A Post-International Gastrointestinal Cancers’ Conference (IGICC) Position Statements

Abstract

Suayib Yalcin,1 Sahin Lacin,2 Ahmed Omar Kaseb,3 Bora Peynircioğlu,4 Murat Cantasdemir,5 Barbaros Erhan Çil,6 Pervin Hurmuz,7 Ahmet Bülent Doğrul,8 Murat Fani Bozkurt,9 Hüseyin Abali,10 Okan Akhan,4 Halis Şimşek,11 Berksoy Sahin,12 Faruk N Aykan,13 İdris Yücel,14 Gürkan Tellioğlu,15 Fatih Selçukbiricik,2 Philip A Philip16 1Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey; 2Department of Medical Oncology, Koç University Faculty of Medicine, İstanbul, Turkey; 3Department of Gastrointestinal Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA; 4Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey; 5Department of Radiology, Memorial Şişli Hospital, İstanbul, Turkey; 6Department of Radiology, Koç University Faculty of Medicine, İstanbul, Turkey; 7Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey; 8Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey; 9Department of Nuclear Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey; 10Department of Medical Oncology, Bahrain Oncology Center, Muharraq, Bahrain; 11Department of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey; 12Department of Medical Oncology, Cukurova University Faculty of Medicine, Adana, Türkiye; 13Department of Medical Oncology, Istinye University Faculty of Medicine Bahçeşehir Liv Hospital, İstanbul, Turkey; 14Medicana International Hospital Samsun, Department of Medical Oncology, Samsun, Turkey; 15Department of General Surgery, Koç University Faculty of Medicine, İstanbul, Turkey; 16Department of Medicine, Division of Hematology-Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USACorrespondence: Sahin Lacin, Email [email protected]: Hepatocellular carcinoma (HCC), the most prevalent liver tumor, is usually linked with chronic liver diseases, particularly cirrhosis. As per the 2020 statistics, this cancer ranks 6th in the list of most common cancers worldwide and is the third primary source of cancer-related deaths. Asia holds the record for the highest occurrence of HCC. HCC is found three times more frequently in men than in women. The primary risk factors for HCC include chronic viral infections, excessive alcohol intake, steatotic liver disease conditions, as well as genetic and family predispositions. Roughly 40– 50% of patients are identified in the late stages of the disease. Recently, there have been significant advancements in the treatment methods for advanced HCC. The selection of treatment for HCC hinges on the stage of the disease and the patient’s medical status. Factors such as pre-existing liver conditions, etiology, portal hypertension, and portal vein thrombosis need critical evaluation, monitoring, and appropriate treatment. Depending on the patient and the characteristics of the disease, liver resection, ablation, or transplantation may be deemed potentially curative. For inoperable lesions, arterially directed therapy might be an option, or systemic treatment might be deemed more suitable. In specific cases, the recommendation might extend to external beam radiation therapy. For all individuals, a comprehensive, multidisciplinary approach should be adopted when considering HCC treatment options. The main treatment strategies for advanced HCC patients are typically combination treatments such as immunotherapy and anti-VEGFR inhibitor, or a combination of immunotherapy and immunotherapy where appropriate, as a first-line treatment. Furthermore, some TKIs and immune checkpoint inhibitors may be used as single agents in cases where patients are not fit for the combination therapies. As second-line treatments, some treatment agents have been reported and can be considered.Keywords: hepatocellular carcinoma, screening, imaging, diagnosis, treatment, immunotherapy, tyrosine kinase inhibitors

Keywords

• hepatocellular carcinoma
• screening
• imaging
• diagnosis
• treatment
• immunotherapy
• tyrosine kinase inhibitors