Supplementary Material for: Management of Hepatocellular Carcinoma in Japan: JSH Consensus Statements and Recommendations 2021 Update

The Clinical Practice Manual for Hepatocellular Carcinoma was published based on evidence confirmed by the Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma along with consensus opinion among a Japan Society of Hepatology (JSH) expert panel on hepatocellular carcinoma (HCC). Since the JSH Clinical Practice Guidelines are based on original articles with extremely high levels of evidence, expert opinions on HCC management in clinical practice or consensus on newly developed treatments are not included. However, the practice manual incorporates the literature based on clinical data, expert opinion, and real-world clinical practice currently conducted in Japan to facilitate its use by clinicians. Alongside each revision of the JSH Guidelines, we issued an update to the manual, with the first edition of the manual published in 2007, the second edition in 2010, the third edition in 2015, and the fourth edition in 2020, which includes the 2017 edition of the JSH Guideline. This article is an excerpt from the fourth edition of the HCC Clinical Practice Manual focusing on pathology, diagnosis, and treatment of HCC. It is designed as a practical manual different from the latest version of the JSH Clinical Practice Guidelines. This practice manual was written by an expert panel from the JSH, with emphasis on the consensus statements and recommendations for the management of HCC proposed by the JSH expert panel. In this article, we included newly developed clinical practices that are relatively common among Japanese experts in this field, although all of their statements are not associated with a high level of evidence, but these practices are likely to be incorporated into guidelines in the future. To write this article, coauthors from different institutions drafted the content and then critically reviewed each other’s work. The revised content was then critically reviewed by the Board of Directors and the Planning and Public Relations Committee of JSH before publication to confirm the consensus statements and recommendations. The consensus statements and recommendations presented in this report represent measures actually being conducted at the highest-level HCC treatment centers in Japan. We hope this article provides insight into the actual situation of HCC practice in Japan, thereby affecting the global practice pattern in the management of HCC.

本《肝细胞癌（hepatocellular carcinoma, HCC）临床实践手册》的编撰依据为《肝细胞癌循证临床实践指南》所确认的证据，以及日本肝病学会（Japan Society of Hepatology, JSH）肝细胞癌（hepatocellular carcinoma, HCC）专家小组达成的共识意见。鉴于JSH临床实践指南基于证据等级极高的原创研究论文，故未纳入临床实践中HCC诊疗的专家意见，或是针对新型治疗手段的共识内容。但本实践手册纳入了基于日本当前临床实际开展的临床数据、专家意见与真实世界临床实践的相关文献，以方便临床医师使用。本手册会随JSH指南的每一次修订同步更新：手册首版于2007年发行，第二版2010年、第三版2015年、第四版2020年发行，其中第四版涵盖了2017版JSH指南内容。本文节选自《肝细胞癌临床实践手册》第四版，聚焦HCC的病理学、诊断与治疗内容，旨在打造一本区别于最新版JSH临床实践指南的实用手册。本实践手册由JSH专家小组编撰，重点呈现JSH专家小组针对HCC诊疗提出的共识声明与推荐意见。本文纳入了当前日本该领域专家较为常用的新型临床实践方案，尽管这些方案的相关声明尚未达到高证据等级，但未来有望被纳入指南之中。本文的撰写由来自不同机构的共同作者完成内容起草，随后进行了互相严谨评审。修订后的内容在正式出版前，还经过了JSH董事会与规划及公共关系委员会的严谨评审，以确认其中的共识声明与推荐意见。本文所呈现的共识声明与推荐意见，代表了日本顶级HCC诊疗中心当前实际开展的诊疗方案。我们期望本文能够帮助读者了解日本HCC临床实践的真实现状，进而对全球HCC诊疗的实践模式产生积极影响。