Saudi Association for the Study of Liver diseases and Transplantation practice guidelines on the diagnosis and management of hepatocellular carcinoma

Alqahtani, Saleh A.; Sanai, Faisal M.; Alolayan, Ashwaq; Abaalkhail, Faisal; Alsuhaibani, Hamad; Hassanain, Mazen; Alhazzani, Waleed; Alsuhaibani, Abdullah; Algarni, Abdulrahman D; Forner, Alejandro; Finn, Richard S.; Al–Hamoudi, Waleed

doi:10.4103/sjg.sjg_477_20

Cited by 14 publications

(30 citation statements)

References 272 publications

(125 reference statements)

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“…In one European study, the average age at diagnosis was 54–57 years [ 37 ]. Liver cancer has a relatively lower incident rate in SA, with a mean age at diagnosis of >60, which could explain the low number of predicted cases in our study [ 38 ].…”

Section: Discussionmentioning

confidence: 95%

The future health and economic burden of obesity-attributable type 2 diabetes and liver disease among the working-age population in Saudi Arabia

Coker¹,

Saxton²,

Retat³

et al. 2022

PLoS ONE

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Background Obesity and type 2 diabetes (T2DM) are increasing in Saudi Arabia (SA). Among other conditions, these risk factors increase the likelihood of non-alcoholic fatty liver disease (NAFLD), which in turn increases risks for advanced liver diseases, such as non-alcoholic steatohepatitis (NASH), cirrhosis and cancer. The goal of this study was to quantify the health and economic burden of obesity-attributable T2DM and liver disease in SA. Methods We developed a microsimulation of the SA population to quantify the future incidence and direct health care costs of obesity-attributable T2DM and liver disease, including liver cancer. Model inputs included population demographics, body mass index, incidence, mortality and direct health care costs of T2DM and liver disease and relative risks of each condition as a function of BMI category. Model outputs included age- and sex-disaggregated incidence of obesity-attributable T2DM and liver disease and their direct health care costs for SA’s working-age population (20–59 years) between 2020 and 2040. Results Between 2020 and 2040, the available data predicts 1,976,593 [± 1834] new cases of T2DM, 285,346 [±874] new cases of chronic liver diseases, and 2,101 [± 150] new cases of liver cancer attributable to obesity, amongst working-age people. By 2040, the direct health care costs of these obesity-attributable diseases are predicted to be 127,956,508,540 [± 51,882,446] USD. Conclusions The increase in obesity-associated T2DM and liver disease emphasises the urgent need for obesity interventions and strategies to meaningfully reduce the future health and economic burden of T2DM, chronic liver diseases and liver cancer in SA.

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Section: Discussionmentioning

confidence: 95%

The future health and economic burden of obesity-attributable type 2 diabetes and liver disease among the working-age population in Saudi Arabia

Coker¹,

Saxton²,

Retat³

et al. 2022

PLoS ONE

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“…Tumour ablation is a widely accepted treatment option for patients with early‐stage HCC and is followed extensively in the MENA region (Figure 5). 79,85–87 A large proportion of patients in the MENA region are diagnosed at a stage of HCC where surgical therapies are no longer viable due to the extent of the disease, poor hepatic reserve, or coexistent morbidities. The most widely available ablation techniques are percutaneous ethanol injection, RFA and MWA.…”

Section: Overview Of Current Management Strategies Of Hcc In Mena Regionmentioning

confidence: 99%

“…RFA is recommended for small tumours ≤3 cm and very early HCC (BCLC 0). However for patients with HCC in proximity such as gallbladder, stomach, colon, or other viscera, percutaneous ethanol injection or surgical resection (if feasible) should be the choice of treatment 87 …”

Section: Overview Of Current Management Strategies Of Hcc In Mena Regionmentioning

confidence: 99%

Multidisciplinary consensus recommendations for management of hepatocellular carcinoma in Middle East and North Africa region

Waked,

Alsammany,

Tirmazy

et al. 2023

Liver International

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Hepatocellular carcinoma (HCC) is a growing health concern projected to cross over a million cases worldwide by 2025. HCC presents a significant burden of disease in Middle East and North African (MENA) countries due to a high prevalence of risk factors such as hepatitis C and B infections and rising incidence of non‐alcoholic steatohepatitis and non‐alcoholic fatty liver disease. In August 2022, an advisory meeting consisting of experts from 5 MENA countries was convened in an attempt to provide consensus recommendations on HCC screening, early diagnosis, current treatment modalities and unmet medical needs in the region. Data were collected from a pre‐meeting survey questionnaire and responses analysed and presented during the advisory meeting. This review summarizes the evidence discussed at the meeting and provides expert recommendations on the management of HCC. The 2022 update of Barcelona clinic liver cancer (BCLC) staging and treatment strategy and its implementation in the MENA region was extensively discussed. A key consensus of the expert panel was that multidisciplinary care is crucial to effective patient management that results in better clinical outcomes and overall survival of the patient. The panel recommended the use of predictive and early response biomarkers to guide clinicians in arriving at more effective therapeutic decisions. The experts also emphasized the role of robust screening/surveillance systems, population‐based registries, effective referral pathways and standardization of guidelines to ensure the successful management of HCC in the region.

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“…[ 4 ] Likewise, the cases of compensated cirrhosis, HCC and advanced liver disease secondary to NAFLD are projected to double by 2030, with an annual incidence of liver-related deaths of 4800. [ 4 10 ] On the other hand, the prevalence of hepatitis B virus (HBV) has decreased in recent years in the younger Saudi population due to the vaccination program. [ 8 ] But the prevalence of HBV in older generations has not been well-characterized and remains a source of concern.…”

Section: Current Status and Future Demands Of The Hepatology Workforc...mentioning

confidence: 99%

Saudi association for the study of liver diseases and transplantation position statement on the hepatology workforce in Saudi Arabia

Al-Judaıbı

Dokus

Al–Hamoudi

et al. 2022

Saudi J Gastroenterol

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The field of hepatology has evolved significantly over the last two decades. Hepatology practice in Saudi Arabia (SA) was dominated by hepatitis B and C viruses but is now being overtaken by patients with non-alcoholic fatty liver disease. These patients require greater medical attention as their care is more complex compared to patients with viral hepatitis. In addition, liver transplantation (LT) has expanded significantly in SA over the last three decades. There is a necessity to increase the hepatology workforce to meet the demand in SA. The time has come to reinforce the transplant hepatology fellowship program, that was launched recently, and to develop a nurse practitioner practice model to meet these demands. In addition, SA is going through a health care reform to enhance health care delivery which may affect the financial compensation polices of various specialties including gastroenterology and hepatology. Therefore, the Saudi Association for the Study of Liver diseases and Transplantation (SASLT) established a task force to discuss the current and future demands in the hepatology workforce in SA, as well as to discuss different avenues of financial compensation for transplant hepatologists in LT centers.

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Saudi Association for the Study of Liver diseases and Transplantation practice guidelines on the diagnosis and management of hepatocellular carcinoma

Cited by 14 publications

References 272 publications

The future health and economic burden of obesity-attributable type 2 diabetes and liver disease among the working-age population in Saudi Arabia

The future health and economic burden of obesity-attributable type 2 diabetes and liver disease among the working-age population in Saudi Arabia

Multidisciplinary consensus recommendations for management of hepatocellular carcinoma in Middle East and North Africa region

Saudi association for the study of liver diseases and transplantation position statement on the hepatology workforce in Saudi Arabia

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