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Article

Multidisciplinary Canadian consensus recommendations for the management and treatment of hepatocellular carcinoma

by
M. Sherman
1,*,
K. Burak
2,
J. Maroun
3,
P. Metrakos
4,
J.J. Knox
5,
R.P. Myers
6,
M. Guindi
7,
G. Porter
8,
J.R. Kachura
9,
P. Rasuli
10,
S. Gill
11,
P. Ghali
12,
P. Chaudhury
13,
J. Siddiqui
14,
D. Valenti
15,
A. Weiss
16 and
R. Wong
17
1
Department of Medicine, University of Toronto; University Health Network; and Canadian Liver Foundation, Toronto, ON
2
Department of Medicine, Liver Unit, and Division of Gastroenterology, Department of Medicine, Gastrointestinal Research Group, University of Calgary, Calgary, AB
3
Division of Medical Oncology, Faculty of Medicine, University of Ottawa, and Ottawa Regional Cancer Centre, Ottawa, ON
4
Division of General Surgery, Department of Anatomy and Cell Biology, McGill University; Multi-Organ Transplant Program; Hepatopan-creatobiliary Surgery, McGill University Health Centre; and LD MacLean Surgical Research Laboratories, Montreal, QC
5
Department of Medicine, University of Toronto, and Department of Medical Oncology, Princess Margaret Hospital, Toronto, ON
6
Liver Unit, University of Calgary, Calgary, AB
7
University of Toronto, Toronto, ON
8
Department of General Surgery, Faculty of Medicine, Dalhousie University, and Cancer Care Program, Ramia Chair in Surgical Oncology, QEII Health Sciences Centre, Halifax, NS
9
Department of Medical Imaging, Faculty of Medicine, University of Toronto; Division of Vascular and Interventional Radiology, Department of Medical Imaging, University Health Network and Mount Sinai Hospital; and Toronto General Research Institute, Toronto, ON
10
Department of Diagnostic Imaging, Faculty of Medicine, University of Ottawa, Ottawa, ON
11
BC Cancer Agency and Faculty of Medicine, University of British Columbia, Vancouver, BC
12
McGill University Health Centre, Hepatology and Live Transplantation, Montreal, QC
13
*McGill University Hepatopancreatobiliary and Transplant and McGill University Health Centre, Montreal, QC
14
Medical Oncology, Memorial University of Newfoundland, and Division of Medical Oncology, Eastern Health, St. John’s, NL
15
McGill University and Division of Interventional Radiology, McGill University Health Centre, Montreal, QC
16
Hepatology, University of British Columbia; Vancouver General Hospital; and BC Cancer Agency, Vancouver, BC
17
Medical Oncology, CancerCare Manitoba, and University of Manitoba, St. Boniface General Hospital, Winnipeg, MB
 
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Author to whom correspondence should be addressed.
Curr. Oncol. 2011, 18(5), 228-240; https://doi.org/10.3747/co.v18i5.952
Submission received: 6 July 2011 / Revised: 10 August 2011 / Accepted: 13 September 2011 / Published: 1 October 2011

Abstract

Globally, hepatocellular carcinoma (hcc) is the third most common cause of death from cancer, after lung and stomach cancer. The incidence of hcc in Canada is increasing and is expected to continue to increase over the next decade. Given the high mortality rate associated with hcc, steps are required to mitigate the impact of the disease. To address this challenging situation, a panel of 17 hcc experts, representing gastroenterologists, hepatologists, hepatobiliary surgeons, medical oncologists, pathologists, and radiologists from across Canada, convened to provide a framework that, using an evidence-based approach, will assist clinicians in optimizing the management and treatment of hcc. The recommendations, summarized here, were developed based on a rigorous methodology in a pre-specified process that was overseen by the steering committee. Specific topics were identified by the steering committee and delegated to a group of content experts within the expert panel, who then systematically reviewed the literature on that topic and drafted the related content and recommendations. The set of recommendations for each topic were reviewed and assigned a level of evidence and grade according to the levels of evidence set out by the Centre for Evidence-based Medicine, Oxford, United Kingdom. Agreement on the level of evidence for each recommendation was achieved by consensus. Consensus was defined as agreement by a two-thirds majority of the 17 members of the expert panel. Recommendations were subject to iterative review and modification by the expert panel until consensus could be achieved.
Keywords: Hepatocellular carcinoma; consensus recommendations; screening; diagnosis; staging; prognosis; surgical resection; transplantation; percutaneous ethanol injection; radiofrequency ablation; transarterial chemotherapy; systemic chemotherapy; clinical management Hepatocellular carcinoma; consensus recommendations; screening; diagnosis; staging; prognosis; surgical resection; transplantation; percutaneous ethanol injection; radiofrequency ablation; transarterial chemotherapy; systemic chemotherapy; clinical management

Share and Cite

MDPI and ACS Style

Sherman, M.; Burak, K.; Maroun, J.; Metrakos, P.; Knox, J.J.; Myers, R.P.; Guindi, M.; Porter, G.; Kachura, J.R.; Rasuli, P.; et al. Multidisciplinary Canadian consensus recommendations for the management and treatment of hepatocellular carcinoma. Curr. Oncol. 2011, 18, 228-240. https://doi.org/10.3747/co.v18i5.952

AMA Style

Sherman M, Burak K, Maroun J, Metrakos P, Knox JJ, Myers RP, Guindi M, Porter G, Kachura JR, Rasuli P, et al. Multidisciplinary Canadian consensus recommendations for the management and treatment of hepatocellular carcinoma. Current Oncology. 2011; 18(5):228-240. https://doi.org/10.3747/co.v18i5.952

Chicago/Turabian Style

Sherman, M., K. Burak, J. Maroun, P. Metrakos, J.J. Knox, R.P. Myers, M. Guindi, G. Porter, J.R. Kachura, P. Rasuli, and et al. 2011. "Multidisciplinary Canadian consensus recommendations for the management and treatment of hepatocellular carcinoma" Current Oncology 18, no. 5: 228-240. https://doi.org/10.3747/co.v18i5.952

APA Style

Sherman, M., Burak, K., Maroun, J., Metrakos, P., Knox, J. J., Myers, R. P., Guindi, M., Porter, G., Kachura, J. R., Rasuli, P., Gill, S., Ghali, P., Chaudhury, P., Siddiqui, J., Valenti, D., Weiss, A., & Wong, R. (2011). Multidisciplinary Canadian consensus recommendations for the management and treatment of hepatocellular carcinoma. Current Oncology, 18(5), 228-240. https://doi.org/10.3747/co.v18i5.952

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