The Korean guideline for hepatocellular carcinoma surveillance.
10.5124/jkma.2015.58.5.385
- Author:
Do Young KIM
1
;
Hyun Jung KIM
;
Seung Eun JEONG
;
Sang Gyune KIM
;
Hyung Joon KIM
;
Dong Hyun SINN
;
Yong Joo LEE
;
Woo Kyoung JEONG
;
Kui Son CHOI
;
Nae Yun HEO
;
Dong Joon KIM
;
Young Seok KIM
;
Yong Bum KIM
;
Yoon Jun KIM
;
Hyoung Ryoul KIM
;
Minseon PARK
;
Chan Wha LEE
;
Won Young TAK
;
Ji Hye CHUNG
;
Soo Young KIM
;
Yeol KIM
;
Won Chul LEE
;
Hong Soo KIM
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
Hepatocellular carcinoma;
Surveillance;
Ultrasonography;
Alpha-fetoprotein
- MeSH:
alpha-Fetoproteins;
Carcinoma, Hepatocellular*;
Cohort Studies;
Complement System Proteins;
Consensus;
Diagnosis;
Fibrosis;
Health Services Needs and Demand;
Hepacivirus;
Hepatitis;
Hepatitis B virus;
Hepatitis C;
Humans;
Incidence;
Korea;
Liver;
Mortality;
Ultrasonography
- From:Journal of the Korean Medical Association
2015;58(5):385-397
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hepatocellular carcinoma (HCC) is one of the major cancers with a high incidence and mortality in Korea. A Korean multidisciplinary collaborative committee consisting of hepatologists, radiologists, epidemiologists and family medicine doctors systematically reviewed clinical practice guidelines in the world and literatures. The level of evidence for each recommendation was assessed and discussed to reach a consensus. Meta-analysis was also conducted to evaluate the grade of recommendation for the five key questions. Several randomized controlled studies and cohort studies showed a survival gain associated with surveillance for those at risk of developing HCC. The target populations for HCC surveillance were identified as hepatitis B virus or hepatitis C virus carriers and cirrhotic patients, since numerous studies revealed that these patients have significantly higher risk of HCC compared with non-infected or non-cirrhotic controls. Individual surveillance strategy according to treatment history or degree of fibrosis in patients with viral hepatitis remains to be settled. Based on several cohort and randomized studies, a surveillance interval of six months was recommend. The starting age of surveillance was determined as 40 years from the epidemiologic data. Although ultrasonography (US) is the mainstay for detection of HCC, its sensitivity is not fully accepted. Measurement of serum alpha-fetoprotein can complement US examination, increasing the sensitivity of HCC detection. The recommendation for HCC surveillance is that those with hepatitis B virus (or hepatitis C virus) infection or cirrhosis should have liver US and serum alpha-fetoprotein measurement every six months from 40 years of age or at the time of diagnosis of cirrhosis.
