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Review Article
- Gobal Discrepancy of Practical Guidelines for Management of Hepatocellular Carcinoma-Resection and Transplanation
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Kwang-Woong Lee
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Journal of the Korean Liver Cancer Study Group. 2011;11(1):18-22. Published online February 28, 2011
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Abstract
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- Hepatocellular carcinoma (HCC) usually appears in the setting of underlying liver disease. Therefore, HCC should be
managed in multidisciplinary settings. Under these circumstances, several practice guidelines were introduced around the world.
Clinically useful practice guidelines should be based on evidences, but socio-economic and medical status of the country should
be considered as well. In this review, 6 well-known global practical guidelines (BCLC-AASLD, NCCN, 2 from Japan, APASL,
Korean) were compared in terms of resection and liver transplantation (LT). BCLC-AASLD from Europe and the United States
stressed more on LT for the patients within Milan criteria. However, the guidelines from the Asia had more extended indication
of liver resection. The number of living donor LT in Korea is the highest in the world. Under this circumstance, indication of LT
for HCC in Korea is inevitably being expanded. Compared to other guidelines, therefore, Korean guideline allowed a limited
expansion of indication for HCC into patients with Child A and/or living donor LT with outside Milan HCC. However, to make
more practical guidelines, high quality evidence from Korea and validation study of current Korean guideline are needed.