Real practice of hepatocellular carcinoma in Japan: conclusions of the Japan Society of Hepatology 2009 Kobe Congress

Abstract

This article presents the current consensus on the management of hepatocellular carcinoma (HCC) formed at the 45th Annual Meeting of the Japan Society of Hepatology (June 4-5, 2009) and the 3rd International Kobe Liver Symposium (June 6-7, 2009) held in Kobe. Concluded important consensuses, which were well accepted by Japanese HCC specialists, are as follows. (1) Patients with type B or type C liver cirrhosis, who are an ultrahigh-risk group of liver cancer, should be screened every 3-4 months by ultrasonography and measurement of AFP and PIVKA-II. (2) Gd-EOB-MRI is useful for the diagnosis of early HCC. (3) The JIS score is more useful for the staging of liver cancer than the BCLC staging system, which is a global standard. (4) The TNM staging system by the Liver Cancer Study Group of Japan is superior to the TNM stage by the AJCC/UICC. (5) The therapeutic algorithm in the Japanese guidelines for the management of liver cancer is superior to the BCLC treatment algorithm. (6) Early stage. Liver cancers should be treated by radiofrequency ablation if they are </=2 cm, and by surgical resection if they are Child-Pugh A solitary lesions. (7) Liver transplantation is only indicated for Child-Pugh C patients within Milan Criteria. In conclusion, these consensuses seem to well reflect the real practice pattern of the management of HCC in Japan and provide valuable information for other countries as well.