Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
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Clinical Practice Guidelines for Hepatocellular Carcinoma: Current and Future Perspectives

간암 진료가이드라인의 현재와 전망

  • Bo Hyun Kim (Center for Liver Cancer, National Cancer Center) ;
  • Joong-Won Park (Center for Liver Cancer, National Cancer Center)
  • Received : 2016.06.04
  • Accepted : 2016.06.13
  • Published : 2016.06.30
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Abstract

Hepatocellular carcinoma (HCC) is rather unique. Most of HCC patients have underlying chronic liver diseases with or without cirrhosis and the prognosis of HCC depends on the liver function, as well as the tumor extent. Non-invasive diagnosis of HCC can be made with certain risk factors and specific imaging findings (e.g. hypervascularity). Patients with HCC can receive surgical resection, radiotherapy, and systemic chemotherapy as other solid malignancies. HCC has more treatment options such as liver transplantation, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). A variety of practice guidelines for HCC has been published by many academic societies. Different healthcare systems and availability of resources also affect the practice guidelines; therefore, practice guidelines have similarities and dissimilarities. Herein, we review the current status of practice guidelines for HCC and future perspectives for the improvement of guidelines are also discussed.

간세포암종은 만성 간질환과 간경변증을 동반하는 경우가 많고, 예후에 종양 인자 이외에도 잔존 간 기능이 주요한 영향을 미친다. 또한, 간세포암종에 대한 고위험인자를 가진 경우 특정한 영상 소견(예: 고혈관성)을 보이면, 조직검사 없이도 비침습적인 진단이 가능하다. 다른 고형암에서와 마찬가지로 수술적 절제, 방사선치료, 항암치료 등의 치료가 시행되기도 하지만, 간세포암종에서만 이루어진다고도 할 수 있는 간이식, 경동맥화학색전술, 고주파열치료술과 같은 치료 방법들이 시행되기도 한다. 종양의 다양성, 치료 방법의 다양성, 사회적 여건(의료 보건 체계, 의료 자원의 가용성 등) 등을 반영하며 여러 간세포암종 가이드라인들이 발표되어 왔으며, 각 가이드라인들은 여러 측면에서 유사하면서도 서로 상이하기도 하다. 본고에서는 다음의 간세포암종 진료 가이드라인들을 살펴보고, 가이드라인들의 특징과 앞으로 가이드라인에서 다루어야 할 부분 등에 대하여 논하고자 한다.

Keywords

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