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Hepatocellular carcinoma: French Intergroup Clinical Practice Guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, AFEF, SIAD, SFR/FRI) |
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Clin Res Hepatol Gastroenterol. 2021 Mar 26;45(2):101590.doi: 10.1016/j.clinre.2020.101590. Online ahead of print.
Jean Frédéric Blanc 1, Audrey Debaillon-Vesque 2, Gaël Roth 3, Jean Claude Barbare 4, Anne Sophie Baumann 5, Valérie Boige 6, Karim Boudjema 7, Mohamed Bouattour 8, Gilles Crehange 9, Barbara Dauvois 10, Thomas Decaens 3, François Dewaele 11, Olivier Farges 8, Boris Guiu 12, Antoine Hollebecque 6, Philippe Merle 13, Janick Selves 14, Thomas Aparicio 15, Isaac Ruiz 16, Olivier Bouché 17, Thésaurus National de Cancérologie Digestive (TNCD); Société Nationale Française de Gastroentérologie (SNFGE); Fédération Francophone de Cancérologie Digestive (FFCD); Groupe Coopérateur multidisciplinaire en Oncologie (GERCOR); Fédération Nationale des Centres de Lutte Contre le Cancer (UNICANCER); Société Française de Chirurgie Digestive (SFCD); Société Française d’Endoscopie Digestive (SFED); Société Française de Radiothérapie Oncologique (SFRO); Association Française pour l’Etude du Foie (AFEF)
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Author information
- 1CHU Haut-Lévêque, Bordeaux, France. Electronic address: jean-frederic.blanc@chu-bordeaux.fr.
- 2CHU Haut-Lévêque, Bordeaux, France.
- 3CHU Grenoble-Alpes, Grenoble, France.
- 4CHU Amiens, Amiens, France.
- 5UNICANCER ICL - Alexis Vautrin, Nancy, France.
- 6UNICANCER Gustave Roussy, Villejuif, France.
- 7CHU Pontchaillou, Rennes, France.
- 8APHP Beaujon, Clichy, France.
- 9UNICANCER François Leclerc, Dijon, France.
- 10Hôpital de la Source, ORLEANS, France.
- 11Centre Catherine de Sienne, Nantes, France.
- 12CHU Saint-Eloi, Montpellier, France.
- 13HCL Hôpital de la Croix-Rousse, Lyon, France.
- 14CHU Purpan, Toulouse, France.
- 15APHP Saint Louis, Paris, France.
- 16APHP Henri Mondor, Créteil, France.
- 17CHU Reims, Reims, France.
Abstract
Introduction: This document is a summary of the French Intergroup guidelines regarding the management of hepatocellular carcinoma (HCC) published in March 2019.
Method: It is a collaborative work under the auspices of most of the French medical societies involved in the management of HCC. It is based on the previous guidelines published in 2017. Recommendations are graded in 3 categories according to the level of evidence of data found in the literature.
Results: The diagnosis and staging of HCC is essentially based on clinical, biological and imaging features. A pathological analysis obtained by a biopsy of tumoral and non-tumoral liver is recommended. HCCs can be divided into 2 groups, taking into account not only the tumor stage, but also liver function. HCCs accessible to curative treatments are tumors that are in Milan criteria or with an AFP score ≤ 2, mainly treated by surgical resection, local ablation or liver transplantation. Intermediate and advanced HCCs with no liver insufficiency, accessible only to palliative treatments, benefit from TACE, SIRT or systemic therapy according to the presence or absence of macrovascular invasion or extrahepatic spread.
Conclusion: Such recommendations are in permanent optimization and each individual case must be discussed in a multidisciplinary expert board.
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