Adianto Nugroho, Arnetta N Lalisang, Toar J M Lalisang, Mohamed Rela, Pierce K H Chow, Stephen Chang, Koh P Soon, Tin T Mar, Amornetta Casupang, Rawisak Chanwat, Erik Prabowo, Indah Jamtani, Nguyen D S Huy, Norihiro Kokudo, Catherine Teh
{"title":"亚太大肝癌修正Delphi共识会议。","authors":"Adianto Nugroho, Arnetta N Lalisang, Toar J M Lalisang, Mohamed Rela, Pierce K H Chow, Stephen Chang, Koh P Soon, Tin T Mar, Amornetta Casupang, Rawisak Chanwat, Erik Prabowo, Indah Jamtani, Nguyen D S Huy, Norihiro Kokudo, Catherine Teh","doi":"10.1016/j.hpb.2025.07.013","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Approximately 80 % of primary liver cancer cases happen in Asia-Pacific and become the leading cause of cancer-related mortality. However, there is no consensus on defining and standardizing the optimal management of large HCCs.</p><p><strong>Methods: </strong>The Asia-Pacific Consensus Conference employed the Modified Delphi method, consisting of three rounds of surveys followed by a discussion panel. In this process, 31 experts anonymously contributed their opinions to refine statements and achieve a consensus on large HCC.</p><p><strong>Results: </strong>A large hepatocellular carcinoma (HCC) is a nodule measuring ≥5 cm. A distinct BCLC staging system is recommended for solitary large HCC (SLHCC) without vascular invasion or tumor dissemination, as these cases show prolonged survival and lower recurrence rates post-liver resection. Portal vein tumor thrombosis (PVTT) is a crucial prognostic factor. Diagnosis of SLHCC can rely on multiphasic contrast-enhancing radiology (CT/MRI) and AFP levels ≥400. Preoperative liver function assessments guide resection planning where liver volumetry is unavailable. Major hepatectomy and laparoscopic approaches are viable for SLHCC, and postoperative radiological surveillance is essential.</p><p><strong>Conclusion: </strong>Tailoring surgical approaches, ensuring readiness, and optimizing resources are key to successful single large HCC management. This consensus aims to guide surgeons, especially in the Asia-Pacific region.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Asia-Pacific modified Delphi consensus conference on large hepatocellular carcinoma.\",\"authors\":\"Adianto Nugroho, Arnetta N Lalisang, Toar J M Lalisang, Mohamed Rela, Pierce K H Chow, Stephen Chang, Koh P Soon, Tin T Mar, Amornetta Casupang, Rawisak Chanwat, Erik Prabowo, Indah Jamtani, Nguyen D S Huy, Norihiro Kokudo, Catherine Teh\",\"doi\":\"10.1016/j.hpb.2025.07.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Approximately 80 % of primary liver cancer cases happen in Asia-Pacific and become the leading cause of cancer-related mortality. However, there is no consensus on defining and standardizing the optimal management of large HCCs.</p><p><strong>Methods: </strong>The Asia-Pacific Consensus Conference employed the Modified Delphi method, consisting of three rounds of surveys followed by a discussion panel. In this process, 31 experts anonymously contributed their opinions to refine statements and achieve a consensus on large HCC.</p><p><strong>Results: </strong>A large hepatocellular carcinoma (HCC) is a nodule measuring ≥5 cm. A distinct BCLC staging system is recommended for solitary large HCC (SLHCC) without vascular invasion or tumor dissemination, as these cases show prolonged survival and lower recurrence rates post-liver resection. Portal vein tumor thrombosis (PVTT) is a crucial prognostic factor. Diagnosis of SLHCC can rely on multiphasic contrast-enhancing radiology (CT/MRI) and AFP levels ≥400. Preoperative liver function assessments guide resection planning where liver volumetry is unavailable. Major hepatectomy and laparoscopic approaches are viable for SLHCC, and postoperative radiological surveillance is essential.</p><p><strong>Conclusion: </strong>Tailoring surgical approaches, ensuring readiness, and optimizing resources are key to successful single large HCC management. This consensus aims to guide surgeons, especially in the Asia-Pacific region.</p>\",\"PeriodicalId\":13229,\"journal\":{\"name\":\"Hpb\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-07-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hpb\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hpb.2025.07.013\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hpb","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hpb.2025.07.013","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Asia-Pacific modified Delphi consensus conference on large hepatocellular carcinoma.
Background: Approximately 80 % of primary liver cancer cases happen in Asia-Pacific and become the leading cause of cancer-related mortality. However, there is no consensus on defining and standardizing the optimal management of large HCCs.
Methods: The Asia-Pacific Consensus Conference employed the Modified Delphi method, consisting of three rounds of surveys followed by a discussion panel. In this process, 31 experts anonymously contributed their opinions to refine statements and achieve a consensus on large HCC.
Results: A large hepatocellular carcinoma (HCC) is a nodule measuring ≥5 cm. A distinct BCLC staging system is recommended for solitary large HCC (SLHCC) without vascular invasion or tumor dissemination, as these cases show prolonged survival and lower recurrence rates post-liver resection. Portal vein tumor thrombosis (PVTT) is a crucial prognostic factor. Diagnosis of SLHCC can rely on multiphasic contrast-enhancing radiology (CT/MRI) and AFP levels ≥400. Preoperative liver function assessments guide resection planning where liver volumetry is unavailable. Major hepatectomy and laparoscopic approaches are viable for SLHCC, and postoperative radiological surveillance is essential.
Conclusion: Tailoring surgical approaches, ensuring readiness, and optimizing resources are key to successful single large HCC management. This consensus aims to guide surgeons, especially in the Asia-Pacific region.
期刊介绍：
HPB is an international forum for clinical, scientific and educational communication.
Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice.
Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice.
HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields.
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HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).
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