2014 KLCSG-NCC Korea Practice Guideline for the Management of Hepatocellular Carcinoma.
Bottom Line: In particular, a substantial body of knowledge has been accumulated on diagnosis, staging, and treatment specific to Asian characteristics, especially Koreans, prompting the proposal of new strategies.Accordingly, the new guideline presented herein was developed on the basis of recent evidence and expert opinions.This guideline provides recommendations for the initial treatment of patients with newly diagnosed HCC.
The guideline for the management of hepatocellular carcinoma (HCC) was first developed in 2003 and revised in 2009 by the Korean Liver Cancer Study Group and the National Cancer Center, Korea. Since then, many studies on HCC have been carried out in Korea and other countries. In particular, a substantial body of knowledge has been accumulated on diagnosis, staging, and treatment specific to Asian characteristics, especially Koreans, prompting the proposal of new strategies. Accordingly, the new guideline presented herein was developed on the basis of recent evidence and expert opinions. The primary targets of this guideline are patients with suspicious or newly diagnosed HCC. This guideline provides recommendations for the initial treatment of patients with newly diagnosed HCC.
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Mentions: According to the central cancer registration statistics published in 2013, there were 218,017 cases of cancer in Korea in 2011. Among them, 7.6% (16,434) of all malignancies were primary liver cancer cases, ranking fifth in incidence.7 Regarding sex, 12,189 cases were in men and 4,274 cases were in women, making primary liver cancer the fourth and sixth most common cancer in men and women in Korea, respectively; the male:female ratio was 2.85:1.7 Regarding age, primary liver cancer occurred most frequently in patients in their 50s (28.6%) followed by 60s (26.0%) and 70s (22.3%).7 The crude incidence rate, i.e., the number of newly occurring cancer patients during the observation period among the study population, was 32.9 (male, 48.6; female, 17.1) per 100,000 population. According to an annual report of the 2010 cancer registration statistics, the diagnostic code of HCC accounted for approximately 76.0% among all primary liver cancers. According to the age-standardized incidence rate, compensated with the mid-year population in 2000, the incidences of primary liver cancer occurrence were 28.9 (male, 48.5; female, 12.6) per 100,000 population in 1999 and 22.8 (male, 36.7; female, 10.5) in 2011. This implies that the occurrence of primary liver cancer has decreased somewhat, showing an annual rate of change of −1.8%. However, the number of new cases of primary liver cancer in 1999 was 13,286 (male, 10,027; female, 3,259), and the sex ratio was similar to that of recent data, whereas the total number of cases is less than that of the recent data (Fig. 1).7,8 This may reflect the age structure of the Korean population, as the absolute number of liver cancer cases is increasing, whereas the age-standardized incidence is decreasing.9