Hepatocellular Carcinoma in the Eastern World: Screening, Diagnosis, Staging and Treatment

Hepatocellular carcinoma (HCC) remains a major public health issue across East Asia due to the high prevalence of hepatitis B viral infection in this area, and each country develops its own guideline according to clinical evidence and local health care resources. The latest guidelines from Taiwan, Hong Kong, China, Korea, and Japan were comprehensively reviewed. We highlight and compare the similarities and differences in epidemiology, surveillance, diagnosis, staging, and treatment strategies. Variations were observed in the issue of surveillance and early diagnosis by tumor marker integration, imaging modalities adoption, and individualized risk assessment tools, which reflect the local health resource availability and disease patterns. However, East Asian guidelines recommend broader criteria for curative treatment, such as liver resection and local ablation, which are beyond the criteria of Western guidelines. The introduction of immune checkpoint inhibitors and targeted therapy changes the treatment landscape for advanced HCC. The conversion strategies and drug-off criteria for patients who achieve tumor control have drawn great attention and discussion. The evolving treatment highlights the importance of the integration of global evidence-based practices and region-specific considerations to improve the treatment outcomes for HCC patients.