The guidelines were co-led by Dr María Reig, head of the Hospital Clínic Liver Oncology Unit and of the Barcelona Clínic Liver Cancer (BCLC) IDIBAPS group, and Dr. Bruno Sangro, coordinator of the Liver and Pancreatic Cancer Area at the Cancer Centre Clínica Universidad de Navarra (CCUN). Both are researchers at the CIBER for Liver and Digestive Diseases (CIBEREHD).
Hepatocellular carcinoma is the most common primary liver cancer, accounting for 90% of diagnosed cases, and is the third leading cause of cancer-related deaths globally, after lung and colorectal cancer. The management of this disease requires a comprehensive approach combining early diagnosis, innovative therapeutic options, and collaboration between different medical specialties.
What is new in these guidelines?
The new recommendations introduce key changes in the way hepatocellular carcinoma is approached. For the first time, the EASL has established a common methodology in all its guidelines, allowing for a more homogeneous approach based on the best evidence available. The BCLC classification is reaffirmed as the reference for HCC staging, facilitating decision-making based on the stage of the disease. Moreover, the LI-RADS criteria have been included to improve communication between professionals in non-invasive diagnosis, but the clinical decision is proposed based on whether or not the diagnosis is associated with a change in strategy.
Another fundamental aspect is the implementation of a multiparametric decision-making model, which allows treatments to be personalized according to the characteristics of the patient and the impact that each therapeutic option may have on their evolution. The guidelines also reinforce the need for a multidisciplinary approach, highlighting the importance of collaboration between specialists to guarantee the best treatment strategy. Finally, new therapeutic advances have been included, with the incorporation of combined treatments and new immunotherapy strategies that have been shown to improve patient survival.
“Liver cancer continues to be a major challenge for medicine. The updating of these guidelines represents the new way of making decisions, which, despite being evidence-based, has nuances as explained in the 2022 version of the BCLC Classification”, explains Maria Reig.
This publication highlights the leadership of Spanish doctors in the field of liver cancer worldwide. It is worth noting that Dr Reig is the first woman from the ESASL to chair the scientific committee and to coordinate HCC guidelines in Europe.
Study reference:
EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma. Sangro, Bruno et al. Journal of Hepatology, Volume 82, Issue 2, 315 - 374
