Interpretation and comparison of AASLD (2023), NCCN (2024), ASCO (2024) guidelines and Chinese guideline for diagnosis and treatment of primary liver cancer (version-2024)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XU Ruoxiang ¹ , ZENG Zhiming ² , ZHU Guangzhi ¹ , HAN Chuangye ¹ , YAN Lünan ³ ,  PENG Tao ^1,4

1. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P. R. China;
2. Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P. R. China;
3. Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
4. Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer, Nanning 530021, P. R. China;

Corresponding author：

PENG Tao, Email: pengtaogmu@163.com

Keywords：

hepatocellular carcinoma; American Association for the Study of Liver Diseases Guideline; National Comprehensive Cancer Network Guideline; American Society of Clinical Oncology Guideline; China Liver Cancer Staging and Treatment Guideline (version-2024); interpretation

DOI：

10.7507/1007-9424.202501077

Video：

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Abstract Full text Figures/Tables Video References Cited by

With the publication of a vast amount of clinical research on hepatocellular carcinoma (HCC), the American Association for the Study of Liver Diseases (AASLD), the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the National Health Commission of China have all updated their diagnostic and treatment guidelines for HCC. There are no differences in the definition of HCC risk populations among the AASLD 2023, NCCN 2024, and China Liver Cancer Staging and Treatment Guideline (CNLC) 2024. Notably, CNLC 2024 has updated its guidance on high-risk factors and prospective surveillance for HCC based on the characteristics of HCC patients in China. The four guidelines have seen significant updates in the areas of neoadjuvant and adjuvant therapies, local treatments, and systemic treatments for HCC. CNLC 2024 refines the indications for local treatment, improves systemic treatment, and introduces new first-line therapy, including camrelizumab combined with rivoceranib or tislelizumab. The second-line therapy nivolumab plus ipilimumab for advanced HCC are recommended by AASLD 2023, NCCN 2024, and ASCO 2024, which may become a new first-line therapeutic option for patients with advanced HCC. We compare and interpret these four guidelines in this paper.

Citation： XU Ruoxiang, ZENG Zhiming, ZHU Guangzhi, HAN Chuangye, YAN Lünan, PENG Tao. Interpretation and comparison of AASLD (2023), NCCN (2024), ASCO (2024) guidelines and Chinese guideline for diagnosis and treatment of primary liver cancer (version-2024). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(2): 184-191. doi: 10.7507/1007-9424.202501077 Copy

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2.	Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology, 2023, 78(6): 1922-1965.
3.	National Comprehensive Cancer Network. Hepatocellular carcinoma (version 4. 2024). (2024-07-02) [2024-09-30]. https://www.nccn.org/professionals/physician_gls/pdf/hcc.pdf.
4.	Gordan JD, Kennedy EB, Abou-Alfa GK, et al. Systemic therapy for advanced hepatocellular carcinoma: ASCO Guideline update. J Clin Oncol, 2024, 42(15): 1830-1850.
5.	中华人民共和国国家卫生健康委员会医政司. 原发性肝癌诊疗指南 (2024年版). 中国普通外科杂志, 2024, 33(4): 475-530.
6.	Zeng H, Cao M, Xia C, et al. Performance and effectiveness of hepatocellular carcinoma screening in individuals with HBsAg seropositivity in China: a multicenter prospective study. Nat Cancer, 2023, 4(9): 1382-1394.
7.	Best J, Bechmann LP, Sowa JP, et al. GALAD score detects early hepatocellular carcinoma in an international cohort of patients with nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol, 2020, 18(3): 728-735. e4.
8.	Zhou J, Yu L, Gao X, et al. Plasma microRNA panel to diagnose hepatitis B virus-related hepatocellular carcinoma. J Clin Oncol, 2011, 29(36): 4781-4788.
9.	Zhou J, Huang A, Yang XR. Liquid biopsy and its potential for management of hepatocellular carcinoma. J Gastrointest Cancer, 2016, 47(2): 157-167.
10.	Piratvisuth T, Hou J, Tanwandee T, et al. Development and clinical validation of a novel algorithmic score (GAAD) for detecting HCC in prospective cohort studies. Hepatol Commun, 2023, 7(11): e0317. doi: 10.1097/HC9.0000000000000317.
11.	Yang T, Xing H, Wang G, et al. A novel online calculator based on serum biomarkers to detect hepatocellular carcinoma among patients with hepatitis B. Clin Chem, 2019, 65(12): 1543-1553.
12.	Lee YJ, Lee JM, Lee JS, et al. Hepatocellular carcinoma: diagnostic performance of multidetector CT and MR imaging-a systematic review and meta-analysis. Radiology, 2015, 275(1): 97-109.
13.	Liu X, Jiang H, Chen J, et al. Gadoxetic acid disodium-enhanced magnetic resonance imaging outperformed multidetector computed tomography in diagnosing small hepatocellular carcinoma: a meta-analysis. Liver Transpl, 2017, 23(12): 1505-1518.
14.	Lin CY, Chen JH, Liang JA, et al. ¹⁸F-FDG PET or PET/CT for detecting extrahepatic metastases or recurrent hepatocellular carcinoma: a systematic review and meta-analysis. Eur J Radiol, 2012, 81(9): 2417-2422.
15.	Boellaard R, O’Doherty MJ, Weber WA, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1. 0. Eur J Nucl Med Mol Imaging, 2010, 37(1): 181-200.
16.	Chalian H, Töre HG, Horowitz JM, et al. Radiologic assessment of response to therapy: comparison of RECIST versions 1.1 and 1.0. Radiographics, 2011, 31(7): 2093-2105.
17.	Siripongsatian D, Promteangtrong C, Kunawudhi A, et al. Comparisons of quantitative parameters of Ga-68-labelled fibroblast activating protein inhibitor (FAPI) PET/CT and [¹⁸F]F-FDG PET/CT in patients with liver malignancies. Mol Imaging Biol, 2022, 24(5): 818-829.
18.	Lan L, Zhang S, Xu T, et al. Prospective comparison of ⁶⁸Ga-FAPI versus ¹⁸F-FDG PET/CT for tumor staging in biliary tract cancers. Radiology, 2022, 304(3): 648-657.
19.	Glantzounis GK, Tokidis E, Basourakos SP, et al. The role of portal vein embolization in the surgical management of primary hepatobiliary cancers. A systematic review. Eur J Surg Oncol, 2017, 43(1): 32-41.
20.	Li PP, Huang G, Jia NY, et al. Associating liver partition and portal vein ligation for staged hepatectomy versus sequential transarterial chemoembolization and portal vein embolization in staged hepatectomy for HBV-related hepatocellular carcinoma: a randomized comparative study. Hepatobiliary Surg Nutr, 2022, 11(1): 38-51.
21.	Zhang Y, Huang G, Wang Y, et al. Is salvage liver resection necessary for initially unresectable hepatocellular carcinoma patients downstaged by transarterial chemoembolization? Ten years of experience. Oncologist, 2016, 21(12): 1442-1449.
22.	Lyu N, Kong Y, Mu L, et al. Hepatic arterial infusion of oxaliplatin plus fluorouracil/leucovorin vs. sorafenib for advanced hepatocellular carcinoma. J Hepatol, 2018, 69(1): 60-69.
23.	肝癌新辅助治疗中国专家共识协作组, 中国研究型医院学会消化外科专业委员会, 中国抗癌协会肝癌专业委员会. 肝癌新辅助治疗中国专家共识 (2023版). 中华外科杂志, 2023, 61(12): 1035-1045.
24.	Wu F, Chen B, Dong D, et al. Phase 2 evaluation of neoadjuvant intensity-modulated radiotherapy in centrally located hepatocellular carcinoma: a nonrandomized controlled trial. JAMA Surg, 2022, 157(12): 1089-1096.
25.	Wang Z, Ren Z, Chen Y, et al. Adjuvant transarterial chemoembolization for HBV-related hepatocellular carcinoma after resection: a randomized controlled study. Clin Cancer Res, 2018, 24(9): 2074-2081.
26.	Li SH, Mei J, Cheng Y, et al. Postoperative adjuvant hepatic arterial infusion chemotherapy with FOLFOX in hepatocellular carcinoma with microvascular invasion: a multicenter, phase Ⅲ, randomized study. J Clin Oncol, 2023, 41(10): 1898-1908.
27.	Lee JH, Lee JH, Lim YS, et al. Adjuvant immunotherapy with autologous cytokine-induced killer cells for hepatocellular carcinoma. Gastroenterology, 2015, 148(7): 1383-1391. e6.
28.	He C, Peng W, Li C, et al. Thymalfasin, a promising adjuvant therapy in small hepatocellular carcinoma after liver resection. Medicine (Baltimore), 2017, 96(16): e6606. doi: 10.1097/MD.0000000000006606.
29.	Qin S, Chen M, Cheng AL, et al. Atezolizumab plus bevacizumab versus active surveillance in patients with resected or ablated high-risk hepatocellular carcinoma (IMbrave050): a randomised, open-label, multicentre, phase 3 trial. Lancet, 2023, 402(10415): 1835-1847.
30.	Killock D. From the ESMO Congress 2024. Nat Rev Clin Oncol, 2024, 21(12): 837. doi: 10.1038/s41571-024-00954-3.
31.	Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11): 693-699.
32.	Kwong AJ, Kim WR, Lake JR, et al. OPTN/SRTR 2019 annual data report: liver. Am J Transplant, 2021, 21 Suppl 2: 208-315.
33.	Tabrizian P, Florman SS, Schwartz ME. PD-1 inhibitor as bridge therapy to liver transplantation? Am J Transplant, 2021, 21(5): 1979-1980.
34.	Zhang YJ, Chen MS, Chen Y, et al. Long-term outcomes of transcatheter arterial chemoembolization combined with radiofrequency ablation as an initial treatment for early-stage hepatocellular carcinoma. JAMA Netw Open, 2021, 4(9): e2126992. doi: 10.1001/jamanetworkopen.2021.26992.
35.	Peng ZW, Zhang YJ, Chen MS, et al. Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial. J Clin Oncol, 2013, 31(4): 426-432.
36.	Chen J, He K, Han Y, et al. Clinical efficacy and safety of external radiotherapy combined with sorafenib in the treatment of hepatocellular carcinoma: a systematic review and meta-analysis. Ann Hepatol, 2022, 27(4): 100710. doi: 10.1016/j.aohep.2022.100710.
37.	Li H, Wu Z, Chen J, et al. External radiotherapy combined with sorafenib has better efficacy in unresectable hepatocellular carcinoma: a systematic review and meta-analysis. Clin Exp Med, 2023, 23(5): 1537-1549.
38.	朱广志, 严律南, 彭涛. 中国《原发性肝癌诊疗指南 (2022年版)》与《BCLC预后预测和治疗推荐策略 (2022年版)》的解读. 中国普外基础与临床杂志, 2022, 29(4): 434-439.
39.	Salem R, Gordon AC, Mouli S, et al. Y-90 radioembolization significantly prolongs time to progression compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology, 2016, 151(6): 1155-1163. e2.
40.	Zhu HD, Li HL, Huang MS, et al. Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma (CHANCE001). Signal Transduct Target Ther, 2023, 8(1): 58. doi: 10.1038/s41392-022-01235-0.
41.	Jin ZC, Zhong BY, Chen JJ, et al. Real-world efficacy and safety of TACE plus camrelizumab and apatinib in patients with HCC (CHANCE2211): a propensity score matching study. Eur Radiol, 2023, 33(12): 8669-8681.
42.	Li S, Wu J, Wu J, et al. Prediction of early treatment response to the combination therapy of TACE plus lenvatinib and anti-PD-1 antibody immunotherapy for unresectable hepatocellular carcinoma: multicenter retrospective study. Front Immunol, 2023, 14: 1109771. doi: 10.3389/fimmu.2023.1109771.
43.	Kudo M, Imanaka K, Chida N, et al. Phase Ⅲ study of sorafenib after transarterial chemoembolisation in Japanese and Korean patients with unresectable hepatocellular carcinoma. Eur J Cancer, 2011, 47(14): 2117-2127.
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45.	Lencioni R, Llovet JM, Han G, et al. Sorafenib or placebo plus TACE with doxorubicin-eluting beads for intermediate stage HCC: the SPACE trial. J Hepatol, 2016, 64(5): 1090-1098.
46.	Kudo M, Cheng AL, Park JW, et al. Orantinib versus placebo combined with transcatheter arterial chemoembolisation in patients with unresectable hepatocellular carcinoma (ORIENTAL): a randomised, double-blind, placebo-controlled, multicentre, phase 3 study. Lancet Gastroenterol Hepatol, 2018, 3(1): 37-46.
47.	Meyer T, Fox R, Ma YT, et al. Sorafenib in combination with transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma (TACE 2): a randomised placebo-controlled, double-blind, phase 3 trial. Lancet Gastroenterol Hepatol, 2017, 2(8): 565-575.
48.	Qin S, Chan SL, Gu S, et al. Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma (CARES-310): a randomised, open-label, international phase 3 study. Lancet, 2023, 402(10408): 1133-1146.
49.	Qin S, Kudo M, Meyer T, et al. Tislelizumab vs sorafenib as first-line treatment for unresectable hepatocellular carcinoma: a phase 3 randomized clinical trial. JAMA Oncol, 2023, 9(12): 1651-1659.
50.	Abou-Alfa GK, Lau G, Kudo M, et al. Plain language summary of the HIMALAYA study: tremelimumab and durvalumab for unresectable hepatocellular carcinoma (liver cancer). Future Oncol, 2023, 19(38): 2505-2516.
51.	Galle PR, Decaens T, Kudo M, et al. Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): first results from CheckMate 9DW. J Clin Oncol, 2024, 42(17_suppl): LBA4008. doi: 10.1200/JCO.2024.42.17_suppl.LBA4008.
52.	Yau T, Kang YK, Kim TY, et al. Efficacy and safety of nivolumab plus ipilimumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib: the CheckMate 040 randomized clinical trial. JAMA Oncol, 2020, 6(11): e204564. doi: 10.1001/jamaoncol.2020.4564.
53.	Yau T, Park JW, Finn RS, et al. Nivolumab versus sorafenib in advanced hepatocellular carcinoma (CheckMate 459): a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol, 2022, 23(1): 77-90.
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1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology, 2023, 78(6): 1922-1965.
3. National Comprehensive Cancer Network. Hepatocellular carcinoma (version 4. 2024). (2024-07-02) [2024-09-30]. https://www.nccn.org/professionals/physician_gls/pdf/hcc.pdf.
4. Gordan JD, Kennedy EB, Abou-Alfa GK, et al. Systemic therapy for advanced hepatocellular carcinoma: ASCO Guideline update. J Clin Oncol, 2024, 42(15): 1830-1850.
5. 中华人民共和国国家卫生健康委员会医政司. 原发性肝癌诊疗指南 (2024年版). 中国普通外科杂志, 2024, 33(4): 475-530.
6. Zeng H, Cao M, Xia C, et al. Performance and effectiveness of hepatocellular carcinoma screening in individuals with HBsAg seropositivity in China: a multicenter prospective study. Nat Cancer, 2023, 4(9): 1382-1394.
7. Best J, Bechmann LP, Sowa JP, et al. GALAD score detects early hepatocellular carcinoma in an international cohort of patients with nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol, 2020, 18(3): 728-735. e4.
8. Zhou J, Yu L, Gao X, et al. Plasma microRNA panel to diagnose hepatitis B virus-related hepatocellular carcinoma. J Clin Oncol, 2011, 29(36): 4781-4788.
9. Zhou J, Huang A, Yang XR. Liquid biopsy and its potential for management of hepatocellular carcinoma. J Gastrointest Cancer, 2016, 47(2): 157-167.
10. Piratvisuth T, Hou J, Tanwandee T, et al. Development and clinical validation of a novel algorithmic score (GAAD) for detecting HCC in prospective cohort studies. Hepatol Commun, 2023, 7(11): e0317. doi: 10.1097/HC9.0000000000000317.
11. Yang T, Xing H, Wang G, et al. A novel online calculator based on serum biomarkers to detect hepatocellular carcinoma among patients with hepatitis B. Clin Chem, 2019, 65(12): 1543-1553.
12. Lee YJ, Lee JM, Lee JS, et al. Hepatocellular carcinoma: diagnostic performance of multidetector CT and MR imaging-a systematic review and meta-analysis. Radiology, 2015, 275(1): 97-109.
13. Liu X, Jiang H, Chen J, et al. Gadoxetic acid disodium-enhanced magnetic resonance imaging outperformed multidetector computed tomography in diagnosing small hepatocellular carcinoma: a meta-analysis. Liver Transpl, 2017, 23(12): 1505-1518.
14. Lin CY, Chen JH, Liang JA, et al. ¹⁸F-FDG PET or PET/CT for detecting extrahepatic metastases or recurrent hepatocellular carcinoma: a systematic review and meta-analysis. Eur J Radiol, 2012, 81(9): 2417-2422.
15. Boellaard R, O’Doherty MJ, Weber WA, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1. 0. Eur J Nucl Med Mol Imaging, 2010, 37(1): 181-200.
16. Chalian H, Töre HG, Horowitz JM, et al. Radiologic assessment of response to therapy: comparison of RECIST versions 1.1 and 1.0. Radiographics, 2011, 31(7): 2093-2105.
17. Siripongsatian D, Promteangtrong C, Kunawudhi A, et al. Comparisons of quantitative parameters of Ga-68-labelled fibroblast activating protein inhibitor (FAPI) PET/CT and [¹⁸F]F-FDG PET/CT in patients with liver malignancies. Mol Imaging Biol, 2022, 24(5): 818-829.
18. Lan L, Zhang S, Xu T, et al. Prospective comparison of ⁶⁸Ga-FAPI versus ¹⁸F-FDG PET/CT for tumor staging in biliary tract cancers. Radiology, 2022, 304(3): 648-657.
19. Glantzounis GK, Tokidis E, Basourakos SP, et al. The role of portal vein embolization in the surgical management of primary hepatobiliary cancers. A systematic review. Eur J Surg Oncol, 2017, 43(1): 32-41.
20. Li PP, Huang G, Jia NY, et al. Associating liver partition and portal vein ligation for staged hepatectomy versus sequential transarterial chemoembolization and portal vein embolization in staged hepatectomy for HBV-related hepatocellular carcinoma: a randomized comparative study. Hepatobiliary Surg Nutr, 2022, 11(1): 38-51.
21. Zhang Y, Huang G, Wang Y, et al. Is salvage liver resection necessary for initially unresectable hepatocellular carcinoma patients downstaged by transarterial chemoembolization? Ten years of experience. Oncologist, 2016, 21(12): 1442-1449.
22. Lyu N, Kong Y, Mu L, et al. Hepatic arterial infusion of oxaliplatin plus fluorouracil/leucovorin vs. sorafenib for advanced hepatocellular carcinoma. J Hepatol, 2018, 69(1): 60-69.
23. 肝癌新辅助治疗中国专家共识协作组, 中国研究型医院学会消化外科专业委员会, 中国抗癌协会肝癌专业委员会. 肝癌新辅助治疗中国专家共识 (2023版). 中华外科杂志, 2023, 61(12): 1035-1045.
24. Wu F, Chen B, Dong D, et al. Phase 2 evaluation of neoadjuvant intensity-modulated radiotherapy in centrally located hepatocellular carcinoma: a nonrandomized controlled trial. JAMA Surg, 2022, 157(12): 1089-1096.
25. Wang Z, Ren Z, Chen Y, et al. Adjuvant transarterial chemoembolization for HBV-related hepatocellular carcinoma after resection: a randomized controlled study. Clin Cancer Res, 2018, 24(9): 2074-2081.
26. Li SH, Mei J, Cheng Y, et al. Postoperative adjuvant hepatic arterial infusion chemotherapy with FOLFOX in hepatocellular carcinoma with microvascular invasion: a multicenter, phase Ⅲ, randomized study. J Clin Oncol, 2023, 41(10): 1898-1908.
27. Lee JH, Lee JH, Lim YS, et al. Adjuvant immunotherapy with autologous cytokine-induced killer cells for hepatocellular carcinoma. Gastroenterology, 2015, 148(7): 1383-1391. e6.
28. He C, Peng W, Li C, et al. Thymalfasin, a promising adjuvant therapy in small hepatocellular carcinoma after liver resection. Medicine (Baltimore), 2017, 96(16): e6606. doi: 10.1097/MD.0000000000006606.
29. Qin S, Chen M, Cheng AL, et al. Atezolizumab plus bevacizumab versus active surveillance in patients with resected or ablated high-risk hepatocellular carcinoma (IMbrave050): a randomised, open-label, multicentre, phase 3 trial. Lancet, 2023, 402(10415): 1835-1847.
30. Killock D. From the ESMO Congress 2024. Nat Rev Clin Oncol, 2024, 21(12): 837. doi: 10.1038/s41571-024-00954-3.
31. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11): 693-699.
32. Kwong AJ, Kim WR, Lake JR, et al. OPTN/SRTR 2019 annual data report: liver. Am J Transplant, 2021, 21 Suppl 2: 208-315.
33. Tabrizian P, Florman SS, Schwartz ME. PD-1 inhibitor as bridge therapy to liver transplantation? Am J Transplant, 2021, 21(5): 1979-1980.
34. Zhang YJ, Chen MS, Chen Y, et al. Long-term outcomes of transcatheter arterial chemoembolization combined with radiofrequency ablation as an initial treatment for early-stage hepatocellular carcinoma. JAMA Netw Open, 2021, 4(9): e2126992. doi: 10.1001/jamanetworkopen.2021.26992.
35. Peng ZW, Zhang YJ, Chen MS, et al. Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial. J Clin Oncol, 2013, 31(4): 426-432.
36. Chen J, He K, Han Y, et al. Clinical efficacy and safety of external radiotherapy combined with sorafenib in the treatment of hepatocellular carcinoma: a systematic review and meta-analysis. Ann Hepatol, 2022, 27(4): 100710. doi: 10.1016/j.aohep.2022.100710.
37. Li H, Wu Z, Chen J, et al. External radiotherapy combined with sorafenib has better efficacy in unresectable hepatocellular carcinoma: a systematic review and meta-analysis. Clin Exp Med, 2023, 23(5): 1537-1549.
38. 朱广志, 严律南, 彭涛. 中国《原发性肝癌诊疗指南 (2022年版)》与《BCLC预后预测和治疗推荐策略 (2022年版)》的解读. 中国普外基础与临床杂志, 2022, 29(4): 434-439.
39. Salem R, Gordon AC, Mouli S, et al. Y-90 radioembolization significantly prolongs time to progression compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology, 2016, 151(6): 1155-1163. e2.
40. Zhu HD, Li HL, Huang MS, et al. Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma (CHANCE001). Signal Transduct Target Ther, 2023, 8(1): 58. doi: 10.1038/s41392-022-01235-0.
41. Jin ZC, Zhong BY, Chen JJ, et al. Real-world efficacy and safety of TACE plus camrelizumab and apatinib in patients with HCC (CHANCE2211): a propensity score matching study. Eur Radiol, 2023, 33(12): 8669-8681.
42. Li S, Wu J, Wu J, et al. Prediction of early treatment response to the combination therapy of TACE plus lenvatinib and anti-PD-1 antibody immunotherapy for unresectable hepatocellular carcinoma: multicenter retrospective study. Front Immunol, 2023, 14: 1109771. doi: 10.3389/fimmu.2023.1109771.
43. Kudo M, Imanaka K, Chida N, et al. Phase Ⅲ study of sorafenib after transarterial chemoembolisation in Japanese and Korean patients with unresectable hepatocellular carcinoma. Eur J Cancer, 2011, 47(14): 2117-2127.
44. Kudo M, Han G, Finn RS, et al. Brivanib as adjuvant therapy to transarterial chemoembolization in patients with hepatocellular carcinoma: a randomized phase Ⅲ trial. Hepatology, 2014, 60(5): 1697-1707.
45. Lencioni R, Llovet JM, Han G, et al. Sorafenib or placebo plus TACE with doxorubicin-eluting beads for intermediate stage HCC: the SPACE trial. J Hepatol, 2016, 64(5): 1090-1098.
46. Kudo M, Cheng AL, Park JW, et al. Orantinib versus placebo combined with transcatheter arterial chemoembolisation in patients with unresectable hepatocellular carcinoma (ORIENTAL): a randomised, double-blind, placebo-controlled, multicentre, phase 3 study. Lancet Gastroenterol Hepatol, 2018, 3(1): 37-46.
47. Meyer T, Fox R, Ma YT, et al. Sorafenib in combination with transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma (TACE 2): a randomised placebo-controlled, double-blind, phase 3 trial. Lancet Gastroenterol Hepatol, 2017, 2(8): 565-575.
48. Qin S, Chan SL, Gu S, et al. Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma (CARES-310): a randomised, open-label, international phase 3 study. Lancet, 2023, 402(10408): 1133-1146.
49. Qin S, Kudo M, Meyer T, et al. Tislelizumab vs sorafenib as first-line treatment for unresectable hepatocellular carcinoma: a phase 3 randomized clinical trial. JAMA Oncol, 2023, 9(12): 1651-1659.
50. Abou-Alfa GK, Lau G, Kudo M, et al. Plain language summary of the HIMALAYA study: tremelimumab and durvalumab for unresectable hepatocellular carcinoma (liver cancer). Future Oncol, 2023, 19(38): 2505-2516.
51. Galle PR, Decaens T, Kudo M, et al. Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): first results from CheckMate 9DW. J Clin Oncol, 2024, 42(17_suppl): LBA4008. doi: 10.1200/JCO.2024.42.17_suppl.LBA4008.
52. Yau T, Kang YK, Kim TY, et al. Efficacy and safety of nivolumab plus ipilimumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib: the CheckMate 040 randomized clinical trial. JAMA Oncol, 2020, 6(11): e204564. doi: 10.1001/jamaoncol.2020.4564.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Interpretation and comparison of AASLD (2023), NCCN (2024), ASCO (2024) guidelines and Chinese guideline for diagnosis and treatment of primary liver cancer (version-2024)

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