J Hepatol. 2025 Feb;82(2):315-374. doi: 10.1016/j.jhep.2024.08.028. Epub 2024 Dec 17.
Liver cancer is the third leading cause of cancer-related deaths worldwide, with hepatocellular carcinoma (HCC) accounting for approximately 90% of primary liver cancers. Advances in diagnostic and therapeutic tools, along with improved understanding of their application, are transforming patient treatment. Integrating these innovations into clinical practice presents challenges and necessitates guidance. These clinical practice guidelines offer updated advice for managing patients with HCC and provide a comprehensive review of pertinent data. Key updates from the 2018 EASL guidelines include personalised surveillance based on individual risk assessment and the use of new tools, standardisation of liver imaging procedures and diagnostic criteria, use of minimally invasive surgery in complex cases together with updates on the integrated role of liver transplantation, transitions between surgical, locoregional, and systemic therapies, the role of radiation therapies, and the use of combination immunotherapies at various stages of disease. Above all, there is an absolute need for a multiparametric assessment of individual risks and benefits, considering the patient's perspective, by a multidisciplinary team encompassing various specialties.
肝癌是全球癌症相关死亡的第三大主要原因，其中肝细胞癌（HCC）约占原发性肝癌的90%。诊断和治疗工具的进步，以及对其应用的深入理解，正在改变患者的治疗方式。将这些创新整合到临床实践中存在挑战，需要指导。这些临床实践指南为HCC患者的管理提供了最新建议，并对相关数据进行了全面回顾。2018年欧洲肝脏研究学会（EASL）指南的关键更新包括基于个体风险评估的个性化监测和新工具的使用、肝脏成像程序和诊断标准的标准化、复杂病例中微创外科手术的应用以及肝移植综合作用的更新、手术、局部区域和全身治疗之间的转换、放射治疗的作用以及疾病各个阶段联合免疫治疗的使用。最重要的是，一个涵盖各个专业的多学科团队绝对有必要从患者的角度对个体风险和益处进行多参数评估。
