A Post-International Gastrointestinal Cancers' Conference (IGICC) Position Statements

Area of Science:

• Hepatology and Oncology
• Cancer Research
• Clinical Medicine

Background:

• Hepatocellular carcinoma (HCC) is the most common primary liver tumor, frequently associated with chronic liver diseases like cirrhosis.
• Globally, HCC ranks as the sixth most common cancer and the third leading cause of cancer-related mortality, with Asia experiencing the highest incidence.
• Key risk factors include chronic viral infections, alcohol consumption, fatty liver disease, and genetic predispositions, with a notable gender disparity (males affected thrice as often).

Purpose of the Study:

• To review recent advancements in treatment methodologies for advanced Hepatocellular carcinoma.
• To highlight the critical factors influencing treatment selection for HCC, including disease stage and patient health.
• To discuss current and emerging therapeutic strategies for managing advanced HCC.

Main Methods:

• Review of current literature on Hepatocellular carcinoma diagnosis and treatment.
• Analysis of treatment guidelines and clinical trial outcomes for advanced HCC.
• Evaluation of multidisciplinary approaches and personalized treatment strategies.

Main Results:

• Approximately 40-50% of HCC cases are diagnosed at late stages, necessitating advanced treatment options.
• Treatment selection is multifactorial, considering disease stage, liver condition, etiology, portal hypertension, and portal vein thrombosis.
• Potentially curative options include liver resection, ablation, or transplantation for eligible patients.
• For inoperable cases, arterially directed therapy, systemic treatments, or external beam radiation therapy are considered.
• First-line treatments for advanced HCC often involve combination therapies (e.g., immunotherapy with anti-VEGFR inhibitors) or dual immunotherapy.
• Tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors can be used as monotherapy for patients unsuitable for combination treatments.
• Second-line treatment options have also been identified and are under consideration.

Conclusions:

• A comprehensive, multidisciplinary approach is essential for optimizing HCC treatment decisions.
• Significant progress has been made in managing advanced HCC, with combination therapies showing promise.
• Ongoing research continues to expand the therapeutic arsenal for Hepatocellular carcinoma, improving patient outcomes.