguchi대한간학회 · Clinical and Molecular Hepatology2023 · 제29권 제2호2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinomaKorean Liver Cancer Association (KLCA), National Cancer Center (NCC) Korea대한간학회 · Clinical and Molecular Hepatology2022 · 제28권 제4호

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