Content:

Treatment of HCC patients can be complex and involves multiple disciplines including Radiology, Interventional Radiology, Hepatology, Oncology and Hepatobiliary surgery.  There are a myriad of treatments and pathways to treat these complex patients, and sometimes it is unknown how to provide the best care for these patients and provide optimal transplant eligibility without a multidisciplinary discussion.   For example, patients may receive locoregional therapy when surgical resection may be more appropriate.

All patients with a newly diagnosed HCC will be reviewed in HCC Tumor Board in a multidisciplinary fashion to allow for full review of treatment options by all pertinent specialists. Additionally, any HCC patient who has undergone treatment will also be presented at HCC Tumor Board to obtain consensus on appropriate treatment strategy.

Target Audience: 

Interventional radiologists, body imaging radiologists, Hepatologists, GI oncologists, and Hepatobiliary Surgeons.  

1. Apply the conclusions of the discussion and devise a plan of treatment in accordance with the latest guidelines for locoregional treatment
2. Recommend courses of action which will allow patients best chance of transplant eligibility based on latest UNOS criteria
3. Increase referral for radiation segmentectomy (Y-90)
4. Participants will be more likely and able to follow through on recommendations due to more clear and concise communication of tumor board recommendations via Health Connect encounter note.

Planning Committee:

• Vishal Sidhar, MD, Chief of Radiology
• Varun Saxena, MD, Department of Gastroenterology and Hepatology
• Jie Zheng, MD, Chief of Medical Education
• Agnes Lau, Sr. Quality Specialist

Cultural and Linguistic Competency:

Elderly patients may not always be eligible for transplant or surgical resection. Younger patients tend to be offered more aggressive therapies upfront.

References:

1. Multidisciplinary Management of Hepatocellular Carcinoma Improves Access to Therapy and Patient Survival. Agarwal, Parul D. MD *; Phillips, Paulina MD *; Hillman, Luke MD +; Lucey, Michael R. MD *; Lee, Fred MD ++; Mezrich, Josh D. MD [S]; Said, Adnan MD Journal of Clinical Gastroenterology. 51(9):845-849, October 2017.
2. Serper M, Taddei TH, Mehta R, et al. Association of Provider Specialty and Multidisciplinary Care With Hepatocellular Carcinoma Treatment and Mortality. Gastroenterology. 2017;152(8):1954-1964.
3.  Gaba R, et al.  Imaging surveillance and multidisciplinary review improves curative therapy access and survival in HCC patients.  Annals of Hepatology.  2013; 12 (5) : 766-773

Disclosure:

The regular presenters and program planners of this case conference have disclosed that they have no relevant financial relationships with commercial interest (s). The CME Department has reviewed their disclosure information for the planner(s) and/or committee / faculty or this program and they do not have relationships that present a relevant financial conflict of interest.

Kaiser Permanente South San Francisco takes responsibility for the content, quality, and scientific integrity of this CME Activity.

Kaiser Permanente does not endorse any brand-name products.

Accreditation Statement:

Kaiser Permanente South San Francisco Medical Center is accredited by the California Medical Association (CMA) to provide continuing medical education for physicians.

Credit Statement:

The Kaiser Permanente South San Francisco Medical Center designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses may report up to a maximum total of 1.0 AMA PRA Category 1 Credit(s)™ towards the Continuing Medical Education requirements for license renewal by the California Board of Registered Nurses.

Other credit have been planned on a session by session basis, by this planning committee in the categories of Radiologic Technology (1.0 per session).