2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

다국어 초록 (Multilingual Abstract)

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association- National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.

참고문헌 (Reference)

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771 Hayakawa Y, "Early experience of atezolizumab plus bevacizumab therapy in Japanese patients with unresectable hepatocellular carcinoma in real-world practice" 40 : 392-402, 2022

772 Yamanaka K, "Early evaluation of transcatheter arterial chemoembolization-refractory hepatocellular carcinoma" 47 : 343-346, 2012

773 Portolani N, "Early and late recurrence after liver resection for hepatocellular carcinoma : prognostic and therapeutic implications" 243 : 229-235, 2006

774 European Association For The Study Of The Liver, "EASL-EORTC clinical practice guidelines : management of hepatocellular carcinoma" 56 : 908-943, 2012

775 European Association for the Study of the Liver, "EASL clinical practice guidelines : management of hepatocellular carcinoma" 69 : 182-236, 2018

776 European Association for the Study of the Liver, "EASL clinical practice guidelines : management of chronic hepatitis B virus infection" 57 : 167-185, 2012

777 Lin CY, "Dynamic-contrastenhanced magnetic resonance imaging of cirrhotic liver parenchyma : a comparison between gadolinium-diethylenetriamine pentaacetic acid and gadolinium-ethoxybenzyldiethylenetriamine pentaacetic acid" 78 : 666-672, 2015

778 Robert C, "Durable complete response after discontinuation of pembrolizumab in patients with metastatic melanoma" 36 : 1668-1674, 2018

779 UFaDAF UDoHaHS, "Drugs: acetaminophen information"

780 Zanetto A, "Dropout rate from the liver transplant waiting list because of hepatocellular carcinoma progression in hepatitis C virus-infected patients treated with direct-acting antivirals" 23 : 1103-1112, 2017

781 Chong JU, "Downstaging with localized concurrent chemoradiotherapy can identify optimal surgical candidates in hepatocellular carcinoma with portal vein tumor thrombus" 25 : 3308-3315, 2018

782 Mehta N, "Downstaging outcomes for hepatocellular carcinoma : results from the multicenter evaluation of reduction in tumor size before liver transplantation(MERITS-LT)consortium" 161 : 1502-1512, 2021

783 Yao FY, "Downstaging of hepatocellular cancer before liver transplant : long-term outcome compared to tumors within Milan criteria" 61 : 1968-1977, 2015

784 Parikh ND, "Downstaging hepatocellular carcinoma : a systematic review and pooled analysis" 21 : 1142-1152, 2015

785 Yoon JH, "Double lowdose dual-energy liver CT in patients at high-risk of HCC : a prospective, randomized, single-center study" 55 : 340-348, 2020

786 Kim TH, "Dose-volumetric parameters predicting radiation-induced hepatic toxicity in unresectable hepatocellular carcinoma patients treated with three-dimensional conformal radiotherapy" 67 : 225-231, 2007

787 Lee JG, "Donor safety in living donor liver transplantation : the Korean organ transplantation registry study" 23 : 999-1006, 2017

788 Shin M, "Donor morbidity including biliary complications in livingdonor liver transplantation : single-center analysis of 827cases" 93 : 942-948, 2012

789 Ghobrial RM, "Donor morbidity after living donation for liver transplantation" 135 : 468-476, 2008

790 Qin S, "Donafenib versus sorafenib in first-line treatment of unresectable or metastatic hepatocellular carcinoma : a randomized, openlabel, parallel-controlled phase II-III trial" 39 : 3002-3011, 2021

791 Dart RC, "Does therapeutic use of acetaminophen cause acute liver failure?" 27 : 1219-1230, 2007

792 Lazzara C, "Does the margin width influence recurrence rate in liver surgery for hepatocellular carcinoma smaller than 5 cm?" 21 : 523-529, 2017

793 Lin N, "Does the intermittent pringle maneuver affect the recurrence following surgical resection for hepatocellular carcinoma? A systematic review" 15 : e0229870-, 2020

794 Basha MAA, "Does a combined CT and MRI protocol enhance the diagnostic efficacy of LI-RADS in the categorization of hepatic observations? A prospective comparative study" 28 : 2592-2603, 2018

795 Cho Y, "Does 18F-FDG positron emission tomography-computed tomography have a role in initial staging of hepatocellular carcinoma?" 9 : e105679-, 2014

796 Mendizabal M, "Disease progression in patients with hepatitis C virus infection treated with direct-acting antiviral agents" 18 : 2554-2563.e3, 2020

797 Jansen YJL, "Discontinuation of anti-PD-1antibody therapy in the absence of disease progression or treatment limiting toxicity : clinical outcomes in advanced melanoma" 30 : 1154-1161, 2019

798 Cabibbo G, "Direct-acting antivirals after successful treatment of early hepatocellular carcinoma improve survival in HCV-cirrhotic patients" 71 : 265-273, 2019

799 Poon RT, "Differentiating early and late recurrences after resection of HCC in cirrhotic patients : implications on surveillance, prevention, and treatment strategies" 16 : 792-794, 2009

800 성필수 ; 배시현 ; 장정원 ; 송도선 ; 김희언 ; 유선홍 ; 박정화 ; 권정현 ; 송명준 ; 유찬란 ; 최종영 ; 윤승규, "Differences in the patterns and outcomes of enhanced viral replication between hepatitis C virus and hepatitis B virus in patients with hepatocellular carcinoma during transarterial chemolipiodolization" 대한간학회 17 (17): 299-306, 2011

801 Nakamura Y, "Diagnostic value of deep learning reconstruction for radiation dose reduction at abdominal ultra-high-resolution CT" 31 : 4700-4709, 2021

802 Lee JE, "Diagnostic value for extrahepatic metastases of hepatocellular carcinoma in positron emission tomography/computed tomography scan" 18 : 2979-2987, 2012

803 Hammerstingl R, "Diagnostic efficacy of gadoxetic acid(primovist)-enhanced MRI and spiral CT for a therapeutic strategy : comparison with intraoperative and histopathologic findings in focal liver lesions" 18 : 457-467, 2008

804 Choi SH, "Diagnostic criteria for hepatocellular carcinoma ≤3 cm with hepatocyte-specific contrast-enhanced magnetic resonance imaging" 64 : 1099-1107, 2016

805 Tateishi R, "Diagnostic accuracy of tumor markers for hepatocellular carcinoma : a systematic review" 2 : 17-30, 2008

806 Joo I, "Diagnostic accuracy of liver imaging reporting and data system(LI-RADS)v2014 for intrahepatic mass-forming cholangiocarcinomas in patients with chronic liver disease on gadoxetic acid-enhanced MRI" 44 : 1330-1338, 2016

807 이상민 ; 이정민 ; 안수좌 ; Hyo-Jin Kang ; 양현경 ; Jeong Hee Yoon, "Diagnostic Performance of 2018 KLCA-NCC Practice Guideline for Hepatocellular Carcinoma on Gadoxetic Acid-Enhanced MRI in Patients with Chronic Hepatitis B or Cirrhosis: Comparison with LI-RADS Version 2018" 대한영상의학회 22 (22): 1066-1076, 2021

808 Marrero JA, "Diagnosis, staging, and management of hepatocellular carcinoma : 2018 practice guidance by the American Association for the Study of Liver Diseases" 68 : 723-750, 2018

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810 El-Serag HB, "Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma" 126 : 460-468, 2004

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812 Brouwers MC, "Development of the AGREE II, part 2 : assessment of validity of items and tools to support application" 182 : E472-E478, 2010

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816 Yau T, "Development of Hong Kong liver cancer staging system with treatment stratification for patients with hepatocellular carcinoma" 146 : 1691-1700, 2014

817 Singal AG, "Detection of hepatocellular carcinoma at advanced stages among patients in the HALT-C trial : where did surveillance fail?" 108 : 425-432, 2013

818 Llovet JM, "Design and endpoints of clinical trials in hepatocellular carcinoma" 100 : 698-711, 2008

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824 Parikh ND, "Costeffectiveness of hepatocellular carcinoma surveillance : an assessment of benefits and harms" 115 : 1642-1649, 2020

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831 Huda W, "Converting dose-length product to effective dose at CT" 248 : 995-1003, 2008

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833 Zhong J, "Conventional oral systemic chemotherapy for postoperative hepatocellular carcinoma : a systematic review" 2 : 1091-1096, 2014

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842 Kang YK, "Composite criteria using clinical and FDG PET/CT factors for predicting recurrence of hepatocellular carcinoma after living donor liver transplantation" 29 : 6009-6017, 2019

843 Shim JH, "Complete necrosis after transarterial chemoembolization could predict prolonged survival in patients with recurrent intrahepatic hepatocellular carcinoma after curative resection" 17 : 869-877, 2010

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846 Govalan R, "Comparison of surgical resection and systemic treatment for hepatocellular carcinoma with vascular invasion : national cancer database analysis" 10 : 407-418, 2021

847 Wang Q, "Comparison of radiofrequency ablation and surgical resection for hepatocellular carcinoma conforming to the Milan criteria : a metaanalysis" 91 : E432-E438, 2021

848 Wei CY, "Comparison of prognosis between surgical resection and transarterial chemoembolization for patients with solitary huge hepatocellular carcinoma" 8 : 238-, 2020

849 Ko SE, "Comparison of procedure-related complications between percutaneous cryoablation and radiofrequency ablation for treating periductal hepatocellular carcinoma" 37 : 1354-1361, 2020

850 Kodama K, "Comparison of outcome of hepatic arterial infusion chemotherapy combined with radiotherapy and sorafenib for advanced hepatocellular carcinoma patients with major portal vein tumor thrombosis" 94 : 215-222, 2018

851 Joo Hyun Oh ; Dong Hyun Sinn ; Gyu-Seong Choi ; Jong Man Kim ; Jae-Won Joh ; Tae Wook Kang ; Dongho Hyun ; Wonseok Kang ; Geum-Youn Gwak ; Yong-Han Paik ; Joon Hyeok Lee ; Kwang Cheol Koh ; Seung Woon Paik ; Moon Seok Choi, "Comparison of outcome between liver resection, radiofrequency ablation, and transarterial therapy for multiple small hepatocellular carcinoma within the Milan criteria" 대한외과학회 99 (99): 238-246, 2020

852 Kim KH, "Comparison of open and laparoscopic live donor left lateral sectionectomy" 98 : 1302-1308, 2011

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854 Miyayama S, "Comparison of local control in transcatheter arterial chemoembolization of hepatocellular carcinoma ≤6 cm with or without intraprocedural monitoring of the embolized area using cone-beam computed tomography" 37 : 388-395, 2014

855 Zhao Q, "Comparison of intra-arterial chemoembolization with and without radiotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis : a meta-analysis" 13 : 21-31, 2016

856 Kawaoka T, "Comparison of hepatic arterial infusion chemotherapy versus sorafenib monotherapy in patients with advanced hepatocellular carcinoma" 16 : 505-512, 2015

857 Kim GA, "Comparison of chemoembolization with and without radiation therapy and sorafenib for advanced hepatocellular carcinoma with portal vein tumor thrombosis : a propensity score analysis" 26 : 320-329.e6, 2015

858 Kaibori M, "Comparison of anatomic and nonanatomic hepatic resection for hepatocellular carcinoma" 24 : 616-626, 2017

859 이선영 ; Seung-seob Kim ; Dong ryul Chang ; Hyerim Kim ; Myeong-Jin Kim, "Comparison of LI-RADS 2018 and KLCA-NCC 2018 for noninvasive diagnosis of hepatocellular carcinoma using magnetic resonance imaging" 대한간학회 26 (26): 340-351, 2020

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862 Lewis S, "Comparative assessment of standard and immune response criteria for evaluation of response to PD-1monotherapy in unresectable HCC" 47 : 969-980, 2022

863 Lee J, "Comparative analysis of lenvatinib and hepatic arterial infusion chemotherapy in unresectable hepatocellular carcinoma : a multi-center, propensity score study" 10 : 4045-, 2021

864 Hanna RF, "Comparative 13-year meta-analysis of the sensitivity and positive predictive value of ultrasound, CT, and MRI for detecting hepatocellular carcinoma" 41 : 71-90, 2016

865 Kornberg A, "Combining 18F-FDG positron emission tomography with up-to-seven criteria for selecting suitable liver transplant patients with advanced hepatocellular carcinoma" 7 : 14176-, 2017

866 Zaitoun MMA, "Combined therapy with conventional trans-arterial chemoembolization(cTACE)and microwave ablation(MWA)for hepatocellular carcinoma >3-<5 cm" 38 : 248-256, 2021

867 Zhou C, "Combined hepatocellular carcinoma-cholangiocarcinoma : MRI features correlated with tumor biomarkers and prognosis" 32 : 78-88, 2022

868 Park MS, "Combination treatment of localized concurrent chemoradiation therapy and transarterial chemoembolization in locally advanced hepatocellular carcinoma with intrahepatic metastasis" 71 : 165-173, 2013

869 Lin J, "Combination treatment including targeted therapy for advanced hepatocellular carcinoma" 7 : 71036-71051, 2016

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873 Gelatti U, "Coffee consumption reduces the risk of hepatocellular carcinoma independently of its aetiology : a case-control study" 42 : 528-534, 2005

874 Rhee H, "Clinico-radio-pathological and molecular features of hepatocellular carcinomas with keratin 19 expression" 9 : 663-681, 2020

875 Kim HY, "Clinical trials of combined molecular targeted therapy and locoregional therapy in hepatocellular carcinoma : past, present, and future" 3 : 9-17, 2014

876 Meier V, "Clinical staging of hepatocellular carcinoma" 27 : 131-141, 2009

877 Yu JI, "Clinical significance of radiotherapy before and/or during nivolumab treatment in hepatocellular carcinoma" 8 : 6986-6994, 2019

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889 He J, "Clinical features and prognostic factors in patients with bone metastases from hepatocellular carcinoma receiving external beam radiotherapy" 115 : 2710-2720, 2009

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