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AASLD Guidance on Liver Cancer Management

February 19, 2024
by Chigoziri Konkwo

Discoveries & Impact (February 2024)

Yale researchers have collaborated with other experts in the field of hepatocellular carcinoma (HCC), or liver cancer, to develop the most recent American Association for the Study of Liver Diseases (AASLD) practice guidance for liver cancer. Hepatocellular carcinoma is the third leading cause of cancer-related deaths worldwide and the leading cause of death in patients with chronic advanced liver disease. This practice guidance serves as the standard practice for the prevention, diagnosis, and treatment of the disease.

Important changes include the recommendation to add an alpha fetoprotein blood test to ultrasound imaging for liver cancer screening. AASLD recommends this as a cost-effective approach for liver cancer screening, in order to balance the sensitivity and specificity of these approaches. While several other promising biomarkers for hepatocellular carcinoma surveillance have been developed, they still require validation in larger clinical trials.

AASLD also recommends surgical treatment for individuals with liver cancer and localized tumor burden, either without liver scarring (cirrhosis), or with well-compensated cirrhosis of the liver. However, given the high incidence of liver cancer recurrence in patients receiving curative surgical resection, therapies to reduce the incidence of HCC recurrence are urgently needed. Thus, the new guidance recommends the use of immune checkpoint inhibitors after initial surgical treatment in patients at high risk of disease recurrence, as recent studies have proven their effectiveness.

To learn more, read the new practice guidance here: AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma

Singal, A. G., Llovet, J. M., Yarchoan, M., Mehta, N., Heimbach, J. K., Dawson, L. A., Jou, J. H., Kulik, L. M., Agopian, V. G., Marrero, J. A., Mishal Mendiratta-Lala, Brown, D. B., Rilling, W. S., Goyal, L., Wei, A. C., & Taddei, T. H. (2023). AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology, Publish Ahead of Print(78).

Submitted by Julie Parry on February 19, 2024