Browsing by Author "Kao J.H."

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    APASL clinical practice guidelines on systemic therapy for hepatocellular carcinoma-2024
    (2024-01-01) Lau G.; Obi S.; Zhou J.; Tateishi R.; Qin S.; Zhao H.; Otsuka M.; Ogasawara S.; George J.; Chow P.K.H.; Cai J.; Shiina S.; Kato N.; Yokosuka O.; Oura K.; Yau T.; Chan S.L.; Kuang M.; Ueno Y.; Chen M.; Cheng A.L.; Cheng G.; Chuang W.L.; Baatarkhuu O.; Bi F.; Dan Y.Y.; Gani R.A.; Tanaka A.; Jafri W.; Jia J.D.; Kao J.H.; Hasegawa K.; Lau P.; Lee J.M.; Liang J.; Liu Z.; Lu Y.; Pan H.; Payawal D.A.; Rahman S.; Seong J.; Shen F.; Shiha G.; Song T.; Sun H.C.; Masaki T.; Sirachainan E.; Wei L.; Yang J.M.; Sallano J.D.; Zhang Y.; Tanwandee T.; Dokmeci A.; Zheng S.S.; fan J.; Fan S.T.; Sarin S.K.; Omata M.; Lau G.; Mahidol University
    In Asia–Pacific region, hepatocellular carcinoma is a serious health threat attributing to over 600,000 deaths each year and account for over 70% of global cases. Clinically, the major unmet needs are recurrence after curative-intent surgery, liver transplantation or local ablation and disease progression in those with hepatocellular carcinoma not eligible for resection or failed locoregional therapy. In the recent few years, new targeted therapy and immune-checkpoint inhibitors have been registered as systemic therapy to address these issues. Notably, new forms of systemic therapy, either as first-line or second-line therapy for unresectable hepatocellular or those not eligible for locoregional therapy, are now available. New data is also emerging with the use of systemic therapy to prevent hepatocellular carcinoma recurrence after curative-intent resection or local ablation therapy and to retard disease progression after locoregional therapy. In the future, further implementation of immune-checkpoint inhibitors and other forms of immunotherapy are expected to bring a new paradigm to the management of hepatocellular carcinoma. New insight related to immune-related adverse events with the use of immunotherapy has allso enabled optimization of the therapeutic approach to patients with hepatocellular carcinoma. The purpose of this clinical practice guideline is to provide an up-to-date recommendation based on clinical evidence and experience from expert Asia–Pacific key opinion leaders in the field of hepatocellular carcinoma. Three key questions will be addressed, namely: (1) Which patients with hepatocellular carcinoma should be considered for systemic therapy? (2) Which systemic therapy should be used? (3) How should a patient planned for immune checkpoint-based systemic therapy be managed and monitored?
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    Temporal trends and regional variations in hepatocellular carcinoma etiology: a multinational study across Asia
    (2026-01-01) Takeuchi Y.; Tateishi R.; Obi S.; Otsuka M.; Mochizuki H.; Jazag A.; Yokosuka O.; Ogasawara S.; Kanogawa N.; Gonchig E.; Matsushita Y.; Kekilli M.; Bilican G.; Kim Y.J.; Hur M.H.; Yu M.L.; Huang C.F.; Morishita A.; Oura K.; Komori A.; Motoyoshi Y.; Siregar L.; Loho I.; Yang M.; Okabe S.; Ueno Y.; Katsumi T.; Sato T.; Kogure H.; Masuzaki R.; Lesmana C.R.; Nababan S.H.H.; Nimanong S.; Huang Y.H.; Nagamatsu H.; Yoshida H.; Uchino K.; Hasan I.; Kitiyakara T.; Akamatsu M.; Okamoto M.; Kondo M.; Moriyama M.; Sukeepaisarnjareon W.; Tangkijvanich P.; Thanapirom K.; Yalcin K.; Kızıl H.D.; Adali G.; Akdogan M.; Gokce D.T.; Balaban Y.; Gokcan H.; Coşar A.M.; Harputluoglu M.; Bahçecioğlu İ.H.; Atasoy A.; Kockar M.C.; Dursun H.; Eminler A.T.; Sollano J.; Su D.J.; Piratvisuth T.; Kao J.H.; Crawford D.; Hou J.; Sharma B.C.; Payawal D.A.; Gani R.A.; Tanwandee T.; Yang J.M.; Lin H.C.; Shiina S.; Jia J.D.; Lau G.; Örmeci N.; Dokmeci A.K.; Wei L.; Sarin S.K.; Omata M.; Takeuchi Y.; Mahidol University
    Background: Hepatocellular carcinoma (HCC) remains a major health burden in Asia. Advances in antiviral therapies are reshaping the etiological landscape of HCC. This study evaluated temporal shifts in HCC etiology across Asian countries and their clinical implications. Methods: This multinational study analyzed 6,261 newly diagnosed HCC patients registered in the APASL Hepatology/Oncology Consortium (A-HOC) from 19 centers across seven Asian countries and regions between 2013 and 2023. Data on demographics, tumor characteristics, etiology, and treatment patterns were collected. Etiologies included hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease (ALD), metabolic dysfunction-associated fatty liver disease (MAFLD), MAFLD plus excess alcoholic intake (MAFLD + eAL), autoimmune liver disease, cryptogenic, and others. Temporal trends and regional variations were assessed. Results: In many countries, HBV remained predominant (43.3%–69.5%) and relatively stable throughout the period, while HCV showed only modest reductions. In Japan, HCV was the leading cause of HCC (33.1%), with a significant decline over time, accompanied by a rise in MAFLD-related HCC. ALD-related HCC increased in South Korea, and MAFLD-related HCC rose in Turkey. Tumor size and stage at diagnosis varied by etiology and region, affecting treatment strategies. Early-stage diagnosis was more frequent in Japan and Taiwan, whereas advanced-stage HCC was common in China and Indonesia. Conclusions: Distinct regional patterns and temporal changes in HCC etiology across Asia highlight the need for tailored prevention and surveillance measures. The growing burden of MAFLD-related HCC emphasizes its emerging role in liver cancer development, particularly in regions with declining viral hepatitis.
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    The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease
    (2025-04-01) Eslam M.; Fan J.G.; Yu M.L.; Wong V.W.S.; Cua I.H.; Liu C.J.; Tanwandee T.; Gani R.; Seto W.K.; Alam S.; Young D.Y.; Hamid S.; Zheng M.H.; Kawaguchi T.; Chan W.K.; Payawal D.; Tan S.S.; Goh G.B.b.; Strasser S.I.; Viet H.D.; Kao J.H.; Kim W.; Kim S.U.; Keating S.E.; Yilmaz Y.; Kamani L.; Wang C.C.; Fouad Y.; Abbas Z.; Treeprasertsuk S.; Thanapirom K.; Al Mahtab M.; Lkhagvaa U.; Baatarkhuu O.; Choudhury A.K.; Stedman C.A.M.; Chowdhury A.; Dokmeci A.K.; Wang F.S.; Lin H.C.; Huang J.F.; Howell J.; Jia J.; Alboraie M.; Roberts S.K.; Yoneda M.; Ghazinian H.; Mirijanyan A.; Nan Y.; Lesmana C.R.A.; Adams L.A.; Shiha G.; Kumar M.; Örmeci N.; Wei L.; Lau G.; Omata M.; Sarin S.K.; George J.; Eslam M.; Mahidol University
    Metabolic dysfunction-associated fatty liver disease (MAFLD) affects over one-fourth of the global adult population and is the leading cause of liver disease worldwide. To address this, the Asian Pacific Association for the Study of the Liver (APASL) has created clinical practice guidelines focused on MAFLD. The guidelines cover various aspects of the disease, such as its epidemiology, diagnosis, screening, assessment, and treatment. The guidelines aim to advance clinical practice, knowledge, and research on MAFLD, particularly in special groups. The guidelines are designed to advance clinical practice, to provide evidence-based recommendations to assist healthcare stakeholders in decision-making and to improve patient care and disease awareness. The guidelines take into account the burden of clinical management for the healthcare sector.