Liver Cancer Working Group report.

Hepatocellular carcinoma is a highly prevalent disease in many Asian countries, accounting for 75-80% of victims worldwide. The incidence of hepatocellular carcinoma varies enormously across Asia, but tends to follow the incidences of hepatitis B infection and liver cirrhosis. The incidence and etiology of hepatocellular carcinoma in Japan are different from the rest of Asia, but similar to that in Western countries because hepatitis C infection is the main etiological factor in Japan. Hepatitis B virus vaccination programs are showing great success in reducing hepatitis B virus-related hepatocellular carcinoma. Screening program improves detection of early hepatocellular carcinoma and has some positive impact on survival, but the majority of hepatocellular carcinoma patients in Asia still present with advanced hepatocellular carcinoma. Long-term outcomes following treatment of even early/intermediate or advanced disease are often unsatisfactory because of a lack of effective adjuvant and systemic therapies. Various clinical practice guidelines for hepatocellular carcinoma have been established and are in use. Clinical diagnosis of hepatocellular carcinoma by imaging diagnosis is replacing diagnosis of hepatocellular carcinoma by pathological confirmation. New imaging and treatment techniques are continuously being developed and guidelines should be updated every 3 or 4 years, incorporating new evidence. New molecularly targeted therapies hold great promise. Sorafenib is the first systemic therapy to demonstrate prolonged survival vs. the placebo in patients with advanced hepatocellular carcinoma. Various other new molecularly targeted agents are currently under investigation.

[1]  M. Kudo,et al.  Management of hepatocellular carcinoma: Report of Consensus Meeting in the 45th Annual Meeting of the Japan Society of Hepatology (2009) , 2010, Hepatology research : the official journal of the Japan Society of Hepatology.

[2]  Jeong Min Lee,et al.  Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma , 2010, Hepatology international.

[3]  M. Kudo The 2008 Okuda lecture: Management of hepatocellular carcinoma: From surveillance to molecular targeted therapy , 2010, Journal of gastroenterology and hepatology.

[4]  M. Kudo,et al.  Non-Invasive Evaluation of Hepatic Fibrosis for Type C Chronic Hepatitis , 2010, Intervirology.

[5]  M. Kudo,et al.  Changing Trends in Hepatitis C Infection over the Past 50 Years in Japan , 2010, Intervirology.

[6]  D. Amarapurkar,et al.  Application of surveillance programs for hepatocellular carcinoma in the Asia–Pacific Region , 2009, Journal of gastroenterology and hepatology.

[7]  Joong-Won Park,et al.  Practical efficacy of sorafenib monotherapy for advanced hepatocellular carcinoma patients in a Hepatitis B virus-endemic area , 2009, Journal of Cancer Research and Clinical Oncology.

[8]  Jin-Lin Hou,et al.  Hepatocellular carcinoma in the Asia pacific region , 2009, Journal of gastroenterology and hepatology.

[9]  Michiie Sakamoto,et al.  Pathologic diagnosis of early hepatocellular carcinoma: A report of the international consensus group for hepatocellular neoplasia , 2009, Hepatology.

[10]  S. Fan,et al.  Phase 2 open‐label study of single‐agent sorafenib in treating advanced hepatocellular carcinoma in a hepatitis B–endemic Asian population , 2009, Cancer.

[11]  M. Kudo,et al.  Epidemiology of Hepatocellular Carcinoma in Japan and Korea , 2008, Oncology.

[12]  J. Bruix,et al.  Molecular targeted therapies in hepatocellular carcinoma , 2008, Hepatology.

[13]  Dieter Häussinger,et al.  Sorafenib in advanced hepatocellular carcinoma. , 2008, The New England journal of medicine.

[14]  Kinuyo Hatanaka,et al.  Differential Diagnosis of Hepatic Tumors: Value of Contrast-Enhanced Harmonic Sonography Using the Newly Developed Contrast Agent, Sonazoid , 2008, Intervirology.

[15]  B. Daniele,et al.  Design and Endpoints of Clinical Trials in Hepatocellular Carcinoma , 2008 .

[16]  S. Fan,et al.  Changing Paradigm in the Management of Hepatocellular Carcinoma Improves the Survival Benefit of Early Detection by Screening , 2008, Annals of surgery.

[17]  Yutaka Matsuyama,et al.  Development of evidence‐based clinical guidelines for the diagnosis and treatment of hepatocellular carcinoma in Japan , 2008, Hepatology research : the official journal of the Japan Society of Hepatology.

[18]  Masatoshi Kudo,et al.  Management of Hepatocellular Carcinoma in Japan: Consensus-Based Clinical Practice Manual Proposed by the Japan Society of Hepatology , 2007, Oncology.

[19]  J. Furuse,et al.  Phase I study of sorafenib in Japanese patients with hepatocellular carcinoma , 2007, Cancer science.

[20]  J. Kim,et al.  Liver cancer in Korea , 2007, Hepatology research : the official journal of the Japan Society of Hepatology.

[21]  M. Makuuchi,et al.  Report of the 17th Nationwide Follow‐up Survey of Primary Liver Cancer in Japan † , 2007, Hepatology research : the official journal of the Japan Society of Hepatology.

[22]  M. Makuuchi,et al.  Staging of Hepatocellular Carcinoma: Assessment of the Japanese TNM and AJCC/UICC TNM Systems in a Cohort of 13,772 Patients in Japan , 2007, Annals of surgery.

[23]  C. Yen,et al.  Two decades of universal hepatitis B vaccination in taiwan: impact and implication for future strategies. , 2007, Gastroenterology.

[24]  D. Amadori,et al.  Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[25]  Masatoshi Kudo,et al.  Validation of a new prognostic staging system for hepatocellular carcinoma: The JIS score compared with the CLIP score , 2004, Hepatology.

[26]  S. Todo,et al.  Living Donor Liver Transplantation for Adult Patients With Hepatocellular Carcinoma: Experience in Japan , 2004, Annals of surgery.

[27]  I. Lauder,et al.  Early detection of hepatocellular carcinoma increases the chance of treatment: Hong Kong experience , 2000, Hepatology.

[28]  J. Ferlay,et al.  Cancer Incidence in Five Continents , 1997 .

[29]  J. Ferlay,et al.  Cancer in Asia - Incidence rates based on data in cancer incidence in five continents IX (1998-2002). , 2010, Asian Pacific journal of cancer prevention : APJCP.

[30]  Yoon-Koo Kang,et al.  Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. , 2009, The Lancet. Oncology.

[31]  M. Yu,et al.  Epidemiology of hepatocellular carcinoma. , 2000, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[32]  J. Bruix,et al.  Prognosis of Hepatocellular Carcinoma: The BCLC Staging Classification , 1999, Seminars in liver disease.