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Hepatocellular carcinoma surveillance: Eastern and Western perspectives
Yvonne Purcell1 , Pauline Copin1,2, Luisa Paulatto1,2, Romain Pommier1,2 , Valérie Vilgrain1,2,3 , Maxime Ronot1,2,3
1Department of Radiology, University Hospitals Paris Nord Val de Seine, Clichy, France
2University Paris Diderot, Sorbonne Paris Cité, Paris, France
3INSERM U1149, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3, Paris, France
Corresponding Author: Maxime Ronot ,Tel: +33-1-40-87-55-66, Fax: +33-1-40-87-44-28, Email: maxime.ronot@aphp.fr
Received: August 2, 2018;  Accepted: October 28, 2018.  Published online: October 28, 2018.
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ABSTRACT
Eastern and Western guidelines for the management of hepatocellular carcinoma (HCC) are known to significantly differ on many points, because they reflect different diagnostic and therapeutic approaches to this cancer. Importantly, these guidelines are primarily consensus-driven when it comes to surveillance, both in term of the tests used and surveillance program design. The main difference between East and West lies in clinical practice, as several Eastern countries implement coordinated and systematic surveillance programs, while most Western countries rely on individual adherence to surveillance recommendations. This review article presents an overview of the evidence supporting surveillance programs for HCC, with a particular focus on the efficacy, cost-effectiveness, and consequences of this approach for patient survival. Western and Eastern guideline recommendations are discussed.
Keywords: Ultrasound; Surveillance; Cirrhosis; Imaging
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