Hepatocellular carcinoma (HCC) is a major cause of death in many countries, including South Korea. To provide useful and sensible advice for clinical management of patients with HCC, the Korean Liver Cancer Association and National Cancer Center Korea Practice Guideline Revision Committee have recently revised the practice guidelines for HCC management. However, there are some differences between practice guidelines and real-life clinical practice. In this review, we describe some key recommendations of the 2022 version of practice guidelines and the real-life clinical situation in South Korea, together with discussion about efforts needed to reduce the difference between guidelines and real-life clinical practice.
Citations
Citations to this article as recorded by
Neutrophil count predicts the complete response after transarterial chemoembolization related to favorable outcome in hepatocellular carcinoma Young Mi Hong European Journal of Gastroenterology & Hepatology.2025; 37(1): 94. CrossRef
Epidemiological characteristics and precise prophylaxis and control of HBV-associated primary liver cancer Yuqi Feng, Letian Fang, Guangwen Cao Hepatoma Research.2025;[Epub] CrossRef
A Prospective, Multicenter, Randomized, Noninferiority Trial of Stopad® Versus Tachosil® for Hemostasis After Liver Resection Seung Yeon Lim, Gi Hong Choi, Jin Hong Lim, Ho-Seong Han, Yoo-Seok Yoon, Hae Won Lee, Boram Lee, Yeshong Park, MeeYoung Kang, Jinju Kim, Hyelim Joo, Jai Young Cho Cancers.2025; 17(5): 757. CrossRef
Reply: Intrahepatic IgA complex induces polarization of cancer-associated fibroblasts to matrix phenotypes in the tumor microenvironment of hepatocellular carcinoma Deok Hwa Seo, Pil Soo Sung Hepatology.2025; 81(4): E123. CrossRef
The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series Fabrizio Bronte, Fabio D'Amato, Maria Rosa Barcellona, Giuseppe Bronte, Giuseppe Malizia, Salvatore Ialuna, Giorgio Fusco, Francesco Verderame, Enrico Bronte, Maria Grazia Bavetta Cancer Reports.2025;[Epub] CrossRef
Roadmap for HCC Surveillance and Management in the Asia Pacific Masatoshi Kudo, Bui Thi Oanh, Chien-Jen Chen, Do Thi Ngat, Jacob George, Do Young Kim, Luckxawan Pimsawadi, Pisit Tangkijvanich, Raoh-Fang Pwu, Rosmawati Mohamed, Sakarn Bunnag, Sheng-Nan Lu, Sirintip Kudtiyakarn, Tatsuya Kanto, Teerha Piratvisuth, Chao-C Cancers.2025; 17(12): 1928. CrossRef
TCR-based cellular immunotherapy for hepatocellular carcinoma: advances, challenges, and prospects Wanting Zeng, Wei Zhu, Guosheng Yuan, Jinzhang Chen, Zhanhui Wang, Jinlin Hou, De-Ke Jiang Cancer Immunology, Immunotherapy.2025;[Epub] CrossRef
Development and validation of a risk prediction model for patients with hepatocellular carcinoma receiving atezolizumab–bevacizumab Heechul Nam, Dong Yun Kim, Do Young Kim, Ji Hoon Kim, Chang Wook Kim, Jaejun Lee, Keungmo Yang, Ji Won Han, Pil Soo Sung, Seung Kew Yoon, Hee Sun Cho, Hyun Yang, Si Hyun Bae, Soon Kyu Lee, Jung Hyun Kwon, Soon Woo Nam, Ahlim Lee, Do Seon Song, U Im Chang, Hepatology.2025;[Epub] CrossRef
Subset of Child-Pugh Score 7 Shows Comparable Survival Outcomes to Child-Pugh Score 6 in Patients with Hepatocellular Carcinoma Treated with Atezolizumab and Bevacizumab Jaejun Lee, Keungmo Yang, Ji Won Han, Pil Soo Sung, Jeong Won Jang, Seung Kew Yoon, Hee Sun Cho, Hyun Yang, Si Hyun Bae, Ji Hoon Kim, Heechul Nam, Chang Wook Kim, Hae Lim Lee, Hee Yeon Kim, Sung Won Lee, Ahlim Lee, Do Seon Song, Myeong Jun Song, Soon Woo Clinical Cancer Research.2025; 31(20): 4323. CrossRef
Atezolizumab Plus Bevacizumab for Advanced Hepatocellular Carcinoma with Macroscopic Vascular Invasion: An Inverse Probability of Treatment Weighted Analysis Jihoon Kim, Jin-Hyoung Kim, Byung Soo Im, Gun Ha Kim, Hee Ho Chu, Dong Il Gwon, Ji Hoon Shin, Ju Hyun Shim, Sang Min Yoon, Sehee Kim Cancers.2025; 18(1): 33. CrossRef
The Position of Multikinase Inhibitors in the Era of Immune-Checkpoint Inhibitors for Hepatocellular Carcinoma Beom Kyung Kim Gut and Liver.2024; 18(1): 3. CrossRef
Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma Josep M. Llovet, Roser Pinyol, Mark Yarchoan, Amit G. Singal, Thomas U. Marron, Myron Schwartz, Eli Pikarsky, Masatoshi Kudo, Richard S. Finn Nature Reviews Clinical Oncology.2024; 21(4): 294. CrossRef
High‐dose proton pump inhibitor treatment is associated with a higher mortality in cirrhotic patients: A multicentre study Jun Sik Yoon, Ji Hoon Hong, Soo Young Park, Seung Up Kim, Hwi Young Kim, Ju Yeon Kim, Moon Haeng Hur, Min Kyung Park, Yun Bin Lee, Han Ah Lee, Gi‐Ae Kim, Dong Hyun Sinn, Sung Jae Park, Youn Jae Lee, Yoon Jun Kim, Jung‐Hwan Yoon, Jeong‐Hoon Lee Alimentary Pharmacology & Therapeutics.2024; 59(8): 973. CrossRef
Role of reimbursement and Physicians' awareness in the survival of sorafenib‐eligible advanced hepatocellular carcinoma patients Hui‐Ling Huang, Te‐Sheng Chang, Lariza Marie Canseco, Fan Wu, Sheng‐Nan Lu The Kaohsiung Journal of Medical Sciences.2024; 40(6): 589. CrossRef
Limited Generalizability of Retrospective Single-Center Cohort Study in Comparison to Multicenter Cohort Study on Prognosis of Hepatocellular Carcinoma Ye Rim Kim, Sung Won Chung, Min-Ju Kim, Won-Mook Choi, Jonggi Choi, Danbi Lee, Han Chu Lee, Ju Hyun Shim Journal of Hepatocellular Carcinoma.2024; Volume 11: 1235. CrossRef
Similar recurrence after curative treatment of HBV-related HCC, regardless of HBV replication activity Mi Na Kim, Beom Kyung Kim, Heejin Cho, Myung Ji Goh, Yun Ho Roh, Su Jong Yu, Dong Hyun Sinn, Soo Young Park, Seung Up Kim, Tyng-Yuan Jang PLOS ONE.2024; 19(8): e0307712. CrossRef
The position of loco-regional therapy in the management of hepatocellular carcinoma with extrahepatic metastases Beom Kyung Kim Journal of Liver Cancer.2024; 24(2): 129. CrossRef
Role of transarterial chemoembolization for hepatocellular carcinoma with extrahepatic metastases in the era of advancing systemic therapy Byeong Geun Song, Myung Ji Goh, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Joon Hyeok Lee, Moon Seok Choi Journal of Liver Cancer.2024; 24(2): 243. CrossRef
Primary treatments for solitary hepatocellular carcinoma ≤ 3 cm: A systematic review and network meta-analysis Sang-Hoon Kim, Ki-Hun Kim, Byeong-Gon Na, Sung Min Kim, Rak-Kyun Oh Annals of Hepato-Biliary-Pancreatic Surgery.2024; 28(4): 397. CrossRef
Evolution of Liver Resection for Hepatocellular Carcinoma: Change Point Analysis of Textbook Outcome over Twenty Years Yeshong Park, Ho-Seong Han, Seung Yeon Lim, Hyelim Joo, Jinju Kim, MeeYoung Kang, Boram Lee, Hae Won Lee, Yoo-Seok Yoon, Jai Young Cho Medicina.2024; 61(1): 12. CrossRef
A Real-World Comparative Analysis of Atezolizumab Plus Bevacizumab and Transarterial Chemoembolization Plus Radiotherapy in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis Soon Kyu Lee, Jung Hyun Kwon, Sung Won Lee, Hae Lim Lee, Hee Yeon Kim, Chang Wook Kim, Do Seon Song, U Im Chang, Jin Mo Yang, Soon Woo Nam, Seok-Hwan Kim, Myeong Jun Song, Ji Hoon Kim, Ahlim Lee, Hyun Yang, Si Hyun Bae, Ji Won Han, Heechul Nam, Pil Soo Su Cancers.2023; 15(17): 4423. CrossRef
What should be done to reduce the discrepancy between guidelines and real-life practice for hepatocellular carcinoma in Korea? Min Kyung Park, Yoon Jun Kim Clinical and Molecular Hepatology.2023; 29(2): 332. CrossRef
The current trends in the health burden of primary liver cancer across the globe Peter Konyn, Aijaz Ahmed, Donghee Kim Clinical and Molecular Hepatology.2023; 29(2): 358. CrossRef
Toward user-friendly and evidence-based practice guidelines for hepatocellular carcinoma Do Young Kim Clinical and Molecular Hepatology.2023; 29(2): 335. CrossRef
A Phase I/IIa Trial of Yttrium-90 Radioembolization in Combination with Durvalumab for Locally Advanced Unresectable Hepatocellular Carcinoma Yun Bin Lee, Joon Yeul Nam, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Hyo-Cheol Kim, Jin Chul Paeng, Jung-Hwan Yoon, Yoon Jun Kim Clinical Cancer Research.2023; 29(18): 3650. CrossRef
Tips for Preparing and Practicing Thermal Ablation Therapy of Hepatocellular Carcinoma Yasunori Minami, Tomoko Aoki, Satoru Hagiwara, Masatoshi Kudo Cancers.2023; 15(19): 4763. CrossRef
Preclinical studies highlighted potential therapeutic applications of aspirin and statins as anticancer agents based on their pleiotropic effects. Epidemiologic studies suggested the role of aspirin and statins in the chemoprevention of hepatocellular carcinoma (HCC). However, observational data is prone to bias, and no prospective randomized trials are currently available to assess the risks and benefits of statin or aspirin therapy for chemoprevention of HCC. It is therefore important for clinicians and researchers to be aware of the quality of current evidence regarding this issue. In this review, we summarize currently available evidence to assist clinicians with their decision to use statin or aspirin and provide information for further clinical investigations.
Citations
Citations to this article as recorded by
Reconsidering statins in MASLD: beyond cardiovascular protection to multisystem benefit Xiao-Dong Zhou, Vincent Wai-Sun Wong, Ming-Hua Zheng Gut.2026; 75(1): 192. CrossRef
Risk factors for hepatocellular carcinoma: an umbrella review of systematic review and meta-analysis Jie Wang, Kaijie Qiu, Songsheng Zhou, Yichao Gan, Keting Jiang, Donghuan Wang, Haibiao Wang Annals of Medicine.2025;[Epub] CrossRef
Steatotic liver disease in chronic hepatitis C related hepatocellular carcinoma: Inflictor or bystander?: Correspondence to editorial on “Dynamic change of metabolic dysfunction-associated steatotic liver disease in chronic hepatitis C patients after vira Chung-Feng Huang, Ming-Lun Yeh, Chia-Yen Dai, Jee-Fu Huang, Wan-Long Chuang, Ming-Lung Yu Clinical and Molecular Hepatology.2025; 31(1): e64. CrossRef
Cancer Chemoprevention: An Exploration of the Efficacy and Potential of Various Materials (Synthetic and Natural) Ikram Fazaa, Leila Achour, Yosr Trabelsi, Hajer Felfel, Freddy Mounsef, Chema Drira Middle Eastern Cancer and Oncology Journal .2025; 1(2): 23. CrossRef
Statin therapy for NAFLD: Molecular underpinnings of myopathic consequences and treatment strategies Pratiksha Nanepag, Shubhada Mangrulkar, Aarti Shriwas, Mayur Kale, Sapana Kushwaha, Nitu Wankhede, Brijesh Taksande, Milind Umekar Aspects of Molecular Medicine.2025; 5: 100091. CrossRef
The value of acetylation reader YEATS2 in hepatocellular carcinoma management Yongjie Shi, Qiwen Xiao, Weichun Xiao, Jiale Kang, Qiang Zhou, Hongyun Jia, Yimei Chen, Sicong Huang Scientific Reports.2025;[Epub] CrossRef
Aspirin Use and Risk of HCC and Gastrointestinal Bleeding in Patients With HBV‐Related Cirrhosis: A Landmark Analysis Mi Na Kim, Geun U. Park, Seng Chan You, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn Journal of Gastroenterology and Hepatology.2025; 40(11): 2750. CrossRef
Aspirin reduces short-term mortality risk in critically ill patients with liver cirrhosis: a propensity-score matched retrospective analysis using the MIMIC-IV database Yu Yi, Yinghua Chen, Yawen Luo BMC Gastroenterology.2025;[Epub] CrossRef
The Impact of Statins on the Survival of Patients with Advanced Hepatocellular Carcinoma Treated with Sorafenib or Lenvatinib Ji Eun Han, Jisu Kim, Jae Youn Cheong, Soon Sun Kim, Sun Gyo Lim, Min Jae Yang, Choong-Kyun Noh, Gil Ho Lee, Jung Woo Eun, Bumhee Park, Hyo Jung Cho Cancers.2024; 16(2): 249. CrossRef
Statin therapy: a potential adjuvant to immunotherapies in hepatocellular carcinoma Jiao Wang, Chengyu Liu, Ronghua Hu, Licheng Wu, Chuanzhou Li Frontiers in Pharmacology.2024;[Epub] CrossRef
Risk of hepatocellular carcinoma after curative treatment when switching from tenofovir disoproxil fumarate or entecavir to tenofovir alafenamide: A real‐world multicenter cohort study Hyunjae Shin, Seung Up Kim, Byeong Geun Song, Youngsu Park, Yunmi Ko, Jeayeon Park, Moon Haeng Hur, Yun Bin Lee, Eun Ju Cho, Jeong‐Hoon Lee, Su Jong Yu, Jung‐Hwan Yoon, Dong Hyun Sinn, Yoon Jun Kim Hepatology Research.2024; 54(7): 627. CrossRef
SGLT2i impact on HCC incidence in patients with fatty liver disease and diabetes: a nation-wide cohort study in South Korea Hyo Jung Cho, Eunyoung Lee, Soon Sun Kim, Jae Youn Cheong Scientific Reports.2024;[Epub] CrossRef
Unmet needs in the post-direct-acting antivirals era: The risk and molecular mechanisms of hepatocellular carcinoma after hepatitis C virus eradication Chung-Feng Huang, Manar Hijaze Awad, Meital Gal-Tanamy, Ming-Lung Yu Clinical and Molecular Hepatology.2024; 30(3): 326. CrossRef
Chemoprevention of hepatocellular carcinoma associated with metabolic dysfunction-associated steatotic liver disease: an updated review Averie Dickinson, Amreen Dinani, Kara Wegermann Hepatoma Research.2024;[Epub] CrossRef
Metformin and statins and their role in reducing hepatocellular carcinoma risk: Randomized trials are needed: Editorial on “Metformin and statins reduce hepatocellular carcinoma risk in chronic hepatitis C patients with failed antiviral therapy” Paul Y. Kwo Clinical and Molecular Hepatology.2024; 30(4): 714. CrossRef
Dipeptidyl peptidase-4 inhibitors are associated with improved survival of patients with diabetes mellitus and hepatocellular carcinoma receiving immunotherapy: Letter to the editor on “Statin and aspirin for chemoprevention of hepatocellular carcinoma: T Dorothy Cheuk-Yan Yiu, Huapeng Lin, Vincent Wai-Sun Wong, Grace Lai-Hung Wong, Ken Liu, Terry Cheuk-Fung Yip Clinical and Molecular Hepatology.2024; 30(4): 970. CrossRef
Evaluating the Role of Aspirin in Liver Disease: Efficacy, Safety, Potential Benefits and Risks Amani Elshaer, Blanca C. Lizaola-Mayo Life.2024; 14(12): 1701. CrossRef
Statin Monotherapy Not Inferior to Aspirin or Combined Aspirin and Statins Reducing the Incidences of Cirrhosis, HCC, and Mortality in MAFLD/MASH Patients: A Population Cohort Study Chern-Horng Lee, Yu-Han Huang, Tzu-Ju Hsu, Tzung-Hai Yen, Sen-Yung Hsieh International Journal of General Medicine.2024; Volume 17: 6495. CrossRef
Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis Niccolò Bitto, Gabriele Ghigliazza, Stanislao Lavorato, Camilla Caputo, Vincenzo La Mura Journal of Clinical Medicine.2023; 12(3): 934. CrossRef
Preventive strategy for nonalcoholic fatty liver disease-related hepatocellular carcinoma Yuri Cho, Bo Hyun Kim, Joong-Won Park Clinical and Molecular Hepatology.2023; 29(Suppl): S220. CrossRef
The potential of epigallocatechin gallate in the chemoprevention and therapy of hepatocellular carcinoma Dongming Li, Donghui Cao, Yingnan Cui, Yuanlin Sun, Jing Jiang, Xueyuan Cao Frontiers in Pharmacology.2023;[Epub] CrossRef
MAFLD: an optimal framework for understanding liver cancer phenotypes Harry Crane, Cameron Gofton, Ankur Sharma, Jacob George Journal of Gastroenterology.2023; 58(10): 947. CrossRef
AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma Amit G. Singal, Josep M. Llovet, Mark Yarchoan, Neil Mehta, Julie K. Heimbach, Laura A. Dawson, Janice H. Jou, Laura M. Kulik, Vatche G. Agopian, Jorge A. Marrero, Mishal Mendiratta-Lala, Daniel B. Brown, William S. Rilling, Lipika Goyal, Alice C. Wei, Ta Hepatology.2023; 78(6): 1922. CrossRef
Statin use and the risk of hepatocellular carcinoma among patients with chronic hepatitis B: an emulated target trial using longitudinal nationwide population cohort data Dong Hyun Sinn, Danbee Kang, Yewan Park, Hyunsoo Kim, Yun Soo Hong, Juhee Cho, Geum-Youn Gwak BMC Gastroenterology.2023;[Epub] CrossRef