Beyond the Algorithm: Patient-Informed Decision-Making in Hepatocellular Carcinoma

The landscape of hepatocellular carcinoma (HCC) treatment options has changed dramatically in recent years. There is also increasing recognition of the importance of incorporating patient values, preferences, and patient-reported outcomes (PROs), including health-related quality of life (HRQOL), into treatment decisions. In light of these changes, the Barcelona Clinic Liver Cancer (BCLC)—which previously advocated a strict treatment algorithm—now endorses the CUSE decision framework incorporating complexity, uncertainty, subjectivity, and emotion. Utilizing more flexible decision frameworks such as CUSE remains most feasible in co-located multidisciplinary HCC clinics but may be more challenging outside of these settings where many patients with HCC receive care. This session aims to provide practical guidance on best practices for assessing patient preferences, monitoring and incorporating PROs, and applying more flexible treatment decision frameworks. These concepts are practiced through an interactive, case-based activity to provide hands-on experience with patient-informed treatment decision-making in common clinical scenarios.