Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases

Abstract

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Synchronous hepatectomy and splenectomy vs hepatectomy for selected patients with hepatocellular carcinoma and clinically significant portal hypertension: A systematic review and meta‐analysis

“…CSPH is defined as a hepatic vein pressure gradient (HVPG) of more than 10 mm Hg and could also be defined by the presence of either esophageal varices or ascites and splenomegaly with a platelet count less than 100×10 9 cells/L . According to Barcelona Clinic Liver Cancer staging, LT was recommended for patients with HCC and CSPH, and liver resection was contraindicated, which was similar to the European Association for Study of Liver and the American Association for Study of Liver Disease guidelines . Nevertheless, although LT could provide favorable survival benefits for patients with HCC and CSPH, a large portion of patients could not benefit from LT, as it is limited by a shortage of donors, and the management of liver resection is under consideration .…”

Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

“…Limited evidence suggests that children with chronic hepatitis C and a history of childhood leukemia may be at increased risk of developing HCC . The HCV guidance panel recommends HCC surveillance using liver ultrasound imaging (with or without alpha‐fetoprotein testing) every 6 months for pediatric patients with HCV and cirrhosis, consistent with AASLD guidance for HCC surveillance in adults . A baseline endoscopy to detect esophageal varices and every 3 years thereafter (in the absence ofviral clearance) is advisable for these patients.…”

“…Undetectable HCV RNA represents SVR and virologic cure. Ultrasound surveillance for HCC (with or without alpha‐fetoprotein testing) every 6 months after treatment completion is recommended for patients with cirrhosis, regardless of achieving SVR . Upper endoscopic surveillance for esophageal varices is recommended, consistent with AASLD guidance on portal hypertensive bleeding in cirrhosis .…”

Hypovascular hepatic nodules as a predictive factor for transcatheter arterial chemoembolization refractoriness in hepatocellular carcinoma

“…We excluded patients whose tumors progressed to BCLC stage C within 3 months after the initial TACE procedure, because such cases might potentially have tumor progression regardless of the TACE results. The diagnoses of all patients who were histologically or radiologically diagnosed with HCC were based on the diagnostic criteria of the American Association for the Study of Liver Diseases guidelines …”