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Hepatology International

, Volume 4, Issue 2, pp 439–474 | Cite as

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

  • Masao Omata
  • Laurentius A. Lesmana
  • Ryosuke Tateishi
  • Pei-Jer Chen
  • Shi-Ming Lin
  • Haruhiko Yoshida
  • Masatoshi Kudo
  • Jeong Min Lee
  • Byung Ihn Choi
  • Ronnie T. P. Poon
  • Shuichiro Shiina
  • Ann Lii Cheng
  • Ji-Dong Jia
  • Shuntaro Obi
  • Kwang Hyub Han
  • Wasim Jafri
  • Pierce Chow
  • Seng Gee Lim
  • Yogesh K. Chawla
  • Unggul Budihusodo
  • Rino A. Gani
  • C. Rinaldi Lesmana
  • Terawan Agus Putranto
  • Yun Fan Liaw
  • Shiv Kumar Sarin
Guidelines

Abstract

Introduction

The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations.

Methods

The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements.

Results

Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

Keywords

Hepatocellular carcinoma Consensus statements Recommendations Epidemiology Diagnosis Treatment algorithm 

Abbreviations

AASLD

American Association for Study of Liver Diseases

AFP

α-Fetoprotein

AFP-L3

Lens culinaris agglutinin-reactive fraction of AFP

APASL

Asian Pacific Association for the Study of the Liver

ECOG

Eastern Cooperative Oncology Group

CI

Confidence interval

CEUS

Contrast-enhanced US

CSF-1

Colony-stimulating factor 1

CTAP

CT during arterial portography

CTHA

CT hepatic arteriography

DCP

Des-γ-carboxyprothrombin

DN

Dysplastic nodule

EASL

European Association for the study of the liver

FNH

Focal nodular hyperplasia

Gd-EOB-DTPA

Gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid

GPC3

Glypican-3

HBeAg

Hepatitis B e antigen

HBsAg

Hepatitis B surface antigen

HBV

Hepatitis B virus

HCC

Hepatocellular carcinoma

HCV

Hepatitis C virus

HGDN

High-grade dysplastic nodules

HH

Hereditary hemochromatosis

IFN

Interferon

LAM

Lamivudine

LGDN

Low-grade dysplastic nodules

LR+

Positive likelihood ratio

MDCT

Multidetector-row CT

MTT

Molecular targeted therapy

NASH

Nonalcoholic steatohepatitis

PDGFR

Platelet-derived growth factor receptors

PIVKA-II

Prothrombin induced by vitamin K absence-II

RCT

Randomized controlled trial

RD

Risk difference

SPIO

Superparamagnetic iron oxide

TACE

Transarterial chemoembolization

US

Ultrasonography

VEGFR

Vascular endothelial growth factor receptors

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Copyright information

© Asian Pacific Association for the Study of the Liver 2010

Authors and Affiliations

  • Masao Omata
    • 1
  • Laurentius A. Lesmana
    • 2
  • Ryosuke Tateishi
    • 1
  • Pei-Jer Chen
    • 3
  • Shi-Ming Lin
    • 4
  • Haruhiko Yoshida
    • 1
  • Masatoshi Kudo
    • 5
  • Jeong Min Lee
    • 6
  • Byung Ihn Choi
    • 6
  • Ronnie T. P. Poon
    • 7
  • Shuichiro Shiina
    • 1
  • Ann Lii Cheng
    • 8
  • Ji-Dong Jia
    • 9
  • Shuntaro Obi
    • 10
  • Kwang Hyub Han
    • 11
  • Wasim Jafri
    • 12
  • Pierce Chow
    • 13
  • Seng Gee Lim
    • 14
  • Yogesh K. Chawla
    • 15
  • Unggul Budihusodo
    • 2
  • Rino A. Gani
    • 16
  • C. Rinaldi Lesmana
    • 2
  • Terawan Agus Putranto
    • 17
  • Yun Fan Liaw
    • 4
  • Shiv Kumar Sarin
    • 18
  1. 1.Department of Gastroenterology, Graduate School of MedicineUniversity of TokyoTokyoJapan
  2. 2.Department of Internal Medicine, Faculty of MedicineUniversity of IndonesiaJakartaIndonesia
  3. 3.Department of Internal Medicine, College of MedicineNational Taiwan UniversityTaipeiTaiwan
  4. 4.Liver Research UnitChang Gung Memorial HospitalTaipeiTaiwan
  5. 5.Division of Gastroenterology and Hepatology, Department of Internal MedicineKinki University School of MedicineOsaka-SayamaJapan
  6. 6.Abdominal Radiology Section, Department of RadiologySeoul National University HospitalSeoulKorea
  7. 7.Department of SurgeryQueen Mary Hospital, The University of Hong KongHong KongChina
  8. 8.Department of Oncology, College of MedicineNational Taiwan UniversityTaipeiTaiwan
  9. 9.Liver Research CenterBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
  10. 10.Division of HepatologyKyoundo HospitalTokyoJapan
  11. 11.Department of Internal MedicineInstitute of Gastroenterology, Yonsei University College of MedicineSeoulKorea
  12. 12.Department of MedicineThe Aga Khan University HospitalKarachiPakistan
  13. 13.Department of General SurgerySingapore General HospitalSingaporeSingapore
  14. 14.Department of Gastroenterology and HepatologyNational University HospitalSingaporeSingapore
  15. 15.Departments of HepatologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia
  16. 16.Hepatology Division, Internal Medicine Department, RSUPN Cipto MangunkusumoJakartaIndonesia
  17. 17.Department of RadiologyCentral Army HospitalJakartaIndonesia
  18. 18.Department of GastroenterologyG. B. Pant Hospital, University of DelhiNew DelhiIndia

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