Consensus of Minimally Invasive and Multidisciplinary Comprehensive Treatment for Hepatocellular Carcinoma – 2020 Guangzhou Recommendations
In China, the majority of patients with hepatocellular carcinoma (HCC) result from long-term infection of hepatitis B. Pathologically, HCC is characterized by rich blood supply, multicentric origins, early vascular invasion and intrahepatic metastasis. Therefore, HCC is not a local disease but a sys...
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Frontiers Media S.A.
2021-07-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.621834/full |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Qi-Feng Chen Qi-Feng Chen Qi-Feng Chen Wang Li Simon Chun-ho Yu Yi-Hong Chou Yi-Hong Chou Yi-Hong Chou Hyunchul Rhim Xiaoming Yang Lujun Shen Lujun Shen Lujun Shen Annan Dong Annan Dong Annan Dong Tao Huang Tao Huang Tao Huang Jinhua Huang Fujun Zhang Weijun Fan Ming Zhao Yangkui Gu Zhimei Huang Mengxuan Zuo Bo Zhai Yueyong Xiao Ming Kuang Jiaping Li Jianjun Han Wei Song Jie Ma Peihong Wu |
spellingShingle |
Qi-Feng Chen Qi-Feng Chen Qi-Feng Chen Wang Li Simon Chun-ho Yu Yi-Hong Chou Yi-Hong Chou Yi-Hong Chou Hyunchul Rhim Xiaoming Yang Lujun Shen Lujun Shen Lujun Shen Annan Dong Annan Dong Annan Dong Tao Huang Tao Huang Tao Huang Jinhua Huang Fujun Zhang Weijun Fan Ming Zhao Yangkui Gu Zhimei Huang Mengxuan Zuo Bo Zhai Yueyong Xiao Ming Kuang Jiaping Li Jianjun Han Wei Song Jie Ma Peihong Wu Consensus of Minimally Invasive and Multidisciplinary Comprehensive Treatment for Hepatocellular Carcinoma – 2020 Guangzhou Recommendations Frontiers in Oncology hepatocellular carcinoma minimally-invasive therapy multidisciplinary comprehensive treatment consensus Guangzhou recommendations |
author_facet |
Qi-Feng Chen Qi-Feng Chen Qi-Feng Chen Wang Li Simon Chun-ho Yu Yi-Hong Chou Yi-Hong Chou Yi-Hong Chou Hyunchul Rhim Xiaoming Yang Lujun Shen Lujun Shen Lujun Shen Annan Dong Annan Dong Annan Dong Tao Huang Tao Huang Tao Huang Jinhua Huang Fujun Zhang Weijun Fan Ming Zhao Yangkui Gu Zhimei Huang Mengxuan Zuo Bo Zhai Yueyong Xiao Ming Kuang Jiaping Li Jianjun Han Wei Song Jie Ma Peihong Wu |
author_sort |
Qi-Feng Chen |
title |
Consensus of Minimally Invasive and Multidisciplinary Comprehensive Treatment for Hepatocellular Carcinoma – 2020 Guangzhou Recommendations |
title_short |
Consensus of Minimally Invasive and Multidisciplinary Comprehensive Treatment for Hepatocellular Carcinoma – 2020 Guangzhou Recommendations |
title_full |
Consensus of Minimally Invasive and Multidisciplinary Comprehensive Treatment for Hepatocellular Carcinoma – 2020 Guangzhou Recommendations |
title_fullStr |
Consensus of Minimally Invasive and Multidisciplinary Comprehensive Treatment for Hepatocellular Carcinoma – 2020 Guangzhou Recommendations |
title_full_unstemmed |
Consensus of Minimally Invasive and Multidisciplinary Comprehensive Treatment for Hepatocellular Carcinoma – 2020 Guangzhou Recommendations |
title_sort |
consensus of minimally invasive and multidisciplinary comprehensive treatment for hepatocellular carcinoma – 2020 guangzhou recommendations |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2021-07-01 |
description |
In China, the majority of patients with hepatocellular carcinoma (HCC) result from long-term infection of hepatitis B. Pathologically, HCC is characterized by rich blood supply, multicentric origins, early vascular invasion and intrahepatic metastasis. Therefore, HCC is not a local disease but a systemic disease at the beginning of its occurrence. For this reason, a comprehensive treatment strategy should be adopted in the management of HCC, including local treatments (such as surgical resection, radiofrequency ablation, microwave ablation, chemical ablation and cryoablation, etc.), organ-level treatments [such as transcatheter arterial infusion of chemotherapy and transcatheter arterial chemoembolization (TACE)], and systemic treatments (such as immunotherapy, antiviral therapy and molecular targeted therapy, etc.). This consensus sets forth the minimally-invasive and multidisciplinary comprehensive guideline of HCC, focusing on the following eight aspects (1) using hepaticarteriography, CT hepatic arteriography (CTHA), CT arterial portography (CTAP), lipiodol CT (Lp-CT), TACE-CT to find the intrahepatic lesion and make precise staging (2) TACE combined with ablation or ablation as the first choice of treatment for early stage or small HCC, while other therapies are considered only when ablation is not applicable (3) infiltrating HCC should be regarded as an independent subtype of HCC (4) minimally-invasive comprehensive treatment could be adopted in treating metastatic lymph nodes (5) multi-level subdivision of M-staging should be used for individualized treatment and predicting prognosis (6) HCC with severe hepatic decompensation is the only candidate criterion for liver transplantation (7) bio-immunotherapy, traditional Chinese medicine therapy, antiviral therapy, and psychosocial and psychopharmacological interventions should be advocated through the whole course of HCC treatment (8) implementation of multicenter randomized controlled trials of minimally-invasive therapy versus surgery for early and intermediate stage HCC is recommended. |
topic |
hepatocellular carcinoma minimally-invasive therapy multidisciplinary comprehensive treatment consensus Guangzhou recommendations |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2021.621834/full |
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doaj-825648e38d8940fbb5a168bfe1e1e2a12021-07-02T12:55:37ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-07-011110.3389/fonc.2021.621834621834Consensus of Minimally Invasive and Multidisciplinary Comprehensive Treatment for Hepatocellular Carcinoma – 2020 Guangzhou RecommendationsQi-Feng Chen0Qi-Feng Chen1Qi-Feng Chen2Wang Li3Simon Chun-ho Yu4Yi-Hong Chou5Yi-Hong Chou6Yi-Hong Chou7Hyunchul Rhim8Xiaoming Yang9Lujun Shen10Lujun Shen11Lujun Shen12Annan Dong13Annan Dong14Annan Dong15Tao Huang16Tao Huang17Tao Huang18Jinhua Huang19Fujun Zhang20Weijun Fan21Ming Zhao22Yangkui Gu23Zhimei Huang24Mengxuan Zuo25Bo Zhai26Yueyong Xiao27Ming Kuang28Jiaping Li29Jianjun Han30Wei Song31Jie Ma32Peihong Wu33Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, ChinaDepartment of Radiology, Taipei General Hospital and School of Medicine, National YangMing University, Taipei, ChinaDepartment of Radiology, Yeezen General Hospital, Taoyuan, ChinaDepartment of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaImage-Guided Bio-Molecular Intervention Research and Division of Vascular and Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA, United StatesDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China0Department of Surgery, Shanghai Jiaotong University School of Medicine Renji Hospital, Shanghai, China1Department of Radiology, The First Medical Centre, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China2Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China3Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China4Department of Intervention, Shandong Cancer Hospital, Jinan, China5Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China6Department of Biotherapy, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaDepartment of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaIn China, the majority of patients with hepatocellular carcinoma (HCC) result from long-term infection of hepatitis B. Pathologically, HCC is characterized by rich blood supply, multicentric origins, early vascular invasion and intrahepatic metastasis. Therefore, HCC is not a local disease but a systemic disease at the beginning of its occurrence. For this reason, a comprehensive treatment strategy should be adopted in the management of HCC, including local treatments (such as surgical resection, radiofrequency ablation, microwave ablation, chemical ablation and cryoablation, etc.), organ-level treatments [such as transcatheter arterial infusion of chemotherapy and transcatheter arterial chemoembolization (TACE)], and systemic treatments (such as immunotherapy, antiviral therapy and molecular targeted therapy, etc.). This consensus sets forth the minimally-invasive and multidisciplinary comprehensive guideline of HCC, focusing on the following eight aspects (1) using hepaticarteriography, CT hepatic arteriography (CTHA), CT arterial portography (CTAP), lipiodol CT (Lp-CT), TACE-CT to find the intrahepatic lesion and make precise staging (2) TACE combined with ablation or ablation as the first choice of treatment for early stage or small HCC, while other therapies are considered only when ablation is not applicable (3) infiltrating HCC should be regarded as an independent subtype of HCC (4) minimally-invasive comprehensive treatment could be adopted in treating metastatic lymph nodes (5) multi-level subdivision of M-staging should be used for individualized treatment and predicting prognosis (6) HCC with severe hepatic decompensation is the only candidate criterion for liver transplantation (7) bio-immunotherapy, traditional Chinese medicine therapy, antiviral therapy, and psychosocial and psychopharmacological interventions should be advocated through the whole course of HCC treatment (8) implementation of multicenter randomized controlled trials of minimally-invasive therapy versus surgery for early and intermediate stage HCC is recommended.https://www.frontiersin.org/articles/10.3389/fonc.2021.621834/fullhepatocellular carcinomaminimally-invasive therapymultidisciplinary comprehensive treatmentconsensusGuangzhou recommendations |