Standardizing management of hepatocellular carcinoma in China: Devising evidence-based clinical practice guidelines

Evidence-based clinical practice guidelines (CPGs) have been used in many countries around the world to promote standardized management of hepatocellular carcinoma (HCC). Guidelines implemented in Japan provide a good example of "translating the best current research evidence into clinical practice and obtaining new evidence in the course of influencing practitioners' attitudes and clinical decision-making". The Japanese guidelines have achieved remarkable results in terms of HCC management in Japan. The first Japanese evidence-based CPGs for HCC (J-HCC Guidelines) were published in 2005 and then revised in 2009. A second updated version that incorporates new evidence was just published on October 15, 2013. China accounts for 55% of HCC cases worldwide. Although the Government devised a series of directives on the management of HCC and Chinese Guidelines on HCC were published in 2009, neither were based on systematic review and evaluation of the literature and neither included recommendations supported by data. The novel concept of "precision surgery" was recently proposed in China. This concept is based on surgeons' clinical experience and should encourage the standardized management of HCC in China. However, recommendations supported by data are still urgently needed to guide clinical decision-making in order to facilitate standardized management of HCC in China.