Multidisciplinary meetings specific to hepatocellular carcinoma: How to proceed?

Abstract

The French "cancer plan" has created a framework for good practice in the course of care for cancer patients. Decisions must be made in a multidisciplinary team meeting (MDM) and an individualized care plan (ICP) is to be established for each patient. Hepatocellular carcinoma (HCC) is a common cancer with complex treatments that warrant a dedicated meeting. Cancer coordination centers (3C) ensure the organization and the functioning of MDMs. Multidisciplinary, standardized and systematic assessment of HCC patients allows for personalized management and orients them toward treatment that is either curative (transplantation, surgical resection, ablathermy) or palliative (chemoembolization, radiotherapy, systemic treatment, supportive care). MDMs bring together all the professionals treating the disease, and who are tasked with producing an enforceable document effective that justifies decisions and is often an essential step towardinclusion of patients in a clinical trial. It must be carried out according to a systematic schema in an approach applied from initial diagnosis to treatment outset and throughout the treatment. Numerous advances in HCC treatments have rendered their management complex, with the possibility of liver transplantation, twhose access is regulated by the Biomedicine Agency requiring the submission of MDM reports. MDMs must meet specific quality criteria to ensure effective management based on general guidelines and yet specifically tailored to each patient.

Keywords: Guidelines; Hepatocellular carcinoma; Liver transplantation; Multidisciplinary meeting; Quality criteria.