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A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
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Asia-Pacific modified Delphi consensus conference on large hepatocellular carcinoma
Adianto Nugroho1, Arnetta N Lalisang2, Toar J M Lalisang2
1Indonesian Society of Digestive Surgeons, Indonesia; Department of Surgery, Fatmawati Central General Hospital, Jakarta, Indonesia.
Summary
Management of large hepatocellular carcinoma (HCC), defined as nodules ≥5 cm, lacks standardized guidelines. This consensus provides recommendations for optimal surgical strategies and diagnosis in the Asia-Pacific region.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Primary liver cancer, particularly large hepatocellular carcinoma (HCC), is a leading cause of cancer mortality in the Asia-Pacific region.
- Optimal management strategies for large HCC remain undefined, necessitating consensus-based guidelines.
Purpose of the Study:
- To establish a consensus on the definition and standardized management of large hepatocellular carcinoma (HCC).
- To provide guidance for surgeons managing large HCC, especially in the Asia-Pacific region.
Main Methods:
- Modified Delphi method involving three survey rounds and a discussion panel.
- Anonymous contributions from 31 experts to refine statements and achieve consensus on large HCC management.
Main Results:
- Large HCC is defined as a nodule measuring ≥5 cm.
- A distinct BCLC staging system is recommended for solitary large HCC (SLHCC) without vascular invasion or dissemination.
- Multiphasic contrast-enhanced CT/MRI and AFP levels ≥400 aid in SLHCC diagnosis; portal vein tumor thrombosis (PVTT) is a critical prognostic factor.
- Major hepatectomy and laparoscopic approaches are viable for SLHCC, with essential postoperative radiological surveillance.
Conclusions:
- Tailoring surgical approaches, ensuring operational readiness, and optimizing resources are crucial for successful large HCC management.
- The consensus provides a framework to guide surgeons in managing large HCC effectively.
