Hepatocellular carcinoma: French Intergroup Clinical Practice Guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, AFEF, SIAD, SFR/FRI) - 20/04/21
, Audrey Debaillon-Vesque a, Gaël Roth b, Jean Claude Barbare c, Anne Sophie Baumann d, Valérie Boige e, Karim Boudjema f, Mohamed Bouattour g, Gilles Crehange h, Barbara Dauvois i, Thomas Decaens b, François Dewaele j, Olivier Farges g, Boris Guiu k, Antoine Hollebecque e, Philippe Merle l, Janick Selves m, Thomas Aparicio n, Isaac Ruiz o, Olivier Bouché pon behalf of the Thésaurus National de Cancérologie Digestive (TNCD)
Société Nationale Française de Gastroentérologie (SNFGE)
Fédération Francophone de Cancérologie Digestive (FFCD)
Groupe Coopérateur multidisciplinaire en Oncologie (GERCOR)
Fédération Nationale des Centres de Lutte Contre le Cancer (UNICANCER)
Société Française de Chirurgie Digestive (SFCD)
Société Française d’Endoscopie Digestive (SFED)
Société Française de Radiothérapie Oncologique (SFRO)
Association Française pour l’Etude du Foie (AFEF)
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Highlight |
• | These practice recommendations provide an update on the state of knowledge in the field of HCC. |
• | Decision algorithms have been developed to guide diagnostic and treatment decisions at all stages of the disease. |
• | The most recent systemic treatments available (including immunotherapy) have been integrated into the therapeutic algorithm. |
Abstract |
Introduction |
This document is a summary of the French Intergroup guidelines regarding the management of hepatocellular carcinoma (HCC) published in March 2019.
Method |
It is a collaborative work under the auspices of most of the French medical societies involved in the management of HCC. It is based on the previous guidelines published in 2017. Recommendations are graded in 3 categories according to the level of evidence of data found in the literature.
Results |
The diagnosis and staging of HCC is essentially based on clinical, biological and imaging features. A pathological analysis obtained by a biopsy of tumoral and non-tumoral liver is recommended. HCCs can be divided into 2 groups, taking into account not only the tumor stage, but also liver function. HCCs accessible to curative treatments are tumors that are in Milan criteria or with an AFP score ≤ 2, mainly treated by surgical resection, local ablation or liver transplantation. Intermediate and advanced HCCs with no liver insufficiency, accessible only to palliative treatments, benefit from TACE, SIRT or systemic therapy according to the presence or absence of macrovascular invasion or extrahepatic spread.
Conclusion |
Such recommendations are in permanent optimization and each individual case must be discussed in a multidisciplinary expert board.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Hepatocellular carcinoma, French Clinical Practice Guidelines
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Vol 45 - N° 2
Articolo 101590- Marzo 2021 Ritorno al numero
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