Clinical Practice Guidelines for Hepatocellular Carcinoma Differ between Japan, United States, and Europe

Toyoda, Hidenori; Kumada, Takashi; Tada, Toshifumi; Sone, Yoshitsugu; Kikuchi, Yuji; Maeda, Atsuyuki; Minami, Yasunori; Kudo, Masatoshi; Siegel, Abby B.; El-Khoueiry, Anthony B.; Finn, Richard S.; Guthrie, Katherine A.; Goyal, Abhishek; Venook, Alan P.; Blanke, Charles D.; Verna, Elizabeth C.; Dove, Lorna; Emond, Jean C.; Kato, Tomoaki; Samstein, Benjamin; Busuttil, Ronald W.; Remotti, Helen; Coffey, Amy; Brown, Robert S.; Hsu, Chiun; Chen, Bang-Bin; Chen, Chien‐Hung; Ho, Ming-Chih; Cheng, Jason Chia‐Hsien; Kokudo, Norihiro; Murakami, Takamichi; Yeo, Winnie; Seong, Jinsil; Jia, Jidong; Han, Kwan-Hyub; Cheng, Ann‐Lii

doi:10.1159/000367730

Cited by 76 publications

(33 citation statements)

References 23 publications

(16 reference statements)

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“…The rationale for this strategy is that imaging criteria is considered sufficient in most cases (8).…”

Section: Discussion Discussionmentioning

confidence: 99%

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

Scheau¹,

Scheau²,

Lupescu³

2017

SGO

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Background: Transcatheter arterial chemoembolization (TACE) is a dedicated method for treating intermediate stage hepatocellular carcinoma (HCC). The Lipiodol used in conventional TACE presents the advantage of being easily visualized and quantified on Computed Tomography (CT). Methods: Immediate postprocedural (baseline) and follow-up CT examinations of twenty patients treated by TACE for HCC were evaluated in this study. Lipiodol uptake on baseline images and progressive washout on follow-up examinations were assessed. Results: Statistically significant lower baseline Lipiodol densities are found in patients that develop tumoral recurrence at some point on follow-up examinations (p=0.0280). Using the treated nodule density as a predictive factor for tumoral recurrence, we obtained a diagnostic sensitivity of 92.31% in patients with cut-off values ≤ 545.36 HU, albeit with a low specificity. All patients develop a quantifiable Lipiodol density decrease over time, regardless of tumoral recurrence implication (p=0.0298). There is evidence to suggest that specific Lipiodol accumulation patterns may be associated with a higher risk of tumor recurrence. Conclusions: Baseline post-procedural Lipiodol accumulation levels may serve as a predictor for tumoral recurrence in patients treated for HCC using TACE, with good sensitivity provided a high cut-off value is set for the measured densities.

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“…The rationale for this strategy is that imaging criteria is considered sufficient in most cases (8).…”

Section: Discussion Discussionmentioning

confidence: 99%

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

Scheau¹,

Scheau²,

Lupescu³

2017

SGO

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“…This unique approach has arisen because the indocyanine green retention test is frequently performed before surgical resection in Japan. In that sense, liver damage is more of an HCC-oriented liver functional reserve classification than Child-Pugh classification, where the latter was originally developed to predict the prognosis of cirrhotic patients [12,13]. …”

Section: General Rules For the Clinical And Pathological Study Of Primentioning

confidence: 99%

General Rules for the Clinical and Pathological Study of Primary Liver Cancer, Nationwide Follow-Up Survey and Clinical Practice Guidelines: The Outstanding Achievements of the Liver Cancer Study Group of Japan

Kudo

Kitano

Sakurai

et al. 2015

Dig Dis

223

163

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This review outlines the significance of establishing general rules, a nationwide follow-up survey, and clinical practice guidelines for liver cancer in Japan. The general rules are an essential part of hepatocellular carcinoma (HCC) treatment, enabling a ‘common language' to be used in daily clinical practice and for the nationwide follow-up survey. The Japanese General Rules for the Clinical and Pathological Study of Primary Liver Cancer, which provide detailed descriptions of HCC, are excellent and are unique to Japan. Items in the General Rules for the Clinical and Pathological Study of Primary Liver Cancer are used substantially in another important project, the Nationwide Follow-Up Survey of Primary Liver Cancer, which has been rigorously undertaken with great effort by the Liver Cancer Study Group of Japan biannually since 1969. Both evidence-based and consensus-based treatment algorithms for HCC are used to complement each other in clinical practice in Japan.

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“…However, in other countries, the clinical guidelines for HCC, such as those issued by the American Association for the Study of Liver Diseases (AASLD) [5] and the European Association for the Study of the Liver (EASL) [6], do not recommend the use of PIVKA-II or AFP-L3 in daily clinical practice. Even AFP is not recommended for the surveillance of liver cancer because of its low sensitivity and specificity, that is, due to its poor cost effectiveness, leaving ultrasound (US) as the only screening method recommended per the Western guidelines [7]. This signifies a huge difference in the way of thinking between researchers in Japan and those in Western countries.…”

Section: Tumor Markersmentioning

confidence: 99%

Challenges of Clinical Research on Hepatocellular Carcinoma

Kudo

Kitano

Sakurai

et al. 2015

Dig Dis

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Challenges of clinical practice and research on hepatocellular carcinoma (HCC) were reviewed. There are several differences in clinical practice between Japan and the Western countries such as tumor markers, understanding of pathological early HCC, imaging diagnosis, treatment strategy, staging system and subclassification of HCC. Further studies are warranted for the clinical practices of Japan to be adopted in the rest of the world.

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Clinical Practice Guidelines for Hepatocellular Carcinoma Differ between Japan, United States, and Europe

Cited by 76 publications

References 23 publications

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

General Rules for the Clinical and Pathological Study of Primary Liver Cancer, Nationwide Follow-Up Survey and Clinical Practice Guidelines: The Outstanding Achievements of the Liver Cancer Study Group of Japan

Challenges of Clinical Research on Hepatocellular Carcinoma

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