Purcell Yvonne, Copin Pauline, Paulatto Luisa, Pommier Romain, Vilgrain Valérie, Ronot Maxime
Department of Radiology, University Hospitals Paris Nord Val de Seine, Clichy, France.
University Paris Diderot, Sorbonne Paris Cité, Paris, France.
Ultrasonography. 2019 Jul;38(3):191-199. doi: 10.14366/usg.18043. Epub 2018 Oct 28.
Eastern and Western guidelines for the management of hepatocellular carcinoma (HCC) are known to significantly differ on many points, because they reflect different diagnostic and therapeutic approaches to this cancer. Importantly, these guidelines are primarily consensus-driven when it comes to surveillance, both in term of the tests used and surveillance program design. The main difference between East and West lies in clinical practice, as several Eastern countries implement coordinated and systematic surveillance programs, while most Western countries rely on individual adherence to surveillance recommendations. This review article presents an overview of the evidence supporting surveillance programs for HCC, with a particular focus on the efficacy, cost-effectiveness, and consequences of this approach for patient survival. Western and Eastern guideline recommendations are discussed.
众所周知,东西方肝细胞癌(HCC)管理指南在许多方面存在显著差异,因为它们反映了针对这种癌症的不同诊断和治疗方法。重要的是,在监测方面,无论是所用检测方法还是监测项目设计,这些指南主要是基于共识制定的。东西方的主要差异在于临床实践,一些东方国家实施了协调一致的系统监测项目,而大多数西方国家则依赖个体对监测建议的遵循。这篇综述文章概述了支持HCC监测项目的证据,特别关注这种方法对患者生存的疗效、成本效益及影响。文中还讨论了东西方指南的建议。