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      Guidelines for Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus in China (2021 Edition)

      research-article
      a , b , c , a , d , a , e , f , g , h , i , d , j , k , l , m , n , o , p , q , r , s , t , u , v , w , q , x , y , z , o , A , B , a , C , D , E , F , G , H , I , J , K , L , M , N , O , P , Q , R , S , d , T , U , b , * , c , ** , a , ***
      Liver Cancer
      S. Karger AG
      Hepatocellular carcinoma, Portal vein tumor thrombus, Multidisciplinary therapy, Guideline

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          Abstract

          Portal vein tumor thrombus (PVTT) is very common and it plays a major role in the prognosis and clinical staging of hepatocellular carcinoma (HCC). We have published the first version of the guideline in 2016 and revised in 2018. Over the past several years, many new evidences for the treatment of PVTT become available, especially for the advent of new targeted drugs and immune checkpoint inhibitors which have further improved the prognosis of PVTT. So, the Chinese Association of Liver Cancer and Chinese Medical Doctor Association revised the 2018 version of the guideline to adapt to the development of PVTT treatment. Future treatment strategies for HCC with PVTT in China would depend on new evidences from more future clinical trials.

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          Most cited references117

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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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            Global cancer statistics, 2012.

            Cancer constitutes an enormous burden on society in more and less economically developed countries alike. The occurrence of cancer is increasing because of the growth and aging of the population, as well as an increasing prevalence of established risk factors such as smoking, overweight, physical inactivity, and changing reproductive patterns associated with urbanization and economic development. Based on GLOBOCAN estimates, about 14.1 million new cancer cases and 8.2 million deaths occurred in 2012 worldwide. Over the years, the burden has shifted to less developed countries, which currently account for about 57% of cases and 65% of cancer deaths worldwide. Lung cancer is the leading cause of cancer death among males in both more and less developed countries, and has surpassed breast cancer as the leading cause of cancer death among females in more developed countries; breast cancer remains the leading cause of cancer death among females in less developed countries. Other leading causes of cancer death in more developed countries include colorectal cancer among males and females and prostate cancer among males. In less developed countries, liver and stomach cancer among males and cervical cancer among females are also leading causes of cancer death. Although incidence rates for all cancers combined are nearly twice as high in more developed than in less developed countries in both males and females, mortality rates are only 8% to 15% higher in more developed countries. This disparity reflects regional differences in the mix of cancers, which is affected by risk factors and detection practices, and/or the availability of treatment. Risk factors associated with the leading causes of cancer death include tobacco use (lung, colorectal, stomach, and liver cancer), overweight/obesity and physical inactivity (breast and colorectal cancer), and infection (liver, stomach, and cervical cancer). A substantial portion of cancer cases and deaths could be prevented by broadly applying effective prevention measures, such as tobacco control, vaccination, and the use of early detection tests. © 2015 American Cancer Society.
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              EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

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                Author and article information

                Journal
                Liver Cancer
                Liver Cancer
                LIC
                Liver Cancer
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                2235-1795
                1664-5553
                July 2022
                17 March 2022
                : 11
                : 4
                : 315-328
                Affiliations
                [1] aDepartment of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [27] ADepartment of Oncology, Shanghai Medical College, Fudan University Shanghai, Shanghai, China
                [2] bDepartment of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
                [28] BDepartment of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [3] cDepartment of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
                [29] CDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, China
                [4] dDepartment of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Fudan University, Shanghai, China
                [30] DDepartment of Hepatobiliary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
                [5] eFaculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
                [31] EDepartment of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
                [6] fDepartment of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China
                [32] FDepartment of Integrated Traditional Chinese and Western Medicine, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [7] gHepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
                [33] GDepartment of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
                [8] hDepartment of Oncology, Clinical College of Weifang Medical University, Weifang, China
                [34] HDivision of Hepatobiliary Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
                [9] iHepatic Surgery Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
                [35] ILiver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
                [10] jDepartment of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Chang Gung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
                [36] JDepartment of Abdominal Surgery, Fujian Provincial Cancer Hospital, Fujian Medical University Teaching Hospital, Fuzhou, China
                [11] kDepartment of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
                [37] KDepartment of Interventional Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [12] lDepartment of Hepatopancreatobiliary Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China
                [38] LDepartment of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China
                [13] mDepartment of Hepatobiliary and Spleenary Surgery, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China
                [39] MDepartment of Hepatobiliary and Pancreas Surgery, The Second Hospital of Jilin University, Changchun, China
                [14] nDepartment of Hepatobiliary Surgery, Zhujiang Hospital, First Military Medical University, Guangzhou, China
                [40] NDepartment of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
                [15] oDepartment of Radiation Oncology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [41] ODepartment of Hepatobiliary and Pancreas Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, China
                [16] pDepartment of General Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
                [42] PDepartment of Traditional Chinese Medicine, Beijing Weida Traditional Chinese Medicine Tumor Hospital, Beijing, China
                [17] qDepartment of General Surgery, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
                [43] QDepartment of General Surgery, Qilu Hospital, Shandong University, Jinan, China
                [18] rDepartment of Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
                [44] RDepartment of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
                [19] sDepartment of Radiation Oncology, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
                [45] SDepartment of Hepatobiliary Surgery, Jiangxi Provincial Cancer Hospital, Nanchang, China
                [20] tDepartment of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China
                [46] TDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
                [21] uDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
                [47] UDepartment of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
                [22] vDepartment of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
                [23] wDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
                [24] xDepartment of Hepatobiliary Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China
                [25] yDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
                [26] zDepartment of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Beijing, China
                Author notes
                Article
                lic-0011-0315
                10.1159/000523997
                9294940
                35978596
                c05cf6ef-a049-4ce8-bfc4-2b6af5eb4274
                Copyright © 2022 by 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. 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.

                History
                : 3 December 2021
                : 5 March 2022
                : 2022
                Page count
                Figures: 1, Tables: 2, References: 119, Pages: 14
                Categories
                Guidelines

                hepatocellular carcinoma,portal vein tumor thrombus,multidisciplinary therapy,guideline

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