title: Clinical guideline SEOM: hepatocellular carcinoma.
abstract: Hepatocellular carcinoma (HCC) represents the second leading cause of cancer-related death worldwide. Surveillance with abdominal ultrasound every 6 months should be offered to patients with a high risk of developing HCC: Child-Pugh A-B cirrhotic patients, all cirrhotic patients on the waiting list for liver transplantation, high-risk HBV chronic hepatitis patients (higher viral load, viral genotype or Asian or African ancestry) and patients with chronic hepatitis C and bridging fibrosis. Accurate diagnosis, staging and functional hepatic reserve are crucial for the optimal therapeutic approach. Characteristic findings on dynamic CT/MR of arterial hyperenhancement with "washout" in the portal venous or delayed phase are highly specific and sensitive for a diagnosis of HCC in patients with previous cirrhosis, but a confirmed histopathologic diagnosis should be done in patients without previous evidence of chronic hepatic disease. BCLC classification is the most common staging system used in Western countries. Surgical procedures, local therapies and systemic treatments should be discussed and planned for each patient by a multidisciplinary team according to the stage, performance status, liver function and comorbidities. Surgical interventions remain as the only curative procedures but both local and systemic approaches may increase survival and should be offered to patients without contraindications.
authors.affiliation: Medical Oncology Department, Hospital Universitario Clínico San Carlos, Prof. Martín Lagos, s/n, 28040, Madrid, Spain. jsastrev@salud.madrid.org.
authors.forename: J
authors.initials: J
authors.lastname: Sastre
authors.affiliation: Medical Oncology Department, Hospital Universitari I Politècnic la Fe, Valencia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Díaz-Beveridge
authors.affiliation: Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: García-Foncillas
authors.affiliation: Medical Oncology Department, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Guardeño
authors.affiliation: Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: C
authors.initials: C
authors.lastname: López
authors.affiliation: Medical Oncology Department, Hospital Universitario Miguel Servet, Saragossa, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Pazo
authors.affiliation: Medical Oncology Department, Hospital Universitario la Paz, Madrid, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Rodriguez-Salas
authors.affiliation: Medical Oncology Department, Complexo Hospitalario de Ourense (CHOU), Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Salgado
authors.affiliation: Medical Oncology Department, Hospital Universitari Arnau de Villanova de Lleida, Lleida, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Salud
authors.affiliation: Medical Oncology Department, Hospital Universitario la Paz, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Feliu
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy; D019468:Disease Management; D055088:Early Detection of Cancer; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008495:Medical Oncology; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic / Q000592:standards*; D011379:Prognosis; D012955:Societies, Medical
keywords: Ablative therapies; Guidelines; Hepatocellular carcinoma; Sorafenib