Brazilian society of hepatology recommendations for the diagnosis and treatment of hepatocellular carcinoma

Abstract

Hepatocellular carcinoma is a malignancy of global importance and is associated with a high rate of mortality. Recent advances in the diagnosis and treatment of this disease make it imperative to update the recommendations on the management of the disease. In order to draw evidence-based recommendations concering the diagnosis and management of hepatocellular carcinoma, the Brazilian Society of Hepatology has sponsored a single-topic meeting in João Pessoa (PB). All the invited pannelists were asked to make a systematic review of the literature and to present topics related to the risk factors for its development, methods of screening, radiological diagnosis, staging systems, curative and palliative treatments and hepatocellular carcinoma in noncirrhotic liver. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript containing the recommendations of the Brazilian Society of Hepatology.

Higher MELD score increases the overall cost on the waiting list for liver transplantation: a micro-costing analysis based study

“…Some correlated disease has strong linkage with high costs procedures and hospitalizations. Hepatocellular carcinoma is a malignancy associated with a high rate of mortality and costs (4) . Hepatocellular carcinoma (HCC) currently, affects 1.5% of the world population and reach approximately 15% of patients on the waiting list for liver transplantation (1,11,21) .…”

Recommendations for Invasive Procedures in Patients With Diseases of the Liver and Biliary Tract: Report of a Joint Meeting of the Brazilian Society of Hepatology (Sbh), Brazilian Society of Digestive Endoscopy (Sobed) and Brazilian Society of Interventional Radiology and Endovascular Surgery (Sobrice)

“…Staging of HCC is a complex task that should take into account tumor burden (number, size and location of HCC nodules; presence of vascular invasion and extrahepatic metastases); liver function assessed by CP classification and clinically significant PH and presence of patients functional status (evaluated by the Eastern Cooperative Oncology Group Performance Status scale (ECOGPS)) (71,72) . The most commonly used staging system for HCC in western countries is the Barcelona Clinic Liver Cancer (BCLC) classification, that is suit especially for subjects candidates for invasive therapeutic in terventions (72,74) . The most used staging system for HCC in western countries is the Barcelona Clinic Liver Cancer Group (BCLC) clas sification that is useful to guide management of patients with HCC according to tumor stage and prognosis (FIGURE 1).…”

“…This paper will address the role of invasive procedures in the treatment of HCC according to BCLC classification. Other treatment modalities are reviewed elsewhere (72) . Locoregional treatments are usually divided as percutaneous ablative therapies and imageguided transcatheter therapies.…”

Incidence of hepatocellular carcinoma in outpatients with cirrhosis in Brazil: A 10-year retrospective cohort study

“…Brazilian Society for Hepatology[41] has recently recommended the performance of abdominal ultrasounds every 6 mo, with measurement of AFP strictly in sites where physicians who are experienced in ultrasound are not available.…”