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      Guidelines for the Diagnosis and Treatment of Primary Liver Cancer (2022 Edition)

      guideline
      a , a , a , * , b , c , d , e , f , g , h , i , j , k , l , m , a , n , o , p , q , r , s , t , u , v , w , x , y , z , A , d , B , C , D , E , a , F , G , H , I , J , K , L , M , N , O , P , Q , R , S , T , U , V , a , h , W , X , j , d , Y , g , a , Z , α , β , γ , d , δ , ε , x , a , ζ , g , η , a , θ , ι , Y , λ , μ , ι , ξ , π , σ , τ , j , a , a , a , c , n , a , h , φ , χ , w , W , d , O , ψ , Γ , a
      Liver Cancer
      S. Karger AG
      Primary liver cancer, Hepatocellular carcinoma, Guidelines, China, Diagnosis, Treatment

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          Abstract

          Background: Primary liver cancer, of which around 75–85% is hepatocellular carcinoma in China, is the fourth most common malignancy and the second leading cause of tumor-related death, thereby posing a significant threat to the life and health of the Chinese people. Summary: Since the publication of Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China in June 2017, which were updated by the National Health Commission in December 2019, additional high-quality evidence has emerged from researchers worldwide regarding the diagnosis, staging, and treatment of liver cancer, that requires the guidelines to be updated again. The new edition (2022 Edition) was written by more than 100 experts in the field of liver cancer in China, which not only reflects the real-world situation in China but also may reshape the nationwide diagnosis and treatment of liver cancer. Key Messages: The new guideline aims to encourage the implementation of evidence-based practice and improve the national average 5-year survival rate for patients with liver cancer, as proposed in the “Health China 2030 Blueprint.”

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            Cancer statistics in China, 2015.

            With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
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              EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

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                Author and article information

                Journal
                LIC
                LIC
                10.1159/issn.1664-5553
                Liver Cancer
                Liver Cancer
                S. Karger AG
                2235-1795
                1664-5553
                2023
                October 2023
                05 April 2023
                : 12
                : 5
                : 405-444
                Affiliations
                [_a] aLiver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
                [_A] ADepartment of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
                [_b] bDepartment of Pathology, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [_B] BDepartment of Hepatobiliary and Spleenary Surgery, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China
                [_c] cDepartment of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
                [_C] CDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
                [_d] dThe Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [_D] DDepartment of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
                [_e] eInstitute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China
                [_E] EGraduate School, Beijing University of Chinese Medicine, Beijing, China
                [_f] fDepartment of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
                [_F] FDepartment of Hepatic Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, China
                [_g] gDepartment of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
                [_G] GDepartment of Oncology, West China Hospital, Sichuan University, Chengdu, China
                [_h] hDepartment of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
                [_H] HDepartment of General Surgery, Qilu Hospital, Shandong University, Jinan, China
                [_i] iDepartment of Liver Diseases and Digestive Interventional Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
                [_I] IThe First Hospital of Lanzhou University, Lanzhou, China
                [_j] jDepartment of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
                [_J] JDepartment of Nuclear Medicine, The First Hospital of China Medical University, Shenyang, China
                [_k] kDepartment of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
                [_K] KDepartment of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
                [_l] lDepartment of Interventional Radiology, The Tumor Hospital of Harbin Medical University, Harbin, China
                [_L] LDepartment of Oncology, Peking University International Hospital, Beijing, China
                [_m] mDepartment of Interventional Oncology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
                [_M] MChanghai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
                [_n] nDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
                [_N] NDepartment of Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
                [_o] oDepartment of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
                [_O] ODepartment of Medical Oncology, PLA Cancer Center, Nanjing Bayi Hospital, Nanjing, China
                [_p] pDepartment of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
                [_P] PInstitute and Hospital of Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, China
                [_q] qEditorial Department of Chinese Journal of Digestive Surgery, Chongqing, China
                [_Q] QDepartment of General Surgery, The First Hospital of Jilin University, Jilin, China
                [_r] rDepartment of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
                [_R] RDepartment of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Beijing, China
                [_s] sDepartment of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
                [_S] SDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
                [_t] tDepartment of Infectious Diseases, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
                [_T] TDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
                [_u] uDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
                [_U] UDepartment of Interventional Radiology the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
                [_v] vDepartment of Pathology, Tumor Prevention and Treatment Center, Sun Yat-sen University, Guangzhou, China
                [_V] VDepartment of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
                [_w] wDepartment of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
                [_W] WDepartment of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
                [_x] xDepartment of Integrative Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
                [_X] XDepartment of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
                [_y] yDepartment of Radiology, West China Hospital of Sichuan University, Chengdu, China
                [_Y] YDepartment of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
                [_z] zDepartment of Hematology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
                [_Z] ZDepartment of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China
                [_α] αDepartment of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
                [_β] βDepartment of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing, China
                [_γ] γDepartment of Gastrointestinal Oncology, Affiliated Hospital Cancer Center, Academy of Military Medical Sciences, Beijing, China
                [_Γ] ΓDepartment of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
                [_δ] δDepartment of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
                [_ε] εDepartment of Hepatic Surgery and Interventional Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [_ζ] ζDepartment of Hepatobiliary Surgery, Zhongshan Hospital of Xiamen University, Xiamen, China
                [_η] ηDepartment of Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
                [_θ] θDepartment of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China
                [_ι] ιDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, ZhengZhou, China
                [_λ] λDepartment of Gastrointestinal Medical Oncology, The Affiliated Tumor Hospital of Harbin Medical University, Harbin, China
                [_μ] μMinimally Invasive Interventional Division, Liver Cancer Group, Sun Yat-Sen University Cancer Center, Guangzhou, China
                [_ξ] ξDepartment of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
                [_π] πDepartment of General Surgery, Xiangya Hospital, Central South University, Changsha, China
                [_σ] σDepartment of Hepatobiliary Surgery, Peking University People’s Hospital, Beijing, China
                [_τ] τDepartment of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
                [_φ] φDepartment of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
                [_χ] χDepartment of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
                [_ψ] ψDepartment of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
                Author notes
                *Minshan Chen, cms64@163.com, Jianqiang Cai, caijianqiang188@sina.com, Weilin Wang, wam@zju.edu.cn, Xiujun Cai, srrsh_cxj@zju.edu.cn, Qiang Li, 402052195@qq.com, Feng Shen, shenfengehbh@sina.com, Shukui Qin, qinsk@csco.org.cn, Gaojun Teng, gjteng@vip.sina.com, Jiahong Dong, dongjh301@163.com, Jia Fan, fan.jia@zs-hospital.sh.cn
                Author information
                https://orcid.org/0000-0002-2759-4844
                https://orcid.org/0000-0002-7397-5779
                https://orcid.org/0000-0002-0299-5289
                https://orcid.org/0000-0001-8933-6392
                https://orcid.org/0000-0002-2934-0880
                https://orcid.org/0000-0002-5108-1774
                https://orcid.org/0000-0003-0985-235X
                https://orcid.org/0000-0003-3278-0534
                https://orcid.org/0000-0003-3593-6098
                https://orcid.org/0000-0003-3817-9117
                https://orcid.org/0000-0002-4051-4474
                https://orcid.org/0000-0003-4467-6021
                https://orcid.org/0000-0002-1025-8895
                https://orcid.org/0000-0001-5142-010X
                https://orcid.org/0000-0002-6293-9158
                Article
                530495 Liver Cancer 2023;12:405–444
                10.1159/000530495
                0292dfb0-e911-441e-8b27-c308ce840f20
                © 2023 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

                History
                : 15 November 2022
                : 24 January 2023
                Page count
                Figures: 3, Tables: 1, Pages: 40
                Funding
                This research received no external funding.
                Categories
                Guidelines

                Medicine
                China,Treatment,Hepatocellular carcinoma,Primary liver cancer,Guidelines,Diagnosis
                Medicine
                China, Treatment, Hepatocellular carcinoma, Primary liver cancer, Guidelines, Diagnosis

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