Minimally-invasive and multidisciplinary comprehensive diagnosis and treatment for HCC: 2018 Guangzhou consensus

• Main Author: Asia-Pacific Association of Image-Guided Therapy of Oncology,Committee of Minimally Invasive Therapy in Oncology, Chinese Anti-Cancer Association,Asian Conference on Tumor Ablation 2017
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2019-10-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=10237

In China，the vast majority of hepatocellular carcinoma (HCC) is the result of long-term development of hepatitis B and cirrhosis. Pathologically, HCC is characterized by rich blood supply and multicenter origin, with early invasion of small branches of portal vein and intrahepatic metastasis. Therefore, HCC is not only a local organ but also a systemic disease at the beginning of its occurrence. For this reason, in clinical treatment of HCC a comprehensive treatment scheme should be adopted, including local treatment (such as surgical resection, radiofrequency ablation, microwave ablation, chemical ablation and cryoablation et al), organ-level therapy (such as transcatheter arterial infusion chemotherapy and transcatheter arterial chemoembolization), and systemic therapy (such as immunotherapy, antiviral therapy and molecular targeted therapy et al). This consensus sets forth the minimally-invasive and multidisciplinary comprehensive diagnosis and treatment of HCC, focusing on the following eight aspects: (1) hepatic arteriography, hepatic arteriography CT（CTHA）, arterioportal angiography CT (CTAP), lipiodol CT (Lp-CT), TACE-CT, which are helpful in finding the lesion and making precise staging; (2) TACE/ablation should be used as the first choice of treatment for early stage or small HCC; (3) infiltrating HCC should be regarded as an independent type; (4) minimally-invasive comprehensive treatment of metastatic lymph nodes; (5) multi-level subdivision of M-staging used for guiding individual treatment and predicting prognosis; (6) HCC with severe hepatic decompensation is a candidate criterion for liver transplantation; (7) promotion of bio-immunotherapy, traditional Chinese medicine therapy, antiviral therapy and social psychotherapy, which should be run through all stages of treatment; (8) implementation of multicenter randomized controlled trials of minimally-invasive therapy and surgery for early and middle stage HCC is recommended.