Non-Surgical Management of Advanced Hepatocellular Carcinoma

This is a clinical practice guideline for adult patients with hepatocellular carcinoma (HCC). Specifically, the guideline provides recommendations for the non-surgical management of patients with locally advanced or advanced HCC, Barcelona Clinic Liver Cancer (BCLC) Stage B and higher, who are not suitable for transplant or surgery. The guideline compares transarterial chemoembolization (TACE) to other local therapies, including transarterial ethanol ablation (TEA), bland transarterial embolization (TAE), radiofrequency ablation (RFA), transarterial radioembolization (TARE), stereotactic body radiation therapy (SBRT) and drug eluting bead transarterial chemoembolization (DEB-TACE). The addition of systemic treatment regimens, such as sorafenib, is also discussed.