最新美国国立综合癌症网络和欧洲肿瘤内科学会肝细胞癌诊疗指南更新要点及与中国指南的差异OA

In recent years,with the rapid development of targeted and immunotherapy drugs in the field of hepatocellular carcinoma(HCC),major guidelines around the world have been updated one after another.Among them,the most frequently updated guidelines are those of the National Comprehensive Cancer Network(NCCN)in the United States,which have been updated 31 times from 2018 to 2025.After a gap of seven years,the European Society for Medical Oncology(ESMO)HCC guidelines also underwent a comprehensive and systematic second-edition update in 2025.In China,the Chinese Society of Clinical Oncology(CSCO)guidelines for the diagnosis and treatment of primary liver cancer were first published in 2018 and have been updated four times,and the National Health Commission released guide-lines for the diagnosis and treatment of primary liver cancer first in 2011 and will officially launch the 5th edition in 2026.Given the signif-icant differences in the etiology,clinical features,and treatment strategies of HCC between the East and the West,this review summarizes and interprets the key points of the recent updates of NCCN and ESMO guidelines for HCC as well as the current guidelines in China.It is found that there are many differences between domestic and foreign guidelines in the screening and diagnosis of HCC,local treatment in the early and intermediate stages,and systemic treatment strategies in the advanced stage.However,there is consistency in emphasizing multi-disciplinary team(MDT)decision making,individualized precision medicine,the preference of combined immunotherapy,and the in-depth application of evidence-based medical evidence.This review aims to provide clinicians with a clear guideline evolution context,combining the clinical recommendations and suggestions of European and American guidelines,to assist in the standardization and individualization of clinical decision making for HCC in China.