AASLD develops evidence-based practice guidelines and practice guidances which are updated regularly by a multi-disciplinary panel of experts, including hepatologists, and include recommendations of preferred approaches to the diagnostic, therapeutic, and preventive aspects of care.
Management of Hepatocellular Carcinoma
Practice Guideline
HCC Diagnosis, Staging and Management Guidance [updated August 2018]
HCC Treatment Guidelines [updated January 2018]
Hepatocellular Carcinoma (HCC) is now the fifth-most common cancer in the world and the third cause of cancer-related mortality as estimated by the World Health Organization. It is estimated that in 2012, there were 782,000 cases worldwide, of which 83% were diagnosed in less developed regions of the world. The annual incidence rates in eastern Asia and Sub-Saharan Africa exceed 15 per 100,000 inhabitants, whereas figures are intermediate (between 5 and 15 per 100,000) in the Mediterranean Basin, Southern Europe, and North America and very low (below 5 per 100,000) in Northern Europe.(4) Vaccination against hepatitis B virus (HBV) has resulted in a decrease in HCC incidence in countries where this virus was highly prevalent.(5) These data suggest that the geographical heterogeneity is primarily related to differences in the exposure rate to risk factors and time of acquisition, rather than genetic predisposition. Studies in migrant populations have demonstrated that first-generation immigrants carry with them the high incidence of HCC that is present in their native countries, but in the subsequent generations the incidence decreases.
Supplemental Materials
Three systematic reviews were commissioned to support the guideline, which were published in January 2018
Therapies for Advanced Stage Hepatocellular Carcinoma with Macrovascular Invasion or Metastatic Disease: A Systematic Review and Meta-analysis
Therapies for Patients with Hepatocellular Carcinoma Awaiting for Liver Transplantation: A Systematic Review and Meta-analysis
Imaging for the Diagnosis of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis
Quality Measures on Hepatocellular Carcinoma
AASLD develops quality measures to help its members measure or quantify healthcare processes and outcomes that are associated with the ability to provide high-quality health care.