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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]
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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
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New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)
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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
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
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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
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Items 501–600 of 1,000
Shin, H. P., & Lee, M. (2025) · Medicina · doi:10.3390/medicina61122164 · Cited by 6
“Systemic therapies with atezolizumab plus bevacizumab or durvalumab plus tremeli-mumab have been recognized as preferred first-line treatment options by several recent guidelines [6,59].”
Fortuny, M., Rosa, A. D., Roca, I., Ouchi, D., Suárez, E., Cadiz, A., Matute‐González, M., Moon, A. M., Rimola, J., Torres, F., et al. (2025) · Hepatology · doi:10.1097/hep.0000000000001630 · Cited by 6
Ascari, S., Chen, R., Sinno, A. D., Stefanini, B., Cescon, M., Serenari, M., Mosconi, C., & Tovoli, F. (2026) · World Journal of Gastroenterology · doi:10.3748/wjg.v32.i3.111528 · Cited by 6
“International guidelines recommend second-line mTKIs following progression on immunotherapy[27,28].”
Kim, N. G., Yao, F. Y. K., Kwong, A. J., & Mehta, N. J. (2026) · Journal of Hepatology · doi:10.1016/j.jhep.2026.01.008 · Cited by 6
Self-citationSafety of Immune Checkpoint Inhibitors Prior to Liver Transplantation in Hepatocellular Carcinoma
Aceituno, L., Magyar, C. T. J., Tabrizian, P., Marino, R., Watt, K., Chascsa, D. M. H., Schnickel, G. T., Banz, V. M., Alconchel, F., Martagón, C., et al. (2026) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70528 · Cited by 6
Matono, T., Tada, T., Hiraoka, A., Hirooka, M., Nakamura, Y., Yoshida, O., Kariyama, K., Nouso, K., Tani, J., Morishita, A., et al. (2026) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.70422 · Cited by 6
Jeong, J. H., Hong, J. Y., Kim, D. Y., Lee, J. S., Kim, M. N., Kim, S. U., Kim, B. K., Park, J. Y., Kim, D. J., Ahn, S. H., et al. (2026) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70850 · Cited by 6
Ryu, H., Kim, T. U., Yoon, K. T., & Hong, Y. M. (2023) · BMC Gastroenterology · doi:10.1186/s12876-023-03038-1 · Cited by 6
“Patients with cirrhosis sometimes undergo CT scans to screen for HCC when ultrasound surveillance is suboptimal [33, 34].”
BackgroundCheon, J., Jung, S., Kim, J. S., Kang, B., Kim, H., Chan, L. L., Becker, L., Gaillard, V. E., Chan, S. L., Kim, C., et al. (2024) · Liver International · doi:10.1111/liv.15935 · Cited by 6
Abdelmalak, J., Strasser, S. I., Ngu, N. L., Dennis, C. V., Sinclair, M. J., Majumdar, A., Collins, K., Bateman, K., Dev, A. T., Abasszade, J. H., et al. (2024) · Cancers · doi:10.3390/cancers16111966 · Cited by 6
“The BCLC treatment algorithm recommends upfront ablation as the locoregional curative treatment choice for BCLC 0/A patients [19], and none of the major international or Australian guidelines recommend TACE as initial therapy in BCLC 0 or A disease [6,20–22].”
MethodRedefining HCC Surveillance in India: A Call for Innovative and Inclusive Strategies
Yelsangikar, A., & Patil, P. S. (2024) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2024.101474 · Cited by 6
Floridi, C., Cacioppa, L. M., Rossini, N., Macchini, M., Bruno, A., Agostini, A., Consoli, V., Inchingolo, R., Acquafredda, F., Nicolini, D., et al. (2024) · La radiologia medica · doi:10.1007/s11547-024-01842-7 · Cited by 6
Yoon, J. K., Han, D. H., Lee, S., Choi, J., Choi, G. H., Kim, D. Y., & Kim, M. (2024) · Liver International · doi:10.1111/liv.16059 · Cited by 6
Embolic and Ablative Therapy for Hepatocellular Carcinoma
Khalid, M., Likhitsup, A., & Parikh, N. D. (2024) · Clinics in Liver Disease · doi:10.1016/j.cld.2024.08.003 · Cited by 6
Chiang, J., Raman, S. S., Ramakrishnan, A., Keshavarz, P., Sayre, J. W., McWilliams, J. P., Finn, R. S., Agopian, V. G., Choi, G., & Lu, D. (2024) · Journal of Vascular and Interventional Radiology · doi:10.1016/j.jvir.2024.09.008 · Cited by 6
Self-citationAbedrabbo, N., Lerner, E., Lam, E., Kadi, D., Dawit, H., van der Pol, C. B., Salameh, J., Naringrekar, H., Adamo, R. G., Alabousi, M., et al. (2024) · Abdominal Radiology · doi:10.1007/s00261-024-04580-6 · Cited by 6
“The choice of treatment is contingent upon several factors including tumor burden, liver function, and patient performance status [25].”
Self-citationTomonari, T., Tani, J., Sato, Y., Tanaka, H., Morishita, A., Okamoto, K., Kawano, Y., Sogabe, M., Miyamoto, H., & Takayama, T. (2024) · JGH Open · doi:10.1002/jgh3.70033 · Cited by 6
“6 Thus, Dur + Tre is recommended as a fi rst-line option for patients at risk of bleeding.”
BackgroundThe Changing Face of Hepatitis Delta Virus Associated Hepatocellular Carcinoma
Cardoso, M. F., & Machado, M. V. (2024) · Cancers · doi:10.3390/cancers16223723 · Cited by 6
“…European and American guidelines recommend HCC surveillance when the annual risk is at least 0.2%, corresponding to the intermediate and high-risk groups in PAGE-B score for HBV mono-infected patients [94,95]. be made to diagnose tumors that still fulfill the criteria for liver transplantation.”
InfluentialTumor Seeding With Needle Biopsy of Hepatocellular Carcinoma: A Systematic Review
Nie, C., Vaska, M. M., Wong, J. K., Bathe, O. F., Przybojewski, S. J., Burak, K. W., Tang, P. A., & Congly, S. E. (2024) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000003210 · Cited by 6
“It must be additionally noted that sensitivity of liver biopsy has been quoted between 70% and 93%, but has been reported as low as 60% in tumors , 2 cm (particularly given a decreased density of tumor vessels in early HCC), necessitating follow-up imaging and potentially a second biopsy (10).”
Liver elastography-based risk score for predicting hepatocellular carcinoma risk
Tian, C., Ye, C., Guo, H., Lu, K., Yang, J., Wang, X., Ge, X., Yu, C., Lu, J., Jiang, L., et al. (2024) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djae304 · Cited by 6
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Lu, J., Feng, J.-K., Zhao, Y., Chen, B., Li, P., He, C., Gong, L., & Bao, L.-L. (2025) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2025.110102 · Cited by 6
Thanapirom, K., Suksawatamnuay, S., Thaimai, P. M., Siripon, N., Geratikornsupuk, N., Treeprasertsuk, S., & Komolmit, P. (2025) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2025.102607 · Cited by 6
Saeoui, T., Kositamongkol, C., Chantrakul, R., Sripongpun, P., Chamroonkul, N., Kongkamol, C., Phisalprapa, P., & Kaewdech, A. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70386 · Cited by 6
Muñoz, S., Sapena, V., García‐Criado, Á., Darnell, A., Forner, A., Belmonte, E., Sanduzzi‐Zamparelli, M., Rimola, J., Soler, A., Llarch, N., et al. (2023) · Cancers · doi:10.3390/cancers15133269 · Cited by 6
Assessment of STAT4 Variants and Risk of Hepatocellular Carcinoma in Latin Americans and Europeans
Ayoub, A., Anugwom, C. M., Prieto, J. E., Balderramo, D. C., Ferrer, J. D., de Mattos, Â. Z., Arrese, M. A., Carrera, E., Groothuismink, Z. M. A., Oliveira, J., et al. (2023) · Cancers · doi:10.3390/cancers15184530 · Cited by 6
“Patients were classified as having HCC if they met the American Association for the Study of Liver Disease’s prescribed biopsy or imaging standards [26].”
MethodFrom evidence to clinical practice: Bridging the gap of new liver cancer therapies in Latin America.
Piñero, F., Mauro, E., Casciato, P. C., & Forner, A. (2023) · Annals of Hepatology · doi:10.1016/j.aohep.2023.101185 · Cited by 6
Health-related quality of life in Thai patients with chronic hepatitis B
Chantrakul, R., Sripongpun, P., Pattarapuntakul, T., Chamroonkul, N., Kongkamol, C., Phisalprapa, P., & Kaewdech, A. (2023) · Gastroenterology report · doi:10.1093/gastro/goae015 · Cited by 6
Gaillard, F., Silverstone, L., & Campos, A. (2008) · Radiopaedia.org · doi:10.53347/rid-1442 · Cited by 6
Halevy, D., Sayed, B. A., Shaikh, F., Siddiqui, I. F. S., & Chavhan, G. B. (2024) · Indian journal of radiology and imaging - new series/Indian journal of radiology and imaging/Indian Journal of Radiology & Imaging · doi:10.1055/s-0044-1785208 · Cited by 5
“11 Role of MRI in detection, characterization, and assessment of staging and extent in hepatic lesions is also well described in children.”
BackgroundMazza, S., Frigerio, C., Alfieri, D., Mauro, A., Viera, F. T., Scalvini, D., Barteselli, C., Sgarlata, C. S., Veronese, L., Bardone, M., et al. (2024) · Medicina · doi:10.3390/medicina60050692 · Cited by 5
“Such a high incidence of HCC in cirrhotic patients supports the implementation of surveillance programs, with a 6-month surveillance with abdominal ultrasound being recommended by European and American guidelines [7,8].”
BackgroundHetta, . F., Hamed, H. M., Mekky, M. A., Abdelmalek, M. O., & Hassan, W. A. (2024) · Egyptian Liver Journal · doi:10.1186/s43066-024-00385-w · Cited by 5
“[5] The intense need for more reliable, sensitive and non-invasive biomarkers utilizes many genetic and molecular tools.”
Tappata, M., Ford, J. S., Kayandabila, J., Morrison, J., Seth, S., Lyimo, B., May, L. S., & Debes, J. D. (2025) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.24-0341 · Cited by 5
Schulze, K., Rose, T. D., Adlung, L., Peschka, M., Pagani, F., Gorgulho, J., Fründt, T., Labgaa, I., Haber, P. K., Zimpel, C., et al. (2025) · JHEP Reports · doi:10.1016/j.jhepr.2025.101340 · Cited by 5
Fassio, E., Colombato, L., Gualano, G., Perez, S., Puga‐Tejada, M., & Landeira, G. (2025) · Cancers · doi:10.3390/cancers17061018 · Cited by 5
“…the Prevention, Diagnosis, and Treatment of Hepatocellular Carcinoma by the American Association for the Study of Liver Diseases states that “HCC incidence is significantly lower in post-SVR patients without cirrhosis, and surveillance is not cost-effective or recommended in this population” [25].”
Advances in radiation therapy for HCC: Integration with liver-directed treatments
Yariv, O., Newman, N. B., Yarchoan, M. M., Rabiee, A., Wood, B. J., Salem, R., Hernandez, J. M., Bang, C. K., Yanagihara, T. K., & Escorcia, F. E. (2025) · Hepatology Communications · doi:10.1097/hc9.0000000000000653 · Cited by 5
“Emerging evidence supporting the efficacy of EBRT for patients with early or intermediate HCC prompted its inclusion in clinical guidelines (eg, National Comprehensive Cancer Network [NCCN], [13] American Association for the Study of Liver Diseases [AASLD] [14] ).”
Self-citationRole of imaging-guided biopsy for hepatocellular carcinoma
Cannella, R., Berman, Z. T., Tirukkovalur, N. V., Tohme, S. T., Minervini, M. I., & Furlan, A. (2025) · European Journal of Radiology · doi:10.1016/j.ejrad.2025.112271 · Cited by 6
Ananchuensook, P., Piyawannasuth, K., Suksawatamnuay, S., Thaimai, P. M., Siripon, N., Sriphoosanaphan, S., Thanapirom, K., & Komolmit, P. (2025) · PLoS ONE · doi:10.1371/journal.pone.0327967 · Cited by 5
“According to the American Association for the Study of Liver Disease guidelines, HCC is diagnosed histopathologically or by a compatible arterial enhancing liver mass with rapid venous washout on contrast-enhanced abdominal imaging in patients with chronic liver disease or cirrhosis [19].”
Che, F., Zhu, J., Li, Q., Jiang, H., Wei, Y., & Song, B. (2025) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.70048 · Cited by 6
“Systemic therapy is recommended for patients with unresectable HCC who are ineligible for curative or locoregional treatments, including those with advanced disease (BCLC C), selected intermediate-stage cases (BCLC B), or progression after LRTs [80].”
Parikh, N. D., Patel, R. A., Hu, J., Stirnadel-Farrant, H. A., Kebede, N., Wang, C., & Garcia-Reyes, K. (2025) · Hepatic Oncology · doi:10.1080/20450923.2025.2530377 · Cited by 5
“For patients with unresectable eHCC, liver transplantation is associated with the best outcomes; however, graft availability and recipient eligibility are barriers to transplantation [5].”
InfluentialVitale, A., Kim, J. S., Cabibbo, G., Gardini, A. C., Iavarone, M. A., Rimassa, L., Ponziani, F. R., Tovoli, F., Chon, H. J., Kang, B., et al. (2025) · Liver Cancer · doi:10.1159/000547792 · Cited by 5
“…with HCC have access to several treatment options, including liver transplantation (LT), liver resection (LR), thermal ablation (TA), intra-arterial therapies, such as trans-arterial chemo-embolisation (TACE) or radioembolisation (TARE), external radiotherapy, and systemic therapies (STs) [5–7].”
Willms, A. G., Krawczyk, M. J., Julich‐Haertel, H., Gries, S. K., Bañales, J. M., Mocan, T., Klein, A., Schaaf, S., Güsgen, C., Schwab, R., et al. (2025) · JHEP Reports · doi:10.1016/j.jhepr.2025.101540 · Cited by 5
Induced Pluripotent Stem Cell-Based Cancer Immunotherapy: Strategies and Perspectives
Xun, X., Hao, J., Cheng, Q., & Gao, P. (2025) · Biomedicines · doi:10.3390/biomedicines13082012 · Cited by 5
Advances in Systemic Therapy for Hepatocellular Carcinoma and Future Prospects
Sugimoto, R., Kurokawa, M., Tanaka, Y., Senju, T., Kohjima, M., & Tanaka, M. (2025) · Current Oncology · doi:10.3390/curroncol32090490 · Cited by 5
“However, with the advent of nucleoside analogues that can cure hepatitis C, the underlying risk factors for HCC have altered, shifting the primary cause of carcinogenesis from viral hepatitis to metabolic dysfunction-associated steatohepatitis, including non-alcoholic steatohepatitis [2].”
MASLD Under the Microscope: How microRNAs and Microbiota Shape Hepatic Metabolic Disease Progression
Asero, C., Franzè, M. S., Cacciola, I., & Gangemi, S. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26178633 · Cited by 6
“MASLD can progressively evolve into metabolic dysfunction-associated steatohepatitis (MASH), characterized by hepatocellular ballooning and lobular inflammation, but also into liver cirrhosis and hepatocellular carcinoma (HCC) [18,19].”
Gong, H., Cheng, Y., Li, Q., He, Y., Cai, Q., Tang, Y., Liu, Y., Kuang, L., Li, Y., Shang, J., et al. (2025) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-025-07548-w · Cited by 5
“Inclusion criteria: (a) age > 18 years; (b) diagnosed with HCC by clinicians based on pathology or clinical diagnostic criteria [ 5]; (c) diagnosed with uHCC by hepatobiliary surgeons based on the patient’s lesion characteristics, invasion and metastasis, liver reserve function, physical status,…”
InfluentialKo, K. A., Oh, H., Kim, M. S., Hong, H. P., Cho, Y. K., Kim, B. I., & Sohn, W. (2025) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.70098 · Cited by 5
Parraga, X., Razzak, I. A., Chumdermpadetsuk, R. R., Alsaqa, M., Lingamsetty, S. S. P., Bonder, A., & Saberi, B. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14197009 · Cited by 5
“For patients with early-stage HCC who are not candidates for resection due to liver dysfunction or multifocal tumors, liver transplant (LT) offers a curative option for both the cancer and the underlying liver disease [2].”
Shen, X., Zhang, J.-X., Yan, H., Liu, J., Liu, S., Shi, H.-B., & Zu, Q. (2025) · Academic Radiology · doi:10.1016/j.acra.2025.09.022 · Cited by 5
Reactivation of the PI3K/mTOR Signaling Pathway Confers Resistance to the FGFR4 Inhibitor FGF401
Huynh, H. T., & Ng, W. H. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26199818 · Cited by 5
“Systemic therapies combining atezolizumab and bevacizumab or durval-umab and tremelimumab are now the preferred first-line option [2], except in patients with high-risk stigmata of varices, gastrointestinal bleeding or advanced liver cirrhosis [16].”
Guo, B., Luo, C., Lu, Y., Wu, Y., Xie, S., Xia, F., Hua, Y., Zhu, J., Cai, G., Zhu, H., et al. (2025) · Annals of Surgical Oncology · doi:10.1245/s10434-025-18549-2 · Cited by 6
Maesaka, K., Hikita, H., Tahata, Y., Nishioka, C., Kai, M., Shirai, K., Murai, K., Makino, Y., Saito, Y., Kodama, T., et al. (2025) · Journal of Gastroenterology · doi:10.1007/s00535-025-02308-x · Cited by 5
Chemoprevention of hepatocellular carcinoma
Schwenk, S., & Kaplan, D. E. (2025) · Hepatology Communications · doi:10.1097/hc9.0000000000000836 · Cited by 6
“[ 2 ] ANTIHYPERTENSIVE AGENTS Antihypertensive medications, including angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and non-selective beta blockers (NSBBs), have been studied in relation to HCC chemoprevention in patients with liver disease.”
InfluentialIoannou, G. N., Taddei, T. H., Planeta, B. M., Huang, G. D., Weiss, N. S., Morgan, T. R. M., Dominitz, J. A., Abou‐Alfa, G. K., Bashir, M. R., Beheshti, M. V., et al. (2025) · JHEP Reports · doi:10.1016/j.jhepr.2025.101666 · Cited by 5
Self-citationYin, L., Li, W., Shao, W., Hou, X., Liu, B., Liu, X., Liu, R., & Huang, P. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1669856 · Cited by 6
Sasaki, R., Shimose, S., Saeki, I., Ito, T., Takeuchi, Y., Tani, J., Tomonari, T., Sasaki, K., Kakizaki, S., Hatanaka, T., et al. (2025) · Liver International · doi:10.1111/liv.70466 · Cited by 5
Hepatitis B Virus RNA Predicts Hepatocellular Carcinoma Despite Viral Suppression
Kumada, T., Toyoda, H., Yasuda, S., Koshiyama, Y., Ito, T., Akita, T., & Tanaka, J. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70483 · Cited by 5
“Less than the lower limit of quantification, HBV RNA 10 copies/mL. patients based on traditional risk factors [24, 25].”
Yoon, J. H., Choi, J.-I., Yoo, J., Jeon, S. K., Kim, J. H., Bae, J. S., Kang, H.-J., Kim, H., Youn, S. Y., Kim, D. H., et al. (2025) · Liver Cancer · doi:10.1159/000548516 · Cited by 5
Care for Vulnerable Populations with Chronic Liver Disease: A Safety-Net Perspective
Wang, M. C., Bangaru, S. D., & Zhou, K. (2023) · Healthcare · doi:10.3390/healthcare11202725 · Cited by 5
“There are suboptimal rates of guideline-concordant screening and surveillance for HCC (ultrasound and alpha-fetoprotein every 6 months) in the US for all cirrhotics, but they are lowest in those of a lower socioeconomic status [30].”
BackgroundMartínez-Blanco, P., Suárez, M., Gil-Rojas, S., Torres, A., Martínez-García, N., Blasco, P., Torralba, M., & Mateo, J. (2024) · Diagnostics · doi:10.3390/diagnostics14040406 · Cited by 5
“However, factors such as MASLD and alcohol consumption continue to be determining factors in the development of ACLD and HCC, with an increasing incidence in recent years, particularly in Western countries [3,37].”
BackgroundInfluentialCao, J., Wang, H., & Ling, W. (2024) · Quantitative Imaging in Medicine and Surgery · doi:10.21037/qims-23-1616 · Cited by 5
“As a radiation-free, real-time, and cost-effective imaging modality, contrast-enhanced ultrasound (CEUS) has been recommended for the screening of high-risk populations and has been shown to exhibit good diagnostic performance in diagnosing HCC (3,4).”
BackgroundStatins in Chronic Liver Disease: Review of the Literature and Future Role
Pham, N., & Benhammou, J. N. (2024) · Seminars in Liver Disease · doi:10.1055/a-2319-0694 · Cited by 5
“166 169 The lack of complete responses to new fi rst-line agents, decrease in liver transplantation in patients with HCC due to recent UNOS policy changes, and rise in MASLD-HCC as an indication for liver transplantation have made identifying chemoprevention agents and treatments more relevant than…”
BackgroundChaiwiriyawong, S., Assawasuwannakit, S., Feuangwattana, P., Sripongpun, P., Chamroonkul, N., Piratvisuth, T., & Kaewdech, A. (2024) · Diagnostics · doi:10.3390/diagnostics14131325 · Cited by 5
Xiao, M., Deng, Y., Zheng, W., Huang, L., Wang, W., Yang, H., Gao, D., Guo, Z., Wang, J., Li, C., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e38850 · Cited by 5
“Therefore, the imaging diagnosis of HCC is particularly important [13,14].”
BackgroundXiao, T. S., Kuon-Yeng, C., Tahmasebi, A., Kono, Y., Piscaglia, F., Wilson, S. R., Medellin, A., Rodgers, S. K., Planz, V. B., Kamaya, A., et al. (2024) · Abdominal Radiology · doi:10.1007/s00261-024-04625-w · Cited by 5
“The most common being hepatocellular carcinoma (HCC), comprising more than 80% of cases [2].”
Koo, E., Dahan, K. S. E., Daher, D., Rich, N. E., Mittal, S., Yang, J. D., Parikh, N. D., & Singal, A. G. (2024) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.08.051 · Cited by 5
Self-citationYoon, J. Y., Shah, S. C., Lin, J. J., Kim, M. K., Itzkowitz, S. H., & Wang, C. P. (2024) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2024.100954 · Cited by 5
“21 Within the US, the aetiology of HCC varies by origin group, where targeted disease surveillance and screening should be considered.”
Prognosis prediction of α-FAtE score for locoregional immunotherapy in hepatocellular carcinoma
Zheng, Z., Guan, R., Zhao, R., Gan, J., Xiong, X., Zou, J., Li, S., Wang, Q., Wei, W., Mei, J., et al. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1496095 · Cited by 5
“…are: 1) diagnosed by imaging examinations or biopsy pathology based on American Association for the Study of Liver Diseases (AASLD) guidelines (16); 2) aged between 18 to 80 years; 3) had treated with at least one locoregional therapy and 2 cycles immunotherapy; 4) had a performance status…”
Persisting challenges in the early detection of hepatocellular carcinoma
Arvind, A., Redmon, K., & Singal, A. G. (2025) · Expert Review of Anticancer Therapy · doi:10.1080/14737140.2025.2467184 · Cited by 5
“Both the AASLD and the American College of Radiology suggest obtaining a follow-up surveillance CT or MRI in patients with severe visualization limitations on ultrasound [13,53].”
Self-citationPang, F., Deng, H., Peng, D., He, J., Zhao, W., Yu, L., Chen, T., Zonggui, X., Cai, H., & Chen, B. (2025) · Radiation Physics and Chemistry · doi:10.1016/j.radphyschem.2025.112642 · Cited by 5
Saborido, B., Darnell, A., Forner, A., García‐Criado, Á., Díaz, A., Ayuso, C., Vilana, R., Bruix, J., Reig, M., & Rimola, J. (2025) · European Radiology · doi:10.1007/s00330-025-11495-3 · Cited by 5
Zheng, S.-S., Wu, J., Zhang, Z., Wu, Y., Chen, Y., Qian, S., & Zhang, B. (2025) · Journal of Hepatocellular Carcinoma · doi:10.2147/jhc.s512302 · Cited by 5
US Liver Imaging Reporting and Data System Version 2017: A Systematic Review and Meta-Analysis
Lee, S., Yoon, J. K., Shin, J., Shin, H. J., Aslam, A., Kamaya, A., Rodgers, S. K., Sirlin, C. B., & Chernyak, V. (2025) · Radiology · doi:10.1148/radiol.240450 · Cited by 5
Lani, L., Zaccherini, G., Giannini, E. G., & Trevisani, F. (2025) · Hepatoma Research · doi:10.20517/2394-5079.2024.136 · Cited by 5
Yang, H. K., Lee, S., Lee, M. Y., & Kim, M. (2025) · European Radiology · doi:10.1007/s00330-025-11517-0 · Cited by 5
Cheng, Z., Yang, X., Ren, Y., Wang, H., Zhang, Q., Lin, S., Wu, W., Yang, X., Zheng, J., Liu, X., et al. (2025) · Translational Oncology · doi:10.1016/j.tranon.2025.102402 · Cited by 5
“Surgical intervention is the primary treatment for early-stage HCC, while immunotherapy is more commonly employed in advanced stages [3,4].”
Wu, Y., Ye, Z., Yang, T., Yao, S., Chen, J., Yin, T., & Song, B. (2025) · European Radiology · doi:10.1007/s00330-025-11633-x · Cited by 5
THE CONCEPT OF “CONVERSE THERAPEUTIC HIERARCHY” FOR PATIENTS WITH HEPATOCELLULAR CARCINOMA
Vitale, A., Cabibbo, G., Rimassa, L., Iavarone, M. A., Colli, A., Crocetti, L., Pawlik, T. M., Gardini, A. C., Ponziani, F. R., Bargellini, I., et al. (2025) · Liver Cancer · doi:10.1159/000546360 · Cited by 5
“…available for patients with HCC, including liver transplantation (LT), liver resection (LR), thermal ablation (TA), external radiotherapy ablation, intra-arterial therapies (IAT) such as transarterial chemo-embolisation (TACE) or transarterial radio-embolisation, and systemic therapy (ST) [5, 6].”
Hatanaka, T., Kakizaki, S., Hiraoka, A., Tada, T., Kariyama, K., Itobayashi, E., Tsuji, K., Ishikawa, T., Toyoda, H., Koshiyama, Y., et al. (2025) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.17025 · Cited by 5
Haghshomar, M., Kierans, A. S., Kulik, L., Miller, F. H., & Borhani, A. A. (2025) · British Journal of Radiology · doi:10.1093/bjr/tqaf123 · Cited by 5
Self-citationPark, Y., Cho, Y., Kim, S. U., Kim, A., Shin, H., Kim, H., Lee, I. J., Kim, G. M., Hyun, D., Ko, Y., et al. (2025) · Diagnostic and Interventional Imaging · doi:10.1016/j.diii.2025.09.002 · Cited by 5
Woodrell, C. D., Mulholland, C. N., Goldstein, N. E., Hutchinson, C. L., Schiano, T. D., & Hansen, L. (2023) · Cancers · doi:10.3390/cancers15143617 · Cited by 5
“HCC is distinct from other types of solid cancer in terms of biology (frequent presence of concurrent cirrhosis), treatment modalities (systemic treatment is generally reserved for advanced disease), and a uniquely complex clinical landscape [9].”
BackgroundIs Cell-Free DNA Testing in Hepatocellular Carcinoma Ready for Prime Time?
Jeepalyam, S., Sheel, A., Ejaz, A. M., Miller, E. D., & Manne, A. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241814231 · Cited by 5
Blood-Based Biomarkers for HCC Surveillance: Ready for the Center Stage?
Singal, A. G., Yang, J. D., & Parikh, N. D. (2023) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002539 · Cited by 5
Self-citationMoon, A. M., Cook, S., Swier, R. M., Sanoff, H. K., Kappelman, M. D., Wagner, L. I., Barritt, A. S., Singal, A. G., Shah, N., Mauro, D. M., et al. (2023) · Hepatology Communications · doi:10.1097/hc9.0000000000000315 · Cited by 5
“Inclusion criteria were: age ≥ 18 years, HCC diagnosis based on American Association for the Study of Liver Diseases criteria, [23] plan to receive thermal ablation, TACE, TARE or SBRT, and English-speaking.”
MethodSelf-citationHuang, C., Liang, P., Wang, C., Jang, T., Hsu, P., Tsai, P., Wei, Y., Yeh, M., Hsieh, M., Lin, Y., et al. (2024) · The Kaohsiung Journal of Medical Sciences · doi:10.1002/kjm2.12804 · Cited by 5
Unome, S., Imai, K., Miwa, T., Hanai, T., Suetsugu, A., Takai, K., Suzui, N., Miyazaki, T., & Shimizu, M. (2024) · Internal Medicine · doi:10.2169/internalmedicine.3071-23 · Cited by 5
“In this case, based on the elevated AFP levels, we considered the HCC component to be dominant and administered Dur/Tre as first-line treatment for unresectable HCC (27).”
MethodDetection of hepatocellular carcinoma methylation markers in salivary DNA
Mezzacappa, C., Wang, Z., Lu, L., Risch, H. A., Taddei, T. H., & Yu, H. (2024) · Bioscience Reports · doi:10.1042/bsr20232063 · Cited by 5
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“…stage, societal guidelines from the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver recommend ultrasound-based surveillance in at-risk patients including patients with cirrhosis or chronic hepatitis B virus (HBV) infection (5,6).”
Self-citationYounis, M. A., & Harashima, H. (2024) · Pharmacogenomics and Personalized Medicine · doi:10.2147/pgpm.s431346 · Cited by 7
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Zhang, Y., Jin, L., Ma, H., & Zuo, S. (2024) · Journal of Hepatocellular Carcinoma · doi:10.2147/jhc.s476439 · Cited by 5
“6 To prolong the survival of HCC patients the clarification of the 2nd line treatment regimen after the occurrence of resistance to lenvatinib is extremely urgent.”
BackgroundRattanasupar, A., Prateepchaiboon, T., Akarapatima, K., Songjamrat, A., Pakdeejit, S., & Chang, A. (2024) · Scientific Reports · doi:10.1038/s41598-024-70266-0 · Cited by 5
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“Traditionally, primary liver cancer with macrovascular invasion has been classified as advanced hepatocellular carcinoma (HCC), which carries a poor prognosis, and systemic palliative treatment has been considered the sole therapeutic option [3].”
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“AFP is the most widely used serum biomarker for HCC diagnosis and HCC surveillance using ultrasound and AFP at semiannual intervals is recommended in the American Association for the Study of Liver Diseases (AASLD) guideline [40].”
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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