Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2017 Edition)

Abstract

Background: Hepatocellular carcinoma (HCC) (about 85-90% of primary liver cancer) is particularly prevalent in China because of the high prevalence of chronic hepatitis B infection. HCC is the fourth most common malignancy and the third leading cause of tumor-related deaths in China. It poses a significant threat to the life and health of Chinese people.

Summary: This guideline presents official recommendations of the National Health and Family Planning Commission of the People's Republic of China on the surveillance, diagnosis, staging, and treatment of HCC occurring in China. The guideline was written by more than 50 experts in the field of HCC in China (including liver surgeons, medical oncologists, hepatologists, interventional radiologists, and diagnostic radiologists) on the basis of recent evidence and expert opinions, balance of benefits and harms, cost-benefit strategies, and other clinical considerations.

Key messages: The guideline presents the Chinese staging system, and recommendations regarding patients with HCC in China to ensure optimum patient outcomes.

Keywords: Cancer; Carcinoma; China; Diagnosis; Liver; Treatment.

Figures

Fig. 1.

Guidelines for diagnosis of liver cancer. Typical manifestations: defined as obvious enhancements of lesions during the enhanced arterial phase (mainly late arterial phase) and reductions in enhancements during the portal venous or delayed phase that exhibit an enhancement mode of “rapid wash in and out.” Atypical manifestations: in the absence of lesion enhancement in the arterial phase, or when there is no reduction or no obvious reduction or even a mild increase in enhancement noted in the portal venous and delayed phases. Dynamic MRI: defined as dynamic enhanced MRI scan. Dynamic enhanced CT: defined as dynamic enhanced triphasic scan. CEUS: defined as the real-time monitoring of blood flow perfusion of normal tissues and lesion tissues using ultrasonography contrast agents. EOB-MRI: defined as Gd-EOB-DTPA-enhanced MRI scan. AFP+: above the upper limits of normal of serum AFP.

Fig. 2.

Guidelines for treatment of liver cancer.