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  • Module 1: Hepatocellular carcinoma (HCC)
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Module 1:

Hepatocellular carcinoma (HCC)

1. Surveillance

1.1. Context

  • Guidelines recommend surveillance of hepatocellular carcinoma (HCC) by ultrasound in patients with liver cirrhosis/other risk factors.
  • Ultrasound is inexpensive but its sensitivity is suboptimal, particularly in nodular or fatty liver.
  • Nodules larger than 1 cm on ultrasound need further investigation with multiphasic dynamic computed tomography (CT) or MRI, which offer greater accuracy.
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    • 1
      Marrero JA, Kulik LM, Sirlin CB, et al. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2018;68(2):723-750.
    • 2
      European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182-236.
    • 3
      Omata M, Cheng AL, Kokudo N, et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int. 2017;11(4):317-370.
    • 4
      Zhou J, Sun HC, Wang Z, et al. Guidelines for diagnosis and treatment of primary liver cancer in China (2017 edition). Liver Cancer. 2018;7(3):235-260.
    • 5
      Korean Liver Cancer Association. 2018 Korean Liver Cancer Association-National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma. Gut Liver. 2019;13(3):227-299.
    • 6
      Simmons O, Fetzer DT, Yokoo T, et al. Predictors of adequate ultrasound quality for hepatocellular carcinoma surveillance in patients with cirrhosis. Aliment Pharmacol Ther. 2017;45(1):169-177.