Hepatocellular Carcinoma Clinical Practice Toolkit
The AASLD Digital Toolkit for Hepatocellular Carcinoma (HCC) brings together practical, evidence-based resources to support clinicians at every stage of HCC care—from surveillance and diagnosis through staging and treatment selection. The below collection features guideline-based algorithms, risk calculators, and interactive tools designed for quick reference at the point of care, helping providers translate current practice guidance into everyday clinical decision-making. Whether you are managing surveillance in patients with cirrhosis, interpreting imaging findings, or navigating treatment options across the disease spectrum, this toolkit is intended to serve as a centralized, continually updated resource for the hepatology community.
Screening / Surveillance
Patients at high risk for HCC should be entered into a biannual surveillance program with US and AFP. Those with abnormal US , AFP levels or limited visualizatin warrant further workup
Who Should Undergo HCC Surveillance?
A list of specific population groups whose annual estimated HCC incidence exceeds the threshold to warrant HCC surveillance
Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
Recall Algorithm for HCC Surveillance Ultrasound Findings
AASLD's recall algorithm for subsequent HCC surveillance or diagnostic testing, based on ultrasound visualization, presence of lesions, and AFP levels
Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
Diagnosis
In at-risk patients with cirrhosis or chronic HBV infection, the diagnosis of HCC should be based on noninvasive imaging criteria and/or pathology
Risk of HCC according to LI-RADS Class
Correlation between LI-RADS classifications and observed risk of HCC or other malignancy and subsequent management recommendations
Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
Staging and Treatment
Patients with HCC should be discussed and managed in a multidisciplinary care setting. Treatment plan depends on tumor burden, liver function, Physical status and individual patient characteristics
BCLC Algorithm for HCC Staging and Treatment
Barcelona Clinic Liver Cancer algorithm uses HCC stage, underlying liver function, and patient performance status to offer prognostic and therapeutic recommendations
Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
When to Consider Liver Resection for HCC
Simple algorithm for when to consider surgical management with resection for early stage HCC
Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
Management of Early-stage (T1) HCC
AASLD's algorithm for an unresectable T1 lesion/BCLC 0 in a patient with cirrhosis
Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
HCC Downstaging Criteria for Transplant
Proposed expanded criteria for downstaging patients with HCC beyond Milan prior to liver transplantation
Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
Radiographic Assessment after TACE
AASLD's recommendation for radiologic assessment of treatment response after transarterial chemoembolization (TACE)
Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Hepatology. 2023;78(6):1922-1965. doi:10.1097/HEP.0000000000000466
