| セッション情報 |
International Forum 2(Liver) 3.Practice Guideline
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| タイトル |
IF2-3-I (Keynote lecture) EASL/AASLD Guidelines
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| 演者 |
Jordi Bruix（Hospital Clinic.Liver Unit BCLC Group） |
| 共同演者 |
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| 抄録 |
The incidence of Hepatocellular carcinoma （HCC） has increased in several countries during the last dec－ades and this has increased the attention paid to the diagnosis and management of the cancer． HCC is nowrecognised as the leading cause of death of patients with cirrhosis and the sole approach to increase theproportion of patients that can benefit from treatment is to reach diagnosis at an early stage． This need todetectdiagnose and treat HCC at an early stage has primed the need to develop clinical practice guide－lines． Since patients with liver disease constitute the population at risk for this neoplasmit is not surpris－ing that almost all major liver associations such as EASL and AASLD have produced such documents toguide the management of the patients．According to these recommendationsHCC screening should be engaged in the population at risk （namelypatients with cirrhosis） and be based on US examination every 6 months． Diagnosis of HCC can be estab－lished by non－invasive criteria based on dynamic imaging techniquesbut if the findings are not specific（arterial uptake followed by venous washout） the diagnosis should be based on pathology． Careful stagingof the tumor burden and of the degree of liver function impairment are key to guide therapy． and theBCLC staging and treatment strategy has been endorsed as the most valuable tool for this purpose as itlinks staging with treatment indication． ln briefpatients diagnosed at an early stage can benefit from sur－gical resection1iver transplantation（cadaveric or live donors）or ablation． If patients are at．a more ad－vanced stage the treatment of choice is transarterial chemoembolization． For more advanced stagesitwas stated that no effective option was available and hencethe recommendation was to enrole patientsinto research trials to test new agents． Nowsorafenib has been shown to be effective in the advanced set－ting and thusit should be seen as the standard therapeutic option in these patients． |
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