title: The effect of Guidelines in surgical decision making: The paradigm of hepatocellular carcinoma.
abstract: It is not inconceivable to envision surgeons, offering extended liver resection in patients beyond the Barcelona Clinic Liver Cancer (BCLC) staging system criteria with intermediate/advanced hepatocellular carcinoma (HCC), to be found negligent since extensive liver resection is correlated with increased morbidity compared to conservative or palliative treatment. Given that no other classification system than BCLC has been adopted widely for HCC staging and treatment, a revision of the BCLC algorithm and clinical guidelines should be tailored using new molecular and clinical treatment algorithms, as well as including patient's preferences.
authors.affiliation: Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Moris
authors.forename: Spyridon
authors.initials: S
authors.lastname: Vernadakis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Papalampros
authors.forename: Athanasios
authors.initials: A
authors.lastname: Petrou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Dimitroulis
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Spartalis
authors.forename: Evangelos
authors.initials: E
authors.lastname: Felekouras
authors.forename: John J
authors.initials: JJ
authors.lastname: Fung
mesh_terms: D000465:Algorithms; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003661:Decision Support Techniques; D019983:Guideline Adherence / Q000592:standards*; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome