JSH Consensus-Based Clinical Practice Guidelines for the Management of Hepatocellular Carcinoma: 2014 Update by the Liver Cancer Study Group of Japan

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Abstract

The Clinical Practice Guidelines for the Management of Hepatocellular Carcinoma proposed by the Japan Society of Hepatology was updated in June 2014 at a consensus meeting of the Liver Cancer Study Group of Japan. Three important items have been updated: the surveillance and diagnostic algorithm, the treatment algorithm, and the definition of transarterial chemoembolization (TACE) failure/refractoriness. The most important update to the diagnostic algorithm is the inclusion of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging as a first line surveillance/diagnostic tool. Another significant update concerns removal of the term “lipiodol” from the definition of TACE failure/refractoriness.

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Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma.

Masao Omata, Laurentius Lesmana, Ryosuke Tateishi … (2010)

The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Management of Hepatocellular Carcinoma in Japan: Consensus-Based Clinical Practice Guidelines Proposed by the Japan Society of Hepatology (JSH) 2010 Updated Version

Masatoshi Kudo, M Kudo, Namiki Izumi … (2011)

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death not only in Japan but also worldwide. Clinical practice guidelines for HCC were first published in 2001 by the European Society of Study of the Liver (EASL) followed by the American Association for the Study of Liver Disease (AASLD) published in 2005 and updated in 2010. However, these guidelines have proven to be somewhat unsuitable for Japanese patients. In 2005, supported by the Japanese Ministry of Health, Labour and Welfare, evidence-based clinical practice guidelines for HCC were compiled in Japan. In 2009, a revised version of evidence-based guidelines was published. Based on both ‘evidence-based’ guidelines and the consensus of an expert panel on HCC, the Japan Society of Hepatology (JSH) published the Consensus-Based Clinical Practice Manual in 2007 and updated in 2010. In this article, the 2010 updated version of this manual, especially issues on prevention, surveillance, pathology, diagnosis, staging, and treatment algorithm are summarized.

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Imaging study of early hepatocellular carcinoma: usefulness of gadoxetic acid-enhanced MR imaging.

M Asakawa, Ali Muhi, Tsutomu Araki … (2011)

To describe imaging findings of early hepatocellular carcinoma (HCC) at gadoxetic acid-enhanced magnetic resonance (MR) imaging, dynamic contrast material-enhanced computed tomography (CT), CT during arterial portography (CTAP), and CT during hepatic arteriography (CTHA) and to compare the diagnostic performance of each modality for small (≤ 2 cm) HCC. The institute ethics committee deemed study approval unnecessary. One hundred eight resected small lesions in 64 patients were diagnosed as a dysplastic nodule (DN) (n = 12), progressed HCC (n = 66), or early HCC (n = 30). All but two patients underwent all imaging examinations. The imaging characteristics of the lesions with each modality were determined. To evaluate the diagnostic performance of the modalities, two radiologists graded the presence of HCC with use of a five-point confidence scale. The area under the receiver operating characteristic curve (A(z)), sensitivity, and specificity of each modality were compared. The imaging features that are statistically significant for differentiating an early HCC from a DN include fat-containing lesions at dual-echo T1-weighted MR imaging (seen in 16 of the 30 early HCCs and none of the DNs), low attenuation at unenhanced CT (seen in 13 of the 30 early HCCs and none of the DNs), low attenuation at CTAP (seen in 11 of the 30 early HCCs and none of the DNs), and low signal intensity at hepatocyte phase gadoxetic acid-enhanced MR imaging (seen in 29 of the 30 early HCCs and none of the DNs). The diagnostic performance of gadoxetic acid-enhanced MR imaging (A(z), 0.98 and 0.99) was significantly greater than that of contrast-enhanced CT (A(z), 0.87) and CTHA-CTAP (A(z), 0.85 and 0.86) owing to its significantly higher sensitivity (P < .001). Gadoxetic acid-enhanced MR imaging is the most useful imaging technique for evaluating small HCC, including early HCC. © RSNA, 2011.

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Journal

Journal ID (publisher-id): LIC

Journal ID (pmc): LIC

Journal ID (doi): 10.1159/issn.1664-5553

Title: Liver Cancer

Publisher: S. Karger AG

ISSN (Print): 2235-1795

ISSN (Electronic): 1664-5553

Publication date Subscription-year: 2014

Publication date (Print): October 2014

Publication date (Electronic): 13 October 2014

Volume: 3

Issue: 3-4

Pages: 458-468

Affiliations

^aDepartment of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka, ^bDepartment of Radiology, Kanazawa University Graduate School of Medical Science, Ishikawa, ^cDepartment of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, ^dDivision of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, ^eDepartment of Radiology, Shinshu University School of Medicine, Nagano, ^fDepartment of Gastroenterology, Ikeda Municipal Hospital, Osaka, ^gDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, ^hDepartment of Diagnostic Radiology, Fukuiken Saiseikai Hospital, Fukui, ⁱDepartment of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, ^jDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Chiba, ^kDepartment of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, ^lDepartment of Gastroenterology and ^mDepartment of Radiology, Kanazawa University Hospital, Ishikawa, ⁿDepartment of Interventional Radiology, Mie University School of Medicine, Mie, Japan

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Publisher ID: 343875 Pmcid ID: PMC4531423 Other ID: Liver Cancer 2014;3:458-468

DOI: 10.1159/000343875

PMC ID: PMC4531423

PubMed ID: 26280007

SO-VID: f0f35e1a-376b-46bd-8677-67daeaa03f01

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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JSH Consensus-Based Clinical Practice Guidelines for the Management of Hepatocellular Carcinoma: 2014 Update by the Liver Cancer Study Group of Japan

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Karger: Gastroenterology

Most cited references 105

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma.

Management of Hepatocellular Carcinoma in Japan: Consensus-Based Clinical Practice Guidelines Proposed by the Japan Society of Hepatology (JSH) 2010 Updated Version

Imaging study of early hepatocellular carcinoma: usefulness of gadoxetic acid-enhanced MR imaging.

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Cited by 245

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