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Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

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Abstract

Introduction

The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations.

Methods

The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements.

Results

Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Abbreviations

AASLD:

American Association for Study of Liver Diseases

AFP:

α-Fetoprotein

AFP-L3:

Lens culinaris agglutinin-reactive fraction of AFP

APASL:

Asian Pacific Association for the Study of the Liver

ECOG:

Eastern Cooperative Oncology Group

CI:

Confidence interval

CEUS:

Contrast-enhanced US

CSF-1:

Colony-stimulating factor 1

CTAP:

CT during arterial portography

CTHA:

CT hepatic arteriography

DCP:

Des-γ-carboxyprothrombin

DN:

Dysplastic nodule

EASL:

European Association for the study of the liver

FNH:

Focal nodular hyperplasia

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid

GPC3:

Glypican-3

HBeAg:

Hepatitis B e antigen

HBsAg:

Hepatitis B surface antigen

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

HGDN:

High-grade dysplastic nodules

HH:

Hereditary hemochromatosis

IFN:

Interferon

LAM:

Lamivudine

LGDN:

Low-grade dysplastic nodules

LR+:

Positive likelihood ratio

MDCT:

Multidetector-row CT

MTT:

Molecular targeted therapy

NASH:

Nonalcoholic steatohepatitis

PDGFR:

Platelet-derived growth factor receptors

PIVKA-II:

Prothrombin induced by vitamin K absence-II

RCT:

Randomized controlled trial

RD:

Risk difference

SPIO:

Superparamagnetic iron oxide

TACE:

Transarterial chemoembolization

US:

Ultrasonography

VEGFR:

Vascular endothelial growth factor receptors

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Masao Omata, Ryosuke Tateishi, Haruhiko Yoshida & Shuichiro Shiina

  2. Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia

    Laurentius A. Lesmana, Unggul Budihusodo & C. Rinaldi Lesmana

  3. Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Pei-Jer Chen

  4. Liver Research Unit, Chang Gung Memorial Hospital, Taipei, Taiwan

    Shi-Ming Lin & Yun Fan Liaw

  5. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, Osaka-Sayama, Japan

    Masatoshi Kudo

  6. Abdominal Radiology Section, Department of Radiology, Seoul National University Hospital, Seoul, Korea

    Jeong Min Lee & Byung Ihn Choi

  7. Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China

    Ronnie T. P. Poon

  8. Department of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan

    Ann Lii Cheng

  9. Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China

    Ji-Dong Jia

  10. Division of Hepatology, Kyoundo Hospital, Tokyo, Japan

    Shuntaro Obi

  11. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

    Kwang Hyub Han

  12. Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan

    Wasim Jafri

  13. Department of General Surgery, Singapore General Hospital, Singapore, Singapore

    Pierce Chow

  14. Department of Gastroenterology and Hepatology, National University Hospital, Singapore, Singapore

    Seng Gee Lim

  15. Departments of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Yogesh K. Chawla

  16. Hepatology Division, Internal Medicine Department, RSUPN Cipto Mangunkusumo, Jakarta, Indonesia

    Rino A. Gani

  17. Department of Radiology, Central Army Hospital, Jakarta, Indonesia

    Terawan Agus Putranto

  18. Department of Gastroenterology, G. B. Pant Hospital, University of Delhi, New Delhi, India

    Shiv Kumar Sarin

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  1. Masao Omata
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Correspondence to Masao Omata.

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Omata, M., Lesmana, L.A., Tateishi, R. et al. Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma. Hepatol Int 4, 439–474 (2010). https://doi.org/10.1007/s12072-010-9165-7

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