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AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma
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Singal, Amit G.; Llovet, Josep M.; Yarchoan, Mark; Mehta, Neil; Heimbach, Julie K.; Dawson, Laura A.; Jou, Janice H.; Kulik, Laura M.; Agopian, Vatche G.; Marrero, Jorge A.; Mendiratta-Lala, Mishal; Brown, Daniel B.; Rilling, William S.; Goyal, Lipika; Wei, Alice C.; Taddei, Tamar H. Author Information
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“Surgical resection is recognized worldwide as the preferred treatment for patients with early stage HCC, whereas liver transplantation is indicated in those with early stage disease who are not deemed suitable for resection7,22.”
From Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma (2024) · cites this paper as [7]
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“In general, European and US guidelines recommend more-restrictive criteria for resection than Asian guidelines7,22–27.”
From Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma (2024) · cites this paper as [7]
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“In particular, regimens including immune-checkpoint inhibitors (ICIs) are currently adopted as first-line therapies in clinical guidelines7.”
From Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma (2024) · cites this paper as [7]
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“Currently, clinical decisions are based on clinical factors including, but not limited to, performance status, tumour burden, liver function and comorbidities7.”
From Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma (2024) · cites this paper as [7]
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“Now the positive results of IMbrave 050 (ref. 12) have led to a revised management algorithm for patients with early stage HCC by incorporating adjuvant therapies in this disease setting7 (Fig. 4).”
From Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma (2024) · cites this paper as [7]
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“[309] mRECIST criteria has been proposed to adapt RECIST criteria to particularities of HCC, enabling capture of antitumoral response without observed shrinkage after local and systemic therapies.”
Sorafenib in advanced hepatocellular carcinoma
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“…PD-L1, plus bevacizumab, a monoclonal antibody targeting VEGF, as the preferred first-line treatment option for patients with advanced HCC. [312] The median OS of 19.2 months with atezolizumab plus bevacizumab is the longest median OS of any first-line treatment for advanced-stage HCC to…”
InfluentialMazzaferro, V., Regalia, E., Doci, R., Andreola, S. A., Pulvirenti, A., Bozzetti, F., Montalto, F., Ammatuna, M., Morabito, A., & Gennari, L. (1996) · New England Journal of Medicine · doi:10.1056/nejm199603143341104 · Cited by 7,173 · cited 1×
“[206] 211] The main barrier to LT is a shortage of available liver allografts compared with demand, prompting an allocation system that directs access to deceased donor organs for patients both with and without HCC.”
Llovet, J. M., Kelley, R. K., Villanueva, A., Singal, A. G., Pikarsky, E., Roayaie, S., Lencioni, R., Koike, K., Zucman-Rossi, J., & Finn, R. S. (2021) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-00240-3 · Cited by 7,055
Self-citationCancer statistics for the year 2020: An overview
Ferlay, J., Colombet, M., Soerjomataram, I., Parkin, D. M., Piñeros, M., Znaor, A., & Bray, F. (2021) · International Journal of Cancer · doi:10.1002/ijc.33588 · Cited by 6,308
A New Era of Systemic Therapy for Hepatocellular Carcinoma with Regorafenib and Lenvatinib
Kudo, M. (2017) · Liver Cancer · doi:10.1159/000462153 · Cited by 5,974
Cheng, A.-L., Kang, Y.-K., Chen, Z., Tsao, C.-J., Qin, S., Kim, J. S., Luo, R., Feng, J., Ye, S., Yang, T.-S., et al. (2009) · The Lancet Oncology · doi:10.1016/s1470-2045(08)70285-7 · Cited by 5,832 · cited 1×
“[320] In 2018, lenvatinib (an oral mTKI targeting vascular endothelial growth factor [VEGF]2 and other kinases) met its primary endpoint of noninferiority versus sorafenib in a global phase III randomized study, REFLECT.”
Research works printed but not linked: 2
- Marrero, 2021, GALAD score improves early detection of HCC prior to the diagnosis of HCC: A phase 3 biomarker validation study. Abstract #138, Hepatology, 74, 92A
- Dawson, 2022, ORAL SCIENTIFIC SESSIONS LBA 01: NRG/RTOG 1112: Randomized Phase III Study of Sorafenib vs. Stereotactic Body Radiation Therapy (SBRT) Followed by Sorafenib in Hepatocellular Carcinoma (HCC) (NCT01730937). Int J Radiation Oncol, Biol, Physics, 114, P1057
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“22 Clinical guidelines from Europe and America both now recommend RBS, 6 23 the former arguing that it is a ‘superior strategy to reduce HCC mortality’.”
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“…colorectal carcinoma, and both SBRT and HDR-iBT as treatment options for recurrent HCC [18,47], The American Association for the Study of Liver Diseases (AASLD) also recommends liver SBRT as a treatment option for HCC, achieving durable local control in patients unsuitable for resection [48].”
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“9 Although systemic therapy is the mainstay for advanced HCC with extrahepatic spread, intrahepatic tumor burden is the leading cause of death, as most patients succumb to progression of intrahepatic lesions rather than metastatic complications.”
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“Clinical practice guidelines, 2,24 along with findings from previous studies, 14,15,32 have suggested that ablation should be regarded as the primary treatment strategy for select patients with HCC. Specifically, this recommendation applies when patients present with fewer than three tumors, each…”
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“Eligibility required documented HIV serology (anti-HIV antibodies) and a histological or clinical first diagnosis of HCC per international guidelines [26, 27].”
Wang, Y., Zhixian, Z., Zhu, M., & Wu, S. (2025) · Radiology Imaging Cancer · doi:10.1148/rycan.250259 · Cited by 2
INASL Consensus on Management of HCC: Navigating an Evolving Field
Singal, A. G., Pillai, A. A., & Parikh, N. D. (2023) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2023.10.003 · Cited by 2
Self-citationKim, J.-A., Jeong, W. K., Kim, J. M., Ha, S. Y., & Kim, K. (2023) · Abdominal Radiology · doi:10.1007/s00261-023-04106-6 · Cited by 2
Chang, C.-J., Hsu, W., Jeng, L., Lai, H., Hsu, S.-C., Chen, T.-H., Wang, H., & Peng, C. (2023) · Current Oncology · doi:10.3390/curroncol30120737 · Cited by 2
“The AASLD and EASL mentioned that surgical resection could only be considered for HCC patients with Vp 1 or 2 MVI in high-volume centers or research settings [4,5].”
BackgroundMethodInfluentialPredictors of Survival in Patients With Hepatocellular Cancer Receiving Atezolizumab and Bevacizumab
Ledenko, M., Mercado, L. A., & Patel, T. C. (2023) · American Journal of Clinical Oncology · doi:10.1097/coc.0000000000001067 · Cited by 2
Qiao, W., Fan, Z., Wang, Q., Jin, R., & Hu, C. (2024) · Journal of Hepatocellular Carcinoma · doi:10.2147/jhc.s441540 · Cited by 2
“17 Due to the retrospective nature of this study, the requirement for informed consent was waived.”
Cancer Prevention and Screening for People Living with Human Immunodeficiency Virus
Wilkinson, M. R., McCrea, K. L., & Culbertson, A. (2024) · Nursing Clinics of North America · doi:10.1016/j.cnur.2024.01.002 · Cited by 2
Liver transplant versus liver resection in patients with multifocal hepatocellular carcinoma
Kakish, H. H., Suraju, M. O., Seth, A., DiGioia, O. N., Pawar, O., Kwon, Y., Hemming, A. W., & Aziz, H. (2024) · Journal of Gastrointestinal Surgery · doi:10.1016/j.gassur.2024.04.021 · Cited by 2
Araz, F., Soydaş, B., Özer, B., Karadeli, E., & Erbay, G. (2024) · The Turkish Journal of Gastroenterology · doi:10.5152/tjg.2024.23451 · Cited by 2
Chrysavgis, L., & Cholongitas, Ε. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-21938-2.00020-5 · Cited by 3
Singal, A. G., Daher, D., Dahan, K. S. E., Rich, N. E., Yang, J. D., & Parikh, N. D. (2023) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2023.10.032 · Cited by 2
Self-citationAgainst multidisciplinarity: More is not necessarily better
Colli, A., & Prati, D. (2024) · Liver International · doi:10.1111/liv.15898 · Cited by 2
Editorial: PIVKA‐II Facilitates Risk Stratification for HCC Following HCV Cure
Su, T., & Liao, W. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.18444 · Cited by 2
Ko, M. K.-L., & Mak, L. (2025) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2025.0118 · Cited by 2
“[ 3] Based on cost-effectiveness analyses, HCC surveillance should be performed in individuals with HCC risk exceeding 1.0 – 1.5% per year.”
InfluentialZhao, Z., Sun, J., You, Q., Lan, Z., & Zhu, Y. (2025) · Hepatology · doi:10.1097/hep.0000000000001481 · Cited by 2
How Systematic Review Can Shape Clinical Practice in Radiology
Kim, T., & Woo, S. (2023) · American Journal of Roentgenology · doi:10.2214/ajr.23.29603 · Cited by 1
Integrating the new systemic treatment landscape and surgical therapy in hepatocellular carcinoma
Haber, P. K., Krenzien, F., Sarıbeyoğlu, K., Pratschke, J., & Schöning, W. (2024) · Turkish Journal of Surgery · doi:10.47717/turkjsurg.2024.6375 · Cited by 1
Optimizing care of HBV infection and HBV-related HCC
Lee, S. Y., Nah, B. K. Y., Leo, J., Koh, J. H., & Huang, D. Q. (2024) · Clinical Liver Disease · doi:10.1097/cld.0000000000000169 · Cited by 1
“[32] The AASLD recommends surveillance with ultrasound examination and alpha-fetoprotein (AFP) every 6 months in people at risk of HCC. [33] In patients with CHB with cirrhosis, both AASLD and EASL recommend surveillance in patients with Childs-Pugh stages A or B and in patients with Childs-Pugh C…”
Die moderne TARE 2023 – von der Palliativversorgung zur kurativen Behandlungsalternative
Gebauer, B., Collettini, F., Pfob, C. H., & Lapa, C. (2024) · Nuklearmedizin - NuclearMedicine · doi:10.1055/a-2353-5819 · Cited by 1
“…und Behand-lung des HCC [4], der Leitlinie der Europäischen Arbeitsgemein-schaft zum Studium der Leber (EASL) zum Management des HCC [8] und der Leitlinie zur Behandlung des hepatozellulären Karzinoms der Amerikanischen Gesellschaft für die Erforschung von Leberkrankheiten (AASLD) [11] empfohlen.”
Amadeo, E., Foti, S., Camera, S., Rossari, F., Persano, M., Prinzi, F. L., Vitiello, F., Gardini, A. C., & Rimini, M. (2024) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2024.2377321 · Cited by 1
“Particularly important in the field was the advancement of immune checkpoints inhibitors (ICI) application, currently used in first-line regimes [7], over Sorafenib, a tyrosine kinase inhibitor (TKI) targeting the RAF/ MEK/ERK pathway [8].”
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Diagnostic performance of CT/MRI LI-RADS v2018 in non-cirrhotic hepatitis C virus infection
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The Role of Liver Transplantation in Hepatocellular Carcinoma
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Outpatient management after hospitalisation for acute decompensation of cirrhosis: A practical guide
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“4,5 Moreover, nivolumab demonstrates similar efficacy and safety as a first-line therapy when compared to sorafenib.”
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“Initial treatment included liver resection or TACE, a decision made by a multidisciplinary team relying on established guidelines [3, 4, 15, 16], considering tumor characteristics, liver function, and patients’ treatment intention.”
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Evaluation of screening program for hepatocellular carcinoma at a single center
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Oligometastatic Hepatocellular Carcinoma to the Perirectal Pelvis, a Rare Site of Distant Spread
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“However, sorafenib and len-vatinib, previous the fi rst-line therapy options, remain viable if patients are ineligible for atezolizumab-bevacizumab and the STRIDE regimens [7, 8].”
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“Patients without cirrhosis, or those with HCC arising from fatty liver, are less likely to display typical imaging features, complicating diagnosis [1,9].”
Metadata
- Authors
- Singal, A. G., Llovet, J. M., Yarchoan, M., Mehta, N., Heimbach, J. K., Dawson, L. A., Jou, J. H., Kulik, L. M., Agopian, V. G., Marrero, J. A., Mendiratta-Lala, M., Brown, D. B., Rilling, W. S., Goyal, L., Wei, A. C., & Taddei, T. H.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Institució Catalana de Recerca i Estudis Avançats (ES)
- Johns Hopkins University (US)
- University of California, San Francisco (US)
- Mayo Clinic (US)
- University Health Network (CA)
- Oregon Health & Science University (US)
- Northwestern Medical Faculty Foundation (US)
- University of California, Los Angeles (US)
- University of Pennsylvania (US)
- Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan, USA
- Vanderbilt University Medical Center (US)
- Medical College of Wisconsin (US)
- Stanford Medicine (US)
- Memorial Sloan Kettering Cancer Center (US)
- Yale University (US)
- Corresponding author
- Singal, Amit G.
- ORCID
- Venue
- Hepatology
- Published
- 2023-05-22
- Volume
- 78
- Issue
- 6
- Pages
- 1922-1965
- ISSN
- 0270-9139 (ISSN-L)
- PMC
- PMC10663390
- OpenAlex
- W4377011124
- Cited by
- 2,052
- References
- 341
- Citations by year
- 2026: 760 · 2025: 724 · 2024: 467 · 2023: 97
- FWCI
- 346.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- AstraZeneca
- American Association for the Study of Liver Diseases
- Gilead Sciences
- Boston Scientific Corporation
- Exelixis
- Incyte
- Cancer Research UK (26813)
- Eisai
- Ipsen
- Sirtex Medical
- National Institutes of Health (UL1TR001863)
- Genentech
- National Cancer Institute (P50CA062924, R01CA285544)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- hepatocellular carcinoma, hepatocellular carcinoma prevention, hepatocellular carcinoma diagnosis, hepatocellular carcinoma treatment, liver cancer, clinical guidelines
- MeSH terms
- Contrast Media, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Tomography, X-Ray Computed
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