Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC)

Joong Won Park, Deepak Amarapurkar, Yee Chao, Pei Jer Chen, Jean Francois H. Geschwind, Khean Lee Goh, Kwang Hyub Han, Masatoshi Kudo, Han Chu Lee, Rheun Chuan Lee, Laurentius A. Lesmana, Ho Yeong Lim, Seung Woon Paik, Ronnie T. Poon, Chee Kiat Tan, Tawesak Tanwandee, Gaojun Teng, Ann Lii Cheng

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Hepatocellular carcinoma (HCC) presents with a high burden of disease in East Asian countries. Intermediate-stage HCC as defined by the Barcelona Clinic Liver Cancer (BCLC) staging system poses a clinical challenge as it includes a heterogeneous population of patients that can vary widely in terms of tumour burden, liver function and disease aetiology. Intermediate HCC patients often have unsatisfactory clinical outcomes with repeated transarterial chemoembolization (TACE, due to non-response of the target tumour or the development of further metastasis indicating progressive disease. In September 2011, an Expert Panel Opinion on Interventions in Hepatocellular Carcinoma (EPOIHCC) was convened in HK in an attempt to provide a consensus on the practice of TACE. To that end, current clinical practice throughout Asia was reviewed in detail including safety and efficacy data on TACE alone as well as in combination with targeted systemic therapies. This review summarises the evidence discussed at the meeting and provides expert recommendation regarding the available therapeutic options for unresectable intermediate stage HCC. A key consensus of the Expert Panel was that in order to improve patient outcomes and long-term survival, the possibility of using TACE in combination with targeted agents given systemically should be explored. While the currently available clinical data is promising, the expected completion of several pivotal phase II and III RCTs will provide further evidence in support of the rationale for combination therapy regimens.

Original languageEnglish (US)
Pages (from-to)327-337
Number of pages11
JournalLiver International
Issue number3
StatePublished - Mar 2013
Externally publishedYes


  • Combination therapy
  • Hepatocellular carcinoma
  • Sorafenib
  • TACE

ASJC Scopus subject areas

  • Hepatology


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