ArticleLiver cancer2020
A Changing Paradigm for the Treatment of Intermediate-Stage Hepatocellular Carcinoma: Asia-Pacific Primary Liver Cancer Expert Consensus Statements.
Article in Liver cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 200 papers, 10 of them syntheses that pooled it.
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Who cites it
200 citing papers in PubMed, 10 syntheses or guidelines pooled it, 298 citations in OpenAlex.
- Transcatheter arterial chemoembolization combined with stereotactic body radiation therapy versus transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Taiwan liver cancer association management consensus guidelines for intermediate-stage hepatocellular carcinoma.Clinical and molecular hepatology · 2025Guideline
- Pooled it
- The role of TACE in the era of immune-targeted therapy for hepatocellular carcinoma: a meta-analysis based on PSM.Frontiers in immunology · 2025Pooled it
- SEOM-GEMCAD-TTD clinical guidelines for the management of hepatocarcinoma patients (2023).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024Guideline
- Diagnostic performance of MRI for residual or recurrent hepatocellular carcinoma after locoregional treatment according to contrast agent type: a systematic review and meta‑analysis.Abdominal radiology (New York) · 2024Pooled it
- Efficacy and safety of TACE combined with traditional Chinese medicine versus TACE alone in hepatocellular carcinoma: bayesian network meta-analysis and pharmacological mechanisms study.Frontiers in pharmacology · 2024Pooled it
- Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Japanese perspective.Clinical and molecular hepatology · 2023Guideline
- What Is the Most Suitable Agent Combined With Apatinib for Transarterial Chemoembolization Treatment in Advanced Hepatocellular Carcinoma Patients? A Systematic Review and Network Meta-analysis.Frontiers in oncology · 2022Pooled it
- Optimizing Survival and the Changing Landscape of Targeted Therapy for Intermediate and Advanced Hepatocellular Carcinoma: A Systematic Review.Journal of the National Cancer Institute · 2021Pooled it
- Transarterial chemoembolization plus atezolizumab and bevacizumab in patients with intermediate hepatocellular carcinoma: a single-arm, phase 2 trial.Signal transduction and targeted therapy · 2025Trial
- Survival in patients with unresectable hepatocellular carcinoma: TCC cocktail plus TACE vs TACE alone prospective randomized clinical trial.Journal of translational medicine · 2025Trial
- Trial
- Spatial multi omic profiling maps hypoxia-driven pro-fibrotic SPP1Experimental hematology & oncology · 2026Article
- Optimal treatment selection for hepatocellular carcinoma in the era of immunotherapy.Journal of gastroenterology · 2026Review
- Proton beam therapy versus trans-arterial chemoembolization for BCLC stage B hepatocellular carcinoma-a propensity-matched analysis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Immunotherapy-Based Conversion to Curative-Intent Treatment in Hepatocellular Carcinoma: A Multidisciplinary Framework.Cancers · 2026Review
- Clinical and LI-RADS features on gadoxetic acid‑enhanced MRI for predicting complete response after transarterial chemoembolization in hepatocellular carcinoma > 2 cm.Abdominal radiology (New York) · 2026Article
- Personalised decision-making in hepatocellular carcinoma: conceptual evolution over two decades.BJS open · 2026Review
- TACE plus donafenib and immune checkpoint inhibitors for intermediate HCC (CHANCE2410 study): a propensity score matching analysis.European radiology experimental · 2026Article
140 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 11 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Asia-Pacific Primary Liver Cancer Expert (APPLE) Consensus Statement on the treatment strategy for patients with intermediate-stage hepatocellular carcinoma (HCC) was established on August 31, 2019, in Sapporo, Hokkaido during the 10th Annual APPLE Meeting. This manuscript summarizes the international consensus statements developed at APPLE 2019. Transarterial chemoembolization (TACE) is the only guideline-recommended global standard of care for intermediate-stage HCC. However, not all patients benefit from TACE because intermediate-stage HCC is a heterogeneous disease in terms of tumor burden and liver function. Ten important clinical questions regarding this stage of HCC were raised, and consensus statements were generated based on high-quality evidence. In intermediate-stage HCC, preservation of liver function is as important as achieving a high objective response (OR) because the treatment goal is to prolong overall survival. Superselective conventional TACE (cTACE) is recommended as the first choice of treatment in patients eligible for effective (curative) TACE, whereas in patients who are not eligible, systemic therapy is recommended as the first choice of treatment. TACE is not indicated as the first-line therapy in TACE-unsuitable patients. Another important statement is that TACE should not be continued in patients who develop TACE failure/refractoriness in order to preserve liver function. Targeted therapy is the recommended first-line treatment for TACE-unsuitable patients. Especially, the drug, which can have higher OR rate, is preferred. Immunotherapy, transarterial radioembolization, TACE + targeted therapy or other modalities may be considered alternative options in TACE-unsuitable patients who are not candidates for targeted therapy. Better liver function, such as albumin-bilirubin grade 1, is an important factor for maximizing the therapeutic effect of systemic therapy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.