Diagnosis and management of hepatocellular carcinoma: results of a consensus meeting of The Ottawa Hospital Cancer Centre

  • T. Asmis The Ottawa Hospital Cancer Centre
  • F. Balaa The Ottawa Hospital
  • L. Scully The Ottawa Hospital
  • D. Papadatos The Ottawa Hospital
  • C. Marginean The Ottawa Hospital
  • N. Fasih The Ottawa Hospital
  • T. Shaw-Stiffel The Ottawa Hospital
  • R. Goel The Ottawa Hospital Cancer Centre

Abstract

ABSTRACT

Hepatocellular carcinoma (hcc) is an uncommon tumour, but its incidence is increasing in Canada and elsewhere. Currently, there are no Canadian recommendations for diagnosis and treatment of hcc, and possible options may have regional limitations. A consensus symposium was held in the Ottawa region to consider current diagnostic and management options for hcc. These recommendations were developed:

? Diagnosis—with adequate imaging, a biopsy is not required pre-surgery, but is required before the start of systemic therapy; lesions smaller than 1 cm should be followed and not biopsied; repeat biopsies should be core tissue biopsies; magnetic resonance imaging is preferred, but triphasic computed tomography imaging can be useful

? Resection—recommended for localized hcc

? Radiofrequency ablation—recommended for unresectable or non-transplantable hcc; should not be performed in the presence of ascites

? Trans-arterial chemoembolization (tace)— doxorubicin with lipiodol is the agent of choice; trans-catheter embolization is an alternative for patients if tace is not tolerated or is contraindicated

? Medical management—first-line sorafenib should be considered the standard of care

? Transplantation—suitable patients meeting Milan criteria should be assessed for a graft regardless of other treatments offered The authors feel that the recommendations from this consensus symposium may be of interest to other regions in Canada.

Author Biography

T. Asmis, The Ottawa Hospital Cancer Centre

Assistant Professor, University of Ottawa

Medial Oncology

How to Cite
Asmis, T., Balaa, F., Scully, L., Papadatos, D., Marginean, C., Fasih, N., Shaw-Stiffel, T., & Goel, R. (1). Diagnosis and management of hepatocellular carcinoma: results of a consensus meeting of The Ottawa Hospital Cancer Centre. Current Oncology, 17(2), 6-12. https://doi.org/10.3747/co.v17i2.555
Section
Practice Guideline Series