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AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma
Open accessAbstract
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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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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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Cites
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21660 · Cited by 108,699
New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)
Eisenhauer, E. A., Therasse, P., Bogaerts, J., Schwartz, L. H., Sargent, D., Ford, R., Dancey, J., Arbuck, S., Gwyther, S., Mooney, M., et al. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2008.10.026 · Cited by 29,534 · cited 1×
“[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
Llovet, J. M., Ricci, S., Mazzaferro, V., Hilgard, P., Gane, E., Blanc, J.-F., de Oliveira, A. C., Santoro, A., Raoul, J.-L., Forner, A., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0708857 · Cited by 13,097
Self-citationErdogan, D., Heijnen, B. H. M., Bennink, R. J., Kok, M., Dinant, S., Straatsburg, I. H., Gouma, D. J., & van Gulik, T. M. (2004) · Liver International · doi:10.1111/j.1478-3231.2004.00901.x · Cited by 11,656
Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma
Finn, R. S., Qin, S., Ikeda, M., Galle, P. R., Ducreux, M., Kim, T.-Y., Kudo, M., Breder, V., Merle, P., Kaseb, A. O., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa1915745 · Cited by 7,470 · cited 2×
“…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
Cited by
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Items 101–200 of 1,000
National Liver Cancer Screening Trial (TRACER) study protocol
Singal, A. G., Parikh, N. D., Kanwal, F., Marrero, J. A., Deodhar, S., Page-Lester, S., Lopez, C., Feng, Z., & Tayob, N. (2024) · Hepatology Communications · doi:10.1097/hc9.0000000000000565 · Cited by 31
“[8] Despite professional society guidelines recommending HCC screening in at-risk patients, [9 – 11] a minority of patients with HCC are detected at an early stage.”
BackgroundInfluentialSelf-citationLiver Cirrhosis: Evolving Definitions, and Recent Advances in Diagnosis, Prevention and Management
Battle, A. R., Mudd, J., Ahlenstiel, G., & Kalo, E. (2025) · Livers · doi:10.3390/livers5030028 · Cited by 32
Teng, W., Wang, H., Lin, S., & On behalf of Diagnosis Group and Systemic Therapy Group of TLCA (2024) · Liver Cancer · doi:10.1159/000537686 · Cited by 36
“In conclusion, immunotherapy using either nivolumab plus ipilimumab or pembrolizumab alone, can be considered for patients who are intolerant of or have progressed during treatment with approved multiple kinase inhibitors [12, 98].”
BackgroundMethodInfluentialWei, H., Zheng, T., Zhang, X., Wu, Y., Chen, Y., Zheng, C., Jiang, D., Wu, T., Guo, H., Jiang, H., et al. (2024) · Insights into Imaging · doi:10.1186/s13244-024-01679-8 · Cited by 30
Shi, Y., Taherifard, E., Saeed, A., & Saeed, A. (2024) · Current Issues in Molecular Biology · doi:10.3390/cimb46060356 · Cited by 33
“These interventions, administered via the arteries, encompass transarterial embolization (TAE), transarterial chemoembolization (TACE), and transarterial radioembolization (TARE) and are primary treatments for intermediate-stage and unresectable HCC [52,78,79].”
BackgroundJaber, F. S., Cholankeril, G. T., & El‐Serag, H. B. (2024) · Journal of the Canadian Association of Gastroenterology · doi:10.1093/jcag/gwae025 · Cited by 33
Differences between hepatocellular carcinoma caused by alcohol and other aetiologies
Ganne‐Carrié, N., & Nahon, P. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.12.030 · Cited by 34
Ma, T., Bai, X., Zhang, Q., Chen, W., Huang, K., Tao, Q., Xu, Y., Sun, P., Chen, Y., Xiao, W., et al. (2025) · Hepatology · doi:10.1097/hep.0000000000001233 · Cited by 34
Lai, J. C., Yang, B., Lee, H. W., Lin, H., Tsochatzis, E. A., Petta, S., Bugianesi, E., Yoneda, M., Zheng, M., Hagström, H., et al. (2025) · Gut · doi:10.1136/gutjnl-2025-334981 · Cited by 32
AASLD AST Practice Guideline on adult liver transplantation: Candidate evaluation
Dove, L. M., Chadha, R., Lai, J. C., DiMartini, A., Liapakis, A., Parikh, N. D., Firpi-Morell, R. J., Conteh, L. F., Fallon, M., Trotter, J., et al. (2025) · Hepatology · doi:10.1097/hep.0000000000001644 · Cited by 31
Badhrinarayanan, S., Cotter, C., Zhu, H., Lin, Y., Kudo, M., & Li, D. (2024) · Future Oncology · doi:10.1080/14796694.2024.2355863 · Cited by 32
“…adv anc ed-stage HCC with ext ensive in trahepa tic tumor burden beyond the in termedia te stage or any evidence of vascular invasion or distant metastases, sy st emic therapy can prolong survival by slowing tumor pr ogr ession, with median survival time varying from 8 to 19.2 months [ 9 , 10 ].”
BackgroundInfluentialLee, S. W., Huang, D. Q., Bettencourt, R., Ajmera, V. H., Tincopa, M. A., Noureddin, N., Amangurbanova, M., Siddiqi, H., Madamba, E. V., Majzoub, A. M., et al. (2023) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17783 · Cited by 29
Cabibbo, G., Daniele, B., Borzio, M., Gardini, A. C., Cillo, U., Colli, A., Conforti, M., Dadduzio, V., Dionisi, F., Farinati, F., et al. (2023) · Digestive and Liver Disease · doi:10.1016/j.dld.2023.10.029 · Cited by 29
Wehrle, C. J., Raj, R., Maspero, M., Satish, S., Eghtesad, B., Pita, A., Kim, J., Khalil, M., Calderon, E., Orabi, D., et al. (2024) · International Journal of Surgery · doi:10.1097/js9.0000000000001104 · Cited by 28
“Recurrence was diagnosed based on radiological evidence of new lesions or histological con fi rmation using the Liver Imaging Reporting & Data System (LI-RADS) criteria recommended by the American Association for the Study of Liver Diseases (AASLD) [12] .”
MethodChaiteerakij, R., Ariyaskul, D., Kulkraisri, K., Apiparakoon, T., Sukcharoen, S., Chaichuen, O., Pensuwan, P., Tiyarattanachai, T., Rerknimitr, R., & Marukatat, S. (2024) · Scientific Reports · doi:10.1038/s41598-024-71657-z · Cited by 29
“For benign lesions, diagnoses were primarily determined by characteristic imaging features observed in USG, computed tomography (CT), or magnetic resonance imaging (MRI), which are widely accepted in clinical practice.”
MethodInfluentialTranslational research on drug development and biomarker discovery for hepatocellular carcinoma
Chew, V., Chuang, C.-H., & Hsu, C. (2024) · Journal of Biomedical Science · doi:10.1186/s12929-024-01011-y · Cited by 29
“…combination therapy for unresectable HCC, efficacy appears to a plateau, with an overall survival of 20 months, a progression-free survival of 7–8 months, and an objective tumor response approximately 25% based on RECIST 1.1 (response evaluation criteria in solid tumors, Table 3) [48].”
BackgroundInfluentialPrevention, Diagnosis, and Treatment of Hepatocellular Carcinoma
Park, S., Davis, A. M., & Pillai, A. A. (2024) · JAMA · doi:10.1001/jama.2024.14101 · Cited by 27
Magyar, C. T. J., O'Kane, G. M., Aceituno, L., Li, Z., Vogel, A., Bruix, J., Mazzaferro, V., & Sapisochín, G. (2024) · Journal of Clinical Oncology · doi:10.1200/jco.24.00857 · Cited by 27
Shin, H., Hur, M. H., Song, B. G., Park, S. Y., Kim, G., Choi, G. H., Nam, J. Y., Kim, M. A., Park, Y., Ko, Y., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.12.029 · Cited by 28
Cai, M., Liang, L., Zhang, J., Chen, N., Huang, W., Guo, Y., Hong, X., Lin, L., Liu, Y., Dan, C., et al. (2024) · International Journal of Surgery · doi:10.1097/js9.0000000000001819 · Cited by 26
“Given that both a large tumor burden and the presence of major PVTT are indicative of more advanced disease, treatment dif fi culties and worse outcomes [3,5,8 – 10] , the management of HCC patients with these combined conditions is even more challenging.”
Guo, L., Hao, X., Chen, L., Qian, Y.-S., Wang, C., Liu, X., Fan, X., Jiang, G., Zheng, D., Gao, P., et al. (2024) · EClinicalMedicine · doi:10.1016/j.eclinm.2024.102718 · Cited by 26
“20 Previous studies have indicated that ultrasound exhibits a sensitivity of 84% for detecting HCC in patients with cirrhosis, but this sensitivity drops to 47% for early-stage detection.”
BackgroundHur, M. H., Yip, T. C., Kim, S. U., Lee, H. W., Lee, H. A., Lee, H., Wong, G. L., Wong, V. W., Park, J. Y., Ahn, S. H., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.08.016 · Cited by 26
Matute‐González, M., Darnell, A., Comas‐Cufí, M., Pazó, J., Soler, A., Saborido, B., Mauro, E., Turnés, J., Forner, A., Reig, M., et al. (2024) · Insights into Imaging · doi:10.1186/s13244-024-01850-1 · Cited by 26
Hepatocellular Carcinoma Surveillance Strategies: Major Guidelines and Screening Advances
Wu, G., Bajestani, N., Pracha, N. S., Chen, C., & Makary, M. S. (2024) · Cancers · doi:10.3390/cancers16233933 · Cited by 26
Wu, S., Anand, N., Guo, Z., Li, M., Figueroa, M. S., Jung, L., Kelly, S., & Franses, J. W. (2025) · Cancers · doi:10.3390/cancers17111860 · Cited by 27
Hepatocellular Carcinoma Prevention in the Era of Hepatitis C Elimination
Lazarus, J. V., Picchio, C. A., & Colombo, M. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241814404 · Cited by 27
Epidemiological and economical burden of cholestatic liver disease
Mol, B., Werner, E., Culver, E. L., van der Meer, A. J., Bogaards, J. A., & Ponsioen, C. Y. (2025) · Hepatology · doi:10.1097/hep.0000000000001341 · Cited by 26
El‐Serag, H. B., Kanwal, F., Ning, J., Powell, H., Khaderi, S. A., Singal, A. G., Asrani, S. K., Marrero, J. A., Amos, C. I., Thrift, A. P., et al. (2024) · Gut · doi:10.1136/gutjnl-2024-332034 · Cited by 25
“HCC was defined according to American Association for the Study of Liver Diseases (AASLD) criteria 22 including histological or radiological diagnosis using characteristic appearance (arterial enhancement and delayed washout of contrast) on triple-phase CT or MRI (LI-RAD 5 or 4) that were reviewed…”
MethodSelf-citationSultanik, P., Campani, C., Larrey, E., Campion, B., Evain, M., Roux, C., Blaise, L., Wagner, M., Rudler, M., Nault, J., et al. (2024) · Digestive and Liver Disease · doi:10.1016/j.dld.2024.02.018 · Cited by 24
Ma, Y., Li, Z., Luo, Y., Chen, Y., Ma, L., Liu, X., Xiao, J., Huang, M., Li, Y., Jiang, H., et al. (2024) · ACS Nano · doi:10.1021/acsnano.4c00047 · Cited by 24
Local Ablation Therapy for Hepatocellular Carcinoma
Lee, M. W., Han, S., Gu, K., & Rhim, H. (2024) · Investigative Radiology · doi:10.1097/rli.0000000000001100 · Cited by 24
Exploring the dark side of diagnostic dyes with a focus on Indocyanine green’s adverse reactions
Jiao, Y., Liu, Y., & Jin, M. (2024) · Scientific Reports · doi:10.1038/s41598-024-81903-z · Cited by 24
“Importantly, owing to its metabolism by the liver and excretion through the bile ducts, ICG clearance test is a frequently used tool to measure hepatic reserve or monitor liver function 7,8 .”
Exploring the links between types 2 diabetes and liver‐related complications: A comprehensive review
Sanchez, L. O., Chen, Y., Lassailly, G., & Qi, X. (2023) · United European Gastroenterology Journal · doi:10.1002/ueg2.12508 · Cited by 26
“53 Thus, liver biopsy should be considered in the following situations: alternate/additional - 243 diagnosis is suspected, aminotransferase is persistently elevated 54 The AASLD guidelines state that varices surveillance depends on liver stiffness and platelet count.”
BackgroundImmunotherapy, targeted therapy, and their cross talks in hepatocellular carcinoma
Liu, J., Park, K., Shen, Z., Lee, H. M., Geetha, P., Pakyari, M., & Chai, L. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1285370 · Cited by 24
Rhee, H., Park, Y. N., & Choi, J. (2024) · Korean Journal of Radiology · doi:10.3348/kjr.2024.0307 · Cited by 23
Neoadjuvant atezolizumab plus bevacizumab prior liver transplantation for hepatocellular carcinoma
Tabrizian, P., Marino, R., Bhoori, S., Zeitlhoefler, M., Mehta, N. J., Banz, V. M., Gruttadauria, S., Iavarone, M. A., Mazzarelli, C., Simonotti, N., et al. (2024) · JHEP Reports · doi:10.1016/j.jhepr.2024.101246 · Cited by 24
“…whose rationale is based on the immune-related response to the release of neo-antigens 8 and better progression-free survival in intermediate HCC. 8,13 In our study, LRT alone led to an ORR of 75%, and was further improved with the addition of immunotherapy, thus achieving 94% ORR (including 59%…”
Self-citationPhase 3 Validation of PAaM for Hepatocellular Carcinoma Risk Stratification in Cirrhosis
Fujiwara, N., Lopez, C., Marsh, T. L., Raman, I., Marquez, C. A., Paul, S., Mishra, S. K., Kubota, N., Katz, C., Kanzaki, H., et al. (2024) · Gastroenterology · doi:10.1053/j.gastro.2024.10.035 · Cited by 23
“4,12 HCC risk association of 3 clinical variable-based scores, aMAP score, Toronto HCC Risk Index, and ADRESS-HCC, was compared using Royston’s D-index, 34,35 time-dependent area under receiver operating characteristics curve, Harrell’s c-index, and calibration slope and intercept at 3 years in the…”
Self-citationMuto, H., Kuzuya, T., Kawabe, N., Ohno, E., Funasaka, K., Nagasaka, M., Nakagawa, Y., Miyahara, R., Shibata, T., Hashimoto, S., et al. (2023) · Anticancer Research · doi:10.21873/anticanres.16663 · Cited by 23
Cabibbo, G., Daniele, B., Borzio, M., Gardini, A. C., Cillo, U., Colli, A., Conforti, M., Dadduzio, V., Dionisi, F., Farinati, F., et al. (2023) · Digestive and Liver Disease · doi:10.1016/j.dld.2023.10.028 · Cited by 22
Extracellular vesicles in the HCC microenvironment: Implications for therapy and biomarkers
Cheng, L., Zhang, L., Wang, X., Wang, Y., Yu, J., Li, M., Ma, Z., Ho, P. C., Chen, X., Wang, L., et al. (2024) · Pharmacological Research · doi:10.1016/j.phrs.2024.107419 · Cited by 22
Wu, M. C., Fulgenzi, C. A. M., D’Alessio, A., Cortellini, A., Celsa, C., Manfredi, G. F., Stefanini, B., Wu, L. Y., Huang, Y., Saeed, A., et al. (2024) · JHEP Reports · doi:10.1016/j.jhepr.2024.101232 · Cited by 22
“3,6,8 Prior to the availability of real-world data, a study that constructed a Markov model to estimate survival outcomes for patients treated with 2L TKIs or ramucirumab after progression on atezo/bev predicted that lenvatinib or sorafenib would be most effective.”
Self-citationSong, D., Zhang, Z., Zheng, J., Zhang, W., & Cai, J. (2025) · Biomarker Research · doi:10.1186/s40364-025-00751-9 · Cited by 22
“Current surveillance strategies recommended by the European Association for the Study of the Liver (EASL) and the American Associa - tion for the Study of Liver Diseases (AASLD) primarily include ultrasound with or without alpha-fetoprotein (AFP) testing for high-risk populations [89, 90].”
Systemic treatment in patients with hepatocellular carcinoma and advanced liver dysfunction
Pinter, M., Fulgenzi, C. A. M., Pinato, D. J., & Scheiner, B. (2025) · Gut · doi:10.1136/gutjnl-2025-334928 · Cited by 23
“38 However, MELD is primarily used in the transplant setting 5 but is less important for assessing liver function in patients with advanced stage HCC.”
Tamai, Y., Fujiwara, N., Tanaka, T., Mizuno, S., & Nakagawa, H. (2023) · Cancers · doi:10.3390/cancers15205072 · Cited by 21
Shimose, S., Saeki, I., Tomonari, T., Ito, T., Tani, J., Takeuchi, Y., Yoshioka, N., Naito, T., Takeuchi, M., Kakizaki, S., et al. (2024) · Oncology Letters · doi:10.3892/ol.2024.14530 · Cited by 22
“Recently, immune checkpoint inhibitors (ICIs) have revolutionized the treatment strategy for u‑HCC, and remarkable changes have occurred in systemic treatment settings (5,6).”
BackgroundTargeted therapies in hepatocellular carcinoma: past, present, and future
Gujarathi, R., Franses, J. W., Pillai, A., & Liao, C. (2024) · Frontiers in Oncology · doi:10.3389/fonc.2024.1432423 · Cited by 22
“The use of ICIs is discouraged in patients with moderate to severe autoimmune conditions, and the American Association for the Study of Liver Diseases (AASLD) advises against their use in post-transplant patients due to the high risk of graft loss and mortality (6).”
BackgroundMethodInfluentialThe evolving role of liver biopsy: Current applications and future prospects
Gopal, P., Hu, X., Robert, M. E., & Zhang, X. (2025) · Hepatology Communications · doi:10.1097/hc9.0000000000000628 · Cited by 22
“[71] The AASLD guidelines also support the use of liver biopsies in clinical trials for all LR 4 – 5 nodules and for patients not enrolled in clinical trials, not only for the prevention of misdiagnosis but also for the availability of tissue for molecular analysis.”
Proportion of Time Covered by Hepatocellular Carcinoma Surveillance in Patients With Cirrhosis
Daher, D., Dahan, K. S. E., Yekkaluri, S., Gopal, P., Rich, N. E., Parikh, N. D., Murphy, C. C., & Singal, A. G. (2023) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002596 · Cited by 21
“HCC diagnoses were further con fi rmed to meet the diagnostic criteria set forth by AASLD guidelines (4): histological con fi rmation or imaging with a Liver Imaging Reporting and Data System-5 lesion of at least 1 cm in maximum diameter.”
BackgroundMethodSelf-citationGoins, S. M., Jiang, H., van der Pol, C. B., Salameh, J., Lam, E., Adamo, R. G., McInnes, M. D. F., Costa, A. F., Tang, A., Alhasan, A. S., et al. (2023) · Radiology · doi:10.1148/radiol.231656 · Cited by 24
Kudo, M. (2024) · Liver Cancer · doi:10.1159/000540801 · Cited by 24
Miura, R., Ono, A., Yano, S., Amioka, K., Naruto, K., Yamaoka, K., Fujii, Y., Uchikawa, S., Fujino, H., Nakahara, T., et al. (2024) · Medicine · doi:10.1097/md.0000000000039289 · Cited by 21
“[6] TKIs are recommended as second-line treatments, and ICIs, such as nivolumab–ipilimumab or pem-brolizumab, can only be used in cases where TKI use is infeasible.”
BackgroundInfluentialPrevalence of Low FIB‐4 in MASLD‐Related Hepatocellular Carcinoma: A Multicentre Study
Tan, D. J. H., Tamaki, N., Kim, B. K., Wijarnpreecha, K., Aboona, M. B., Faulkner, C., Kench, C., Salimi, S., Sabih, A., Lim, W. H., et al. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.18346 · Cited by 23
Advancing Surveillance Strategies for Hepatocellular Carcinoma: A New Era of Efficacy and Precision
Singal, A. G., Ng, M., & Kulkarni, A. L. (2024) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2024.101448 · Cited by 22
Self-citationSingal, A. G., Quirk, L., Boike, J. R., Chernyak, V., Feng, Z., Giamarqo, G., Kanwal, F., Ioannou, G. N., Manes, S., Marrero, J. A., et al. (2024) · Hepatology · doi:10.1097/hep.0000000000001203 · Cited by 20
Self-citationDésert, R., Giannone, F., Saviano, A., Hoshida, Y., Heikenwälder, M. F., Nahon, P., & Baumert, T. F. (2025) · npj gut and liver. · doi:10.1038/s44355-025-00018-y · Cited by 23
“The latest AASLD guidelines 10 recommend the use of the atezolizumab plus bevacizumab combination; or tremelimumab plus durvalumab, as first line.”
Hepatocellular carcinoma in patients without cirrhosis
Sato‐Espinoza, K., Valdivia-Herrera, M., Chotiprasidhi, P., & Ferrer, J. D. (2025) · World Journal of Gastroenterology · doi:10.3748/wjg.v31.i23.107100 · Cited by 24
Lee, P., Wu, C.-J., Hung, Y., Lee, C.-J., Mon, H.-C., Chi, C., Lee, I., Kuo, Y.-L., Chou, S.-H., Luo, J., et al. (2025) · Hepatology · doi:10.1097/hep.0000000000001446 · Cited by 20
John, B. V., Bastaich, D., Deng, Y., Singal, A. G., Dahman, B. A., & on behalf of the Veterans Analysis of Liver Disease (VALID) group of investigators (2025) · Hepatology · doi:10.1097/hep.0000000000001498 · Cited by 20
Self-citationJarrah, M., Arvind, A., Gopal, P., Deodhar, S., Yang, J. D., Parikh, N. D., & Singal, A. G. (2025) · Liver Cancer · doi:10.1159/000547895 · Cited by 23
“Accordingly, the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL) recommend HCC surveillance to promote early HCC detection in at-risk patients [5, 6].”
Self-citationImproving surgical treatments for hepatocellular carcinoma
Malik, A. K., Geh, D., Evans, T. R. J., Chow, P. K. H., Mann, D. A., & White, S. A. (2025) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-025-01143-y · Cited by 24
“Macrovascular invasion remains a contraindication to resection and transplantation in Western (USA and Europe) guidelines 19,22–24 .”
InfluentialYanagihara, T. K., Tepper, J. E., Moon, A. M., Barry, A. S., Mollà, M., Seong, J., Torres, F., Apisarnthanarax, S., Buckstein, M. H., Cardenes, H. R., et al. (2024) · Practical Radiation Oncology · doi:10.1016/j.prro.2023.08.016 · Cited by 20
Self-citationSystemic Therapy for Advanced Hepatocellular Carcinoma: ASCO Guideline Update Clinical Insights
Rose, M. G., Kennedy, E. B., Abou‐Alfa, G. K., Finn, R. S., Gade, T. P. F., Kelley, R. K., Taddei, T. H., & Gordan, J. D. (2024) · JCO Oncology Practice · doi:10.1200/op.24.00189 · Cited by 20
Self-citationHuang, C., Awad, M. H., Gal-Tanamy, M., & Yu, M. (2024) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2024.0155 · Cited by 20
Wei, H., Zheng, T., Zhang, X., Zheng, C., Jiang, D., Wu, Y., Lee, J. M., Bashir, M. R., Lerner, E., Liu, R., et al. (2024) · European Radiology · doi:10.1007/s00330-024-10941-y · Cited by 20
Qiu, X. Y., Shen, S., Lu, D., Jiang, N., Feng, Y., Li, J., Yang, C., & Xiang, B. (2024) · Journal of Inflammation Research · doi:10.2147/jir.s468215 · Cited by 20
Saeki, I., Shimose, S., Tomonari, T., Ito, T., Tani, J., Takeuchi, Y., Yoshioka, N., Naito, T., Takeuchi, M., Kakizaki, S., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0311084 · Cited by 20
Li, B., Chi, X., Huang, Y., Wang, W., & Liu, Z. (2024) · Frontiers in Bioscience-Landmark · doi:10.31083/j.fbl2907241 · Cited by 19
“Even though antiviral treatment has become one of the most effective strategies for preventing HCC, chemoprevention measures remain an area of significant need in the case of at-risk patients with nonviral etiologies of liver disease [ 46].”
BackgroundPortal vein tumor thrombosis in hepatocellular carcinoma patients: Is it the end?
Abdelhamed, W., Shousha, H. I., & El‐Kassas, M. (2024) · Liver Research · doi:10.1016/j.livres.2024.09.002 · Cited by 19
Jiang, H., Cannella, R., Wu, Z., Bèaufrere, A., Burgio, M. D., Sartoris, R., Wang, Y., Qin, Y., Chen, J., Chen, Y., et al. (2024) · Radiology · doi:10.1148/radiol.233471 · Cited by 19
LI-RADS: Current Status and Future Directions
Choi, S. H., Fowler, K. J., Chernyak, V., & Sirlin, C. B. (2024) · Korean Journal of Radiology · doi:10.3348/kjr.2024.0161 · Cited by 19
miRNAs in HCC, pathogenesis, and targets
Song, G., Yu, X., Shi, H., Bo, S., & Amateau, S. K. (2024) · Hepatology · doi:10.1097/hep.0000000000001177 · Cited by 19
Emerging evidence-based role for external-beam radiation therapy in hepatocellular carcinoma
Dudzinski, S. O., Newman, N. B., McIntyre, J., Engineer, R. Z., Sanford, N. N., Wo, J. Y.-L., Seong, J., Guha, C., Chang, D. T., Hong, T. S., et al. (2025) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(24)00267-x · Cited by 19
Self-citationSu, J., Li, J., Pan, L.-X., Ma, Y.-L., Tian, W., Jiang, Y.-M., Guo, P.-P., Li, L., Deng, Z., Li, Z., et al. (2025) · Hepatology · doi:10.1097/hep.0000000000001433 · Cited by 19
Cho, H. J., Lee, E., Kim, S. S., & Cheong, J. Y. (2024) · Scientific Reports · doi:10.1038/s41598-024-60133-3 · Cited by 19
Zhou, C., Chang, B., Xiang, Z., Li, Z., Wu, C. T., Bai, M., Jiang, Z., Huang, M., & Chen, J. (2024) · Academic Radiology · doi:10.1016/j.acra.2024.04.045 · Cited by 19
Ruli, T. M., Pollack, E. D., Lodh, A., Evers, C. D., Price, C. A., & Shoreibah, M. (2024) · Cancers · doi:10.3390/cancers16112042 · Cited by 23
“Therefore, in patients at high risk for EGV bleeding, STRIDE should be considered [120].”
BackgroundMethodInfluentialSLC4A11 mediates ammonia import and promotes cancer stemness in hepatocellular carcinoma
Elaimy, A. L., El-Derany, M. O., James, J. G., Wang, Z., Pearson, A. N., Holcomb, E. A., Huber, A. K., Gijón, M. A., Bell, H. N., Sanghvi, V. R., et al. (2024) · JCI Insight · doi:10.1172/jci.insight.184826 · Cited by 19
Hou, J., Berg, T., Vogel, A., Piratvisuth, T., Trojan, J., Toni, E. N. D., Kudo, M., Malinowsky, K., Findeisen, P., Hegel, J. K., et al. (2024) · JHEP Reports · doi:10.1016/j.jhepr.2024.101263 · Cited by 19
Beyond the Liver: A Comprehensive Review of Strategies to Prevent Hepatocellular Carcinoma
Polpichai, N., Saowapa, S., Danpanichkul, P., Chan, S., Sierra, L., Blagoie, J., Rattananukrom, C., Sripongpun, P., & Kaewdech, A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13226770 · Cited by 25
“Target Populations for Surveillance [130] Surveillance for HCC is recommended for individuals at high risk of developing the disease [131].”
Lai, K.-C., Chen, Y., Hung, Y., Chiang, N.-J., Chen, M., & Chen, S. (2024) · Hepatology International · doi:10.1007/s12072-024-10728-9 · Cited by 20
Wu, C.-Y., Lin, L., Lee, T., Hsu, Y., Yeh, C.-C., Chen, C., Kang, Y., & Huang, T. (2024) · International Journal of Surgery · doi:10.1097/js9.0000000000001950 · Cited by 18
TACE vs. TARE for HCC ≥ 8 cm: A propensity score analysis
Phan, N. H., Chun, H. J., Oh, J. S., Kim, S. H., & Choi, B. G. (2024) · Abdominal Radiology · doi:10.1007/s00261-024-04573-5 · Cited by 18
“All patients were diagnosed with HCC based on the American Association for the Study of Liver Diseases criteria [20].”
Jin, Z., Zhou, J., Chen, J., Ding, R., Scheiner, B., Wang, S., Li, H., Shen, Q., Lu, Q., Liu, Y., et al. (2024) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.13615 · Cited by 21
Cheraghpour, M., Hatami, B., & Singal, A. G. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.09.041 · Cited by 19
Self-citationPomej, K., Frick, A. P., Scheiner, B., Balcar, L., Pajancic, L., Klotz, A., Kreuter, A., Lampichler, K., Regnat, K., Zinober, K., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0321189 · Cited by 21
“The combination of atezolizumab plus bevacizumab represents a reference standard in systemic front-line therapy for advanced stage HCC [3,4,7].”
Akabane, M., Imaoka, Y., Kawashima, J., & Pawlik, T. M. (2025) · Hepatic Oncology · doi:10.1080/20450923.2025.2493457 · Cited by 21
“The role of precision medicine in conversion therapy is also a critical aspect of treatment strategy for advanced HCC. Conversion therapy provides a unique opportunity for patients with uHCC to undergo potentially curative surgical treatments by downstaging tumors [91].”
Current and new strategies for hepatocellular carcinoma surveillance
Polpichai, N., Maneenil, C., Danpanichkul, P., Rattananukrom, C., Choudhury, A. K., Wong, Y. J., Sripongpun, P., Liangpunsakul, S., & Kaewdech, A. (2025) · Gastroenterology report · doi:10.1093/gastro/goaf045 · Cited by 21
Hepatocellular Carcinoma Surveillance and Survival in a Contemporary Asia-Pacific Cohort
Lim, R. Y., Koh, B., Ng, C. H., Kulkarni, A. V., Liu, K., Wijarnpreecha, K., Kim, B. K., Muthiah, M. D., Lee, S. W., Zheng, M., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.20294 · Cited by 21
Suárez, M., Gil-Rojas, S., Martínez-Blanco, P., Torres, A., Ramón, A., Blasco-Segura, P., Torralba, M., & Mateo, J. (2024) · Cancers · doi:10.3390/cancers16061114 · Cited by 18
“Inclusion criteria encompassed patients aged 18 and above with a confirmed HCC diagnosis via the presence of an imaging test compatible with its vascular behavior in patients with liver cirrhosis or via liver biopsy for those without cirrhosis or with diagnostic uncertainty [17,25].”
BackgroundHepatocellular carcinoma: Advances in systemic therapies
Wu, T. K.-H., Hui, R. W., Mak, L., Fung, J., Seto, W., & Yuen, M. (2024) · F1000Research · doi:10.12688/f1000research.145493.1 · Cited by 21
Insights into Immune Exhaustion in Chronic Hepatitis B: A Review of Checkpoint Receptor Expression
Costa, J. P., Carvalho, A. D. M., Paiva, A. A., & Borges, O. (2024) · Pharmaceuticals · doi:10.3390/ph17070964 · Cited by 21
“Clinical trials are currently underway, and several therapies are already approved, such as nivolumab, pembrolizumab, and combination therapy with atezolizumab plus bevacizumab and durvalumab plus tremelimumab [178].”
BackgroundHui, R. W., Chiu, K. W.-H., Lee, I., Wang, C., Cheng, H. M., Lu, J., Mao, X., Yu, S. N., Lam, L.-K., Mak, L., et al. (2024) · Hepatology · doi:10.1097/hep.0000000000001180 · Cited by 17
Zhang, K., Ru, J., Wang, W., Ma, Q., Gao, F., Wu, J., Dai, Z., Xie, Q., Mu, L., Zhang, H., et al. (2025) · Nature Communications · doi:10.1038/s41467-025-59197-0 · Cited by 17
“…were evaluated in this study, including the eighth American Joint Committee on Cancer (AJCC) staging system 46 , Barcelona Clinic Liver Cancer (BCLC) staging system 47 , Chinese Liver Cancer (CNLC) staging system 48 , Hong Kong Liver Cancer (HKLC) staging system 49 , Italian Liver Cancer (ITA.”
The present and the future of immunotherapy in hepatocellular carcinoma and biliary tract cancers
Cabibbo, G., Rimassa, L., Lamarca, Á., Masi, G., Daniele, B., Pinato, D. J., & Gardini, A. C. (2025) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2025.102955 · Cited by 18
Wei, H., Jiang, H., Yoo, J., Kim, J. H., Kang, H., Wu, Y., Liu, R., Kim, H., & Lee, J. M. (2025) · European Radiology · doi:10.1007/s00330-025-11659-1 · Cited by 17
Meta‐Analysis: Utilisation of Hepatocellular Carcinoma Surveillance
Tang, N. S. Y., Gunalan, S. Z., Ong, C. E. Y., Koh, B., Tham, E. K. J., Lim, R. Y., Tan, D. J. H., Syn, N. L. X., Ng, C. H., Muthiah, M. D., et al. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70403 · Cited by 18
The global epidemiology of hepatocellular carcinoma
Butt, M. A., Aby, E. S., & Debes, J. D. (2026) · Hepatology Communications · doi:10.1097/hc9.0000000000000932 · Cited by 18
“[16,27,45,49,50] Sustained efforts are needed to expand surveillance coverage, address the rising burden of metabolic risk factors, and reduce socioeconomic and geographic disparities in access to care (Box 3).”
InfluentialHallmarks of liver cancer: Therapeutic implications
Llovet, J. M., Pinyol, R., Affò, S., Yarchoan, M. M., Gores, G. J., Kelley, R. K., Lowe, S. W., Sia, D., & Villanueva, A. (2026) · Cell · doi:10.1016/j.cell.2026.03.001 · Cited by 19
“97,102 (3) Marked tumor heterogeneity.”
Self-citationCurrent Therapeutic Strategies for Hepatocellular Carcinoma in Japan
Kudo, M. (2023) · Liver Cancer · doi:10.1159/000534304 · Cited by 17
“This concept is re fl ected in various global guidelines such as AASLD [56, 68], ESMO [69], and BCLC [70].”
MethodIndication of Liver Transplant for HCC: Current Status and Future Directions
Horwitz, J. K., & Agopian, V. G. (2024) · Current Hepatology Reports · doi:10.1007/s11901-024-00641-y · Cited by 17
Self-citation
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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