HCC guidelines

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  • 7/31/2019 HCC guidelines

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    Cfonocdf Zydc}och Exomhfonhs

    HDSFHAY]C Cfonocdf Zydc}och Exomhfonhs0 Ldndehlhn}ab ghzd}achffxfdy cdyconaldt

    Hxyazhdn Dssacod}oan bay }gh S}xm ab }gh Forhy*& Hxyazhdn Ayednosd}oan bay Yhshdycg dnm ]yhd}lhn} ab Cdnchy

    4. On}yamxc}oan

    HDSFHAY]C Cfonocdf Zydc}och Exomhfonhs 'CZE/an }gh ldndehlhn} ab ghzd}achffxfdy cdyconald'GCC/ mhfflnh }gh xsh ab sxyrhoffdnch& modenasos dnm }ghy,dzhx}oc s}yd}heohs yhcallhnmhm bay zd}ohn}s uo}g }gos}zh ab cdnchy. ]gos os }gh fflys} Hxyazhdn `aon} hay}i }gh Hxyazhdn Dssacod}oan bay }gh S}xm ab }gh Forhy'HDSF/ dnm }gh Hxyazhdn Ayednosd}oan bay Yhshdycgdnm ]yhd}lhn} ab Cdnchy 'HAY]C/ }a zyaromh callanexomhfonhs bay }gh ldndehlhn} ab ghzd}achffxfdy cdyco,nald. ]ghsh exomhfonhs xzmd}h }gh yhcallhnmd}oansyhzay}hm i }gh HDSF zdnhf ab hwzhy}s on GCC zxi,fosghm on 9::4.4 Shrhydf cfonocdf dnm scohn}offlc dmrdnchsgdrh accxyyhm mxyone }gh zds} mhcdmh dnm& }gxs& d lam,hyn rhysoan ab }gh macxlhn} os xyehn}f nhhmhm.

    ]gh zxyzash ab }gos macxlhn} os }a dssos} zgsocodns&zd}ohn}s& ghdf}g,cdyh zyaromhys dnm ghdf}g,zafoc ldkhysbyal Hxyazh dnm uayfmuomh on }gh mhcosoan,ldkonezyachss dccaymone }a hromhnch,idshm md}d. Xshys ab}ghsh exomhfonhs sgaxfm ih dudyh }gd} }gh yhcallhnmd,}oans dyh on}hnmhm }a exomh cfonocdf zydc}och on coycxl,

    s}dnchs ughyh dff zassoifh yhsaxychs dnm }ghydzohs dyh

    drdofdifh. ]gxs& }gh sgaxfm dmdz} }gh yhcallhnmd}oans}a }ghoy facdf yhexfd}oans dnm!ay }hdl cdzdco}ohs& onbyd,s}yxc}xyh dnm cas}ihnhffl} s}yd}heohs. Bondff& }gos macx,lhn} sh}s ax} salh yhcallhnmd}oans }gd} sgaxfm ihons}yxlhn}df on dmrdncone }gh yhshdycg dnm knaufhmehab }gos moshdsh dnm xf}old}hf can}yoix}h }a olzyarhzd}ohn} cdyh.

    ]gh HDSFHAY]C CZE an }gh ldndehlhn} abghzd}achffxfdy cdyconald zyaromh yhcallhnmd}oansidshm an }gh fhrhf ab hromhnch dnm }gh s}yhne}g ab }ghmd}d '}gh cfdssofflcd}oan ab hromhnch os dmdz}hm byal }ghNd}oandf Cdnchy Ons}o}x}h9/ ']difh 4D/ dnm }gh s}yhne}gab yhcallhnmd}oans baffauone zyhroaxsf yhzay}hm ss,}hls 'EYDMH ss}hls/ ']difh 4I/.

    9. Cfonocdf Zydc}och Sxlldy

    ]gh cfonocdf zydc}och exomhfonhs ihfau uoff eorh dmrochbay xz }a md}h ldndehlhn} ab zd}ohn}s uo}g GCC ds uhffds zyaromone dn on,mhz}g yhrohu ab dff }gh yhfhrdn} md}dfhdmone }a }gh cancfxsoans.

    :?8?,7:=?!- , shh byan} ld}}hy 9:49 Zxifosghm i Hfshrohy F}m.

    mao04:.4:42!`.h`cd.9:44.49.:94

    t ]ghsh Exomhfonhs uhyh mhrhfazhm i }gh HDSF dnm }gh HAY]C dnm dyh zxifosghm solxf}dnhaxsf on }gh @axyndf ab Ghzd}afae 'rafxlh 82&

    ossxh =/ dnm }gh Hxyazhdn @axyndf ab Cdnchy 'rafxlh =7& ossxh 8/.Can}yoix}ays0 Cgdoylhn0 @ashz L. Ffarh} 'HDSF/; Locghf Mxcyhxw 'HAY]C/. Cfonocdf Zydc}och Exomhfonhs Lhlihys0 Yoccdyma Fhncoano; Dmyodn L.Mo Ioschefoh; Zh}hy Y. Edffh; @hdn Bydncaos Mxbaxy; ]ol B. Eyh}hn; Hyoc Ydlanm; ]dnod Yaskdls; ]gohyy Mh Idhyh; Locghf Mxcyhxw dnmRonchnpa Ldppdbhyya. HDSF Earhynone Iadym Yhzyhshn}d}orhs0 Ldxya Ihyndymo. Yhrohuhys0 @aymo Iyxow; Ldssola Cafalia; Dnmyhu Pgx.

    * Cayyhszanmhnch }a0 HDSF Affich& 5 yxh mhs Id}}aoys& CG 49:8 Ehnhrd& Suo}phyfdnm. ]hf.0 +=4 99 7:5 :32:; bdw0 +=4 99 397 :59=.H,ldof dmmyhss0 hdsfaffichJhdsfaffich.hx 'Hxyazhdn Dssacod}oan bay }gh S}xm ab }gh Forhy/.

    Diiyhrod}oans 0 GCR& Ghzd}o}os C royxs; SNZ& Sonefh nxcfha}omh zaflayzgosl; ZHE& Zafh}gfhnh efcaf; GDF],C& Ghzd}o}os C dn}oroydf fane,}hyl}yhd}lhn} dedons} coyygasos; HZOC& Hrdfxd}oan ab ZheOn}yan on can}yaf ab ghzd}o}os C coyygasos; C]& Calzx}hm }alaeydzg; LY& Ldenh}ocyhsandnch; LYO& Ldenh}oc yhsandnch oldeone; HzCDL& Hzo}ghfodf chff dmghsoan lafhcxfh; ZZR& Zaso}orh zyhmoc}orh rdfxh; tY],ZCY& Yhdf,}olhyhrhysh,}ydnscyoz}oan zaflhydsh cgdon yhdc}oan; CXZO& Cgonhsh xnorhyso} zyaenas}oc onmhw; CFOZ& Cdnchy ab }gh Forhy O}dfodn zyaeydl; SGDYZ&Saydbhnoi ghzd}achffxfdy cdyconald dsshsslhn} ydnmaloshm zya}acaf.

    Hxyazhdn @axyndf ab Cdnchy '9:49/ =7& 8??2=4

    D r d o f d i f h d } u u u . s c o h n c h m o y h c } . c a l

    ` a x y n d f g a l h z d e h 0 u u u . h ` c a n f o n h . c a l

    http://dx.doi.org/10.1016/j.ejca.2011.12.021http://dx.doi.org/10.1016/j.ejca.2011.12.021http://dx.doi.org/10.1016/j.ejca.2011.12.021http://dx.doi.org/10.1016/j.ejca.2011.12.021http://dx.doi.org/10.1016/j.ejca.2011.12.021http://dx.doi.org/10.1016/j.ejca.2011.12.021http://www.sciencedirect.com/http://www.sciencedirect.com/http://dx.doi.org/10.1016/j.ejca.2011.12.021http://dx.doi.org/10.1016/j.ejca.2011.12.021http://dx.doi.org/10.1016/j.ejca.2011.12.021http://dx.doi.org/10.1016/j.ejca.2011.12.021
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    Sxyrhoffdnch

    Zd}ohn}s d} goeg yosk bay mhrhfazone GCC sgaxfm ih hn}hyhm on}a sxyrhoffdnch zyaeydls. Eyaxzs d} goeg yoskdyh mhzoc}hm on ]difh 3'hromhnch 4I!3D; yhcallhnmd}oan 4D!I/

    Sxyrhoffdnch sgaxfm ih zhybaylhm i hwzhyohnchm zhysannhf on dff d},yosk zazxfd}oans xsone dimalondf xf}yd,saxnm hrhy 2 lan}gs'hromhnch 9M; yhcallhnmd}oan 4I/

    Hwchz}oans0 D sgay}hy baffau,xz on}hyrdf 'hrhy 3= lan}gs/ os yhcallhnmhm on }gh baffauone cdshs0 '4/Ughyh d namxfh ab fhss }gdn 4 cl gds ihhn mh}hc}hm 'shh yhcdff zafoc/& '9/ On }gh baffau,xz s}yd}he db}hy yhshc,}oan ay faca,yheoandf }ghydzohs'hromhnch 3M; yhcallhnmd}oan 9I/

    Zd}ohn}s an }gh udo}one fos} bay forhy }ydnszfdn}d}oan sgaxfm ih scyhhnhm bay GCC on aymhy }a mh}hc} dnm ldn,deh }xlaxy zyaeyhssoan dnm }a ghfz mhfflnh zyoayo} zafocohs bay }ydnszfdn}d}oan'hromhnch 3M; yhcallhnmd}oan 4I/

    Yhcdff zafoc

    On coyyga}oc zd}ohn}s& namxfhs fhss }gdn 4 cl on modlh}hy mh}hc}hm i xf}ydsaxnm sgaxfm ih baffauhm hrhy= lan}gs }gh fflys} hdy dnm uo}g yhexfdy cghckone hrhy 2 lan}gs }ghyhdb}hy'hromhnch 3M; yhcallhnmd}oan 9I/

    On coyyga}oc zd}ohn}s& modenasos ab GCC bay namxfhs ab 49 cl on modlh}hy sgaxfm ih idshm an nan,onrdsorhcyo}hyod ay ioazs,zyarhn zd}gafaeocdf canfflyld}oan. On }gh fd}}hy cdsh& o} os yhcallhnmhm }gd} ioazsohs dyhdsshsshm i dn hwzhy} ghzd}azd}gafaeos}. D shcanm ioazs os yhcallhnmhm on cdsh ab oncancfxsorh fflnmones&ay eyau}g ay cgdneh on hngdnchlhn} zd}}hyn omhn}offlhm mxyone baffau,xz'hromhnch 9M; yhcallhnmd}oan 4I/

    On coyyga}oc zd}ohn}s& namxfhs layh }gdn 9 cl on modlh}hy cdn ih modenashm bay GCC idshm an }zocdf bhd}xyhsan anh oldeone }hcgnotxh. On cdsh ab xnchy}don} ay d}zocdf ydmoafaeocdf fflnmones& modenasos sgaxfm ih can,fflylhm i ioazs'hromhnch 9M; yhcallhnmd}oan 4D/

    Modenasos

    Modenasos ab GCC os idshm an nan,onrdsorh cyo}hyod ay zd}gafae

    'hromhnch 9M; yhcallhnmd}oan 4D/ Zd}gafaeocdf modenasos ab GCC os idshm an }gh yhcallhnmd}oans ab }gh On}hynd}oandf Canshnsxs Zdnhf. Ollx,

    nas}donone bay EZC3& GSZ5:& dnm efx}dlonh sn}gh}dsh dnm!ay ehnh hwzyhssoan zyafflfhs 'EZC3& F_RH4 dnmsxyroron/ dyh yhcallhnmhm }a mohyhn}od}h goeg eydmh mszfds}oc namxfhs byal hdyf GCC'hromhnch 9M; yhcallhnmd}oan 9I/

    Dmmo}oandf s}donone cdn ih cansomhyhm }a mh}hc} zyaehno}ay chff bhd}xyhs 'K4? dnm HzCDL/ ay dsshss nhards,cxfdyosd}oan 'CM3=/.

    Nan,onrdsorh cyo}hyod cdn anf ih dzzfohm }a coyyga}oc zd}ohn}s dnm dyh idshm an oldeone }hcgnotxhs ai}donhmi =,zgdsh lxf}omh}hc}ay C] scdn ay mndloc can}yds},hngdnchm LYO. Modenasos sgaxfm ih idshm an }ghomhn}offlcd}oan ab }gh }zocdf gdffldyk ab GCC 'gzhyrdscxfdy on }gh dy}hyodf zgdsh uo}g udsgax} on }gh zay}dfrhnaxs ay mhfdhm zgdshs/. Ugofh anh oldeone }hcgnotxh os yhtxoyhm bay namxfhs ihanm 4 cl on modlh}hy'hromhnch 9M; yhcallhnmd}oan 9I/& d layh canshyrd}orh dzzyadcg uo}g 9 }hcgnotxhs os yhcallhnmhm on sxi,az}oldf sh}}ones. ]gh yafh ab can}yds},hngdnchm xf}ydsaxnm 'CHXS/ dnm dneoaeydzg os can}yarhysodf. ZH],

    scdn os na} dccxyd}h bay hdyf modenasos.

    S}deone ss}hls

    S}deone ss}hls on GCC sgaxfm mhfflnh ax}calh zyhmoc}oan dnm }yhd}lhn} dssoenlhn}. ]gh sgaxfm bdcofo}d}hhwcgdneh ab onbayld}oan& zyaenasos zyhmoc}oan dnm }yodf mhsoen. Mxh }a }gh nd}xyh ab GCC& }gh ldon zyae,nas}oc rdyodifhs dyh }xlaxy s}deh& forhy bxnc}oan dnm zhybayldnch s}d}xs.

    ]gh ICFC s}deone ss}hl os yhcallhnmhm bay zyaenas}oc zyhmoc}oan dnm }yhd}lhn} dffacd}oan'hromhnch 9D; yhcallhnmd}oan 4I/

    ]gos s}deone ss}hl cdn ih dzzfohm }a las} GCC zd}ohn}s& ds fane ds szhcofflc cansomhyd}oans bay szhcodf sxi,zazxfd}oans 'forhy }ydnszfdn}d}oan/ dyh oncayzayd}hm.

    A}ghy s}deone ss}hls dzzfohm dfanh ay on caliond}oan uo}g ICFC dyh na} yhcallhnmhm on cfonocdf zydc}och.

    2:: Hxyazhdn Dssacod}oan bay }gh S}xm ab }gh Forhy ! Hxyazhdn @axyndf ab Cdnchy =7 '9:49/ 8??2=4

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    Lafhcxfdy cfdssofflcd}oan ab GCC idshm an ehnh soend}xyhs ay lafhcxfdy dinayldfo}ohs os na} yhdm bay cfonocdfdzzfocd}oan'hromhnch 9D; yhcallhnmd}oan 4I/

    ]yhd}lhn}

    ]yhd}lhn} dffacd}oan os idshm an }gh ICFC dffacd}oan ss}hl.

    Yhshc}oan Yhshc}oan os }gh fflys},fonh }yhd}lhn} az}oan bay zd}ohn}s uo}g safo}dy }xlaxys dnm rhy uhff,zyhshyrhm forhy

    bxnc}oan& mhfflnhm ds nayldf iofoyxion uo}g ho}ghy ghzd}oc rhnaxs zyhssxyh eydmohn} 24: llGe ay zfd}hfh}caxn} Z4::&:::'hromhnch 9D; yhcallhnmd}oan 4I/

    Dnd}alocdf yhshc}oans dyh yhcallhnmhm'hromhnch 3D; yhcallhnmd}oan 9C/

    Dmmo}oandf onmocd}oans bay zd}ohn}s uo}g lxf}obacdf }xlaxys lhh}one Lofdn cyo}hyod '23 namxfhs 23 cl/ ayuo}g lofm zay}df gzhy}hnsoan na} sxo}difh bay forhy }ydnszfdn}d}oan yhtxoyh zyaszhc}orh calzdyosans uo}gfaca,yheoandf }yhd}lhn}s'hromhnch 3D; yhcallhnmd}oan 9C/

    Zhyo,azhyd}orh lay}dfo} ab forhy yhshc}oan on coyyga}oc zd}ohn}s os hwzhc}hm }a ih 93(

    Nha,dm`xrdn} ay dm`xrdn} }ghydzohs gdrh na} zyarhn }a olzyarh ax}calh ab zd}ohn}s }yhd}hm uo}g yhshc}oan'ay facdf difd}oan/'hromhnch 4M; yhcallhnmd}oan 9C/

    ]xlaxy yhcxyyhnch yhzyhshn}s }gh ld`ay calzfocd}oan ab yhshc}oan dnm }gh zd}}hyn ab yhcxyyhnch onxhnchssxishtxhn} }ghydz dffacd}oan dn