Nina Niu Sanford, Assistant Professor and Chief of Gastrointestinal Radiation Oncology at Harvard/Brigham and Women’s Hospital/Massachusetts General Hospital, shared a post on X:
“HCC 101!
For the longest time, HCC was a bit of a blackbox to me.
So for today’s ROVER presentation, I started off with a 5-slide summary of HCC basics: a 20,000 foot overview.”
“First, diagnosis. Based on LIRADS.
We use dynamic contrast enhanced MR, but both CT & MR acceptable. A good quality CT is better than a bad MR.”
“BCLC is the most widely used staging system. But it is better for prognostication than treatment algorithms IMO.
Also does need some updating: TARE>TACE, and where is SBRT?”
“First up, early stage. Considerations for resection vs. transplant vs. other local therapies.
Obviously, this is a broad overview here.”
“Next, all other stages.
Important to note that intermediate stage is very heterogeneous. Role of combination therapies TBD.
Also, for systemic – soon to be more approved first line options.”
“Liver transplant 101:
- what is MELD?
- What are exception points?
- When is bridging or downstaging used?”
“These few slides are a basic summary. Many more nuances.
They are based upon the 2023 AASLD guidelines – recommend reading.”
AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma.
Authors: Singal, et al.
“Also did not even get into the local therapy debate here.
Re: SBRT, this piece by Amir Safavi & Laura Dawson is great.”
Do We Have a Winner? Advocating for SBRT in HCC Management.
Authors: Amir H. Safavi, et al.
“By request, here is slide for LI-RADS imaging features: non-rim APHE & non-peripheral washout (2 strongest features for HCC).
Remember LI-RADS validated only if high risk for HCC (cirrhosis, high/intermediate risk HBV, prior HCC) -can’t use w vascular cirrhosis, low risk HBV.”
Nina Niu Sanford is an Assistant Professor and Chief of Gastrointestinal Radiation Oncology at Harvard/Brigham and Women’s Hospital/Massachusetts General Hospital. She specializes in treating gastrointestinal cancers and actively participates in clinical trials combining high-dose radiation therapy with immunotherapy. Additionally, she researches healthcare access disparities and conducts pan-cancer outcomes research using large databases.