Argentinian clinical practice guideline for surveillance, diagnosis, staging and treatment of hepatocellular carcinoma

Annals of Hepatology

Margarita Anders¹  Mario Tanno²  Guillermo Mazzolini³  Federico Piñero⁴  Sebastián Marciano⁴  Beatriz Ameigeiras⁴  Valeria Descalzi⁴  Federico Villamil⁴  Andrés Ruf⁵  Cecilia Lagues⁶  Virginia Reggiardo⁶  Matías Tisi Baña⁷  Florencia Perazzo⁷  Lucas McCormack⁸  Ezequiel Ridruejo⁸  Fernando Cairo⁸  Gabriel Aballay Soteras⁹  Martín Maraschio^1,10  Juan Carlos Spina^1,10  Marcelo Silva^1,10  Adrián Gadano^1,11  Silvia Mengarelli^1,12  Eduardo Fassio^1,12  Silvia Borzi^1,13  Nora Fernández^1,14  Melisa Dirchwolf^1,15 

[1] Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Ciudad de Buenos Aires, Argentina;Corresponding author.;Fundación Favaloro, Ciudad de Buenos Aires, Argentina;Hepatology and Liver Unit, Hospital Universitario Austral, School of Medicine, Austral University, B1629HJ Buenos Aires, Argentina;Hospital Alejandro Posadas, Buenos Aires, Argentina;Hospital Alemán, Ciudad de Buenos Aires, Argentina;Hospital Argerich, Ciudad de Buenos Aires, Argentina;Hospital Británico, Ciudad de Buenos Aires, Argentina;Hospital Centenario de Rosario, Santa Fe, Argentina;Hospital Italiano de Buenos Aires, Argentina;Hospital Privado de Córdoba, Argentina;Hospital Privado de Rosario, Santa Fe, Argentina;Hospital San Roque, Córdoba, Argentina;Instituto Rossi, La Plata, Buenos Aires, Argentina;Internal Medicine and Epidemiology Department, Hospital Universitario Austral, School of Medicine, Austral University, B1629HJ Buenos Aires, Argentina;

关键词: Liver cancer;    Practice guideline;    Latin America;    Argentina;   

DOI  :  

来源: DOAJ

【 摘 要 】

The A.A.E.E.H has developed this guideline for the best care of patients with hepatocellular carcinoma (HCC) from Argentina. It was done from May 2018 to March 2020. Specific clinical research questions were systematically searched. The quality of evidence and level of recommendations were organized according to GRADE. HCC surveillance is strongly recommended with abdominal ultrasound (US) every six months in the population at risk for HCC (cirrhosis, hepatitis B or hepatitis C); it is suggested to add alpha-feto protein (AFP) levels in case of inexeperienced sonographers. Imaging diagnosis in patients at risk for HCC has high specificity and tumor biopsy is not mandatory. The Barcelona Clinic Liver Cancer algorithm is strongly recommended for HCC staging and treatment-decision processes. Liver resection is strongly recommended for patients without portal hypertension and preserved liver function. Composite models are suggested for liver transplant selection criteria. Therapies for HCC with robust clinical evidence include transarterial chemoembolization (TACE) and first to second line systemic treatment options (sorafenib, lenvatinib, regorafenib, cabozantinib and ramucirumab). Immunotherapy with nivolumab and pembrolizumab has failed to show statistical benefit but the novel combination of atezolizumab plus bevacizumab has recently shown survival benefit over sorafenib in frontline.

【 授权许可】

Unknown