Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment, and follow-up of patients with hepatocellular carcinoma.

The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment, and follow-up of patients with hepatocellular carcinoma (HCC) were published in May 2025 and were adapted in August 2025, according to previously established standard methodology, to produce the Pan-Asian adapted ESMO consensus guidelines for the management of Asian patients with HCC. The adapted guidelines presented in this manuscript are the consensus opinions reached by a panel of Asian experts in the treatment of patients with HCC representing the oncological societies of China (Chinese Society of Clinical Oncology), Indonesia (Indonesian Society of Hematology and Medical Oncology), India (Indian Society of Medical and Paediatric Oncology), Japan (Japanese Society of Medical Oncology), Korea (Korean Society of Medical Oncology), Malaysia [Malaysian Oncological Society (MOS)], the Philippines (Philippine Society of Medical Oncology), Singapore (Singapore Society of Oncology), Taiwan (Taiwan Oncology Society), and Thailand (Thai Society of Clinical Oncology) and coordinated by ESMO and the MOS. The voting was based on scientific evidence and was independent of current treatment practices, drug access restrictions, and reimbursement decisions in the different regions of Asia. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with HCC across the different countries of Asia, drawing on the evidence provided by both Western and Asian trials. Attention is drawn to the disparity in the drug approvals and reimbursement strategies between the different regions.