| HCC is ranked as the second cause of cancer death in Taiwan. The etiology of HCC is mainly from HBV or HCV infection in the past. However, the incidence of non-B, non-C HCC is increasing in recent years because of universal HBV vaccination, the introducing of NUCs for CHB and DAAs for CHC in Taiwan. The chronic viral hepatitis patients, surveillance of HCC is highly recommended for at least every 6 months by blood testing and ultrasonography. The DCP or PIVKA-II test has been reimbursed by Taiwan National Health Insurance (NHI) for patients with liver cirrhosis or HCC. However, there was no AFP-L3 in Taiwan. For treatment of HCC, curative intent either by surgical resection or RFA is the standard of care for patients without extrahepatic spreading or main vascular invasion, and with good liver reserve. TACE is widely applied for intermediate stage HCC, but the concept of TACE unsuitable either by up-to-7 or 7-11 criteria is now increasing in application. For patients with advanced stage HCC, atezolizumab plus bevacizumab has been reimbursed since Aug. 2023. However, if the patients maintain only in stable disease by atezo/beva, there will be no further reimbursement after subsequent SD by image evaluation. The benefit of atezo/beva from large Taiwan real-world data is still awaiting after adequate follow-up period. The STRIDE regimen is just begun in Taiwan since the end of 2023. |
