Liver Cancers Country Data

We have developed an interactive data map to view and compare liver cancer information from across Europe. Click on a country to see the available data.

Austria
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist and are updated every 1-5 years, and mostly match ESMO and EASL guidelines. Adherence to guidelines is around 50%. Link to guidelines: https://www.oeggh.at/wp-content/uploads/2023/06/Hepatologie_Onkologie_-hcc_.pdf
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Some patients are treated by multidisciplinary medical teams or “onco-teams”
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised clinics, 20-50% in non-specialised clinics, 10-20% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months, sometimes more. Austria is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: Yes TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Belgium
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines, country specific guidelines exist but not known by all, these are updated every 1-3 years, and mostly match ESMO and EASL. Adherence to guidelines is around 50-75%. No link to country specific guidelines available.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Multidisciplinary treatment Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer” 20-50% of patients are treated in specialised clinics/expert centres, approximately 50% in non-specialised clinics, approximately 50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months, sometimes more. Belgium is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible:Yes Advanced-stage HCC: No TACE is performed in all/most hospitals.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry for liver cancer patients exists, which is accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Bulgaria
Guidelines for liver cancer treatment	77% of respondents (were familiar with ESMO and EASL guidelines, 23% only with EASL guidelines. Country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Approximately 50% of patients are treated in a local setting, further data unavailable.
Transplants	Transplants are rarely performed; the waiting list is more than 6 months. Bulgaria is a member of Europtransplant. Living-donor liver transplants are rarely performed, or not at all. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

Croatia
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines, country specific guidelines do not exist.
CT and MRI scans	All respondents were familiar with ESMO and EASL guidelines, country specific guidelines do not exist.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Approximately 50% of patients are treated in non-specialised clinics, approximately 50% in a local setting.
Transplants	Data unavailable on how commonly transplants are performed in liver cancer patients. Croatia is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): No Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: Yes TACE is performed in all/most hospitals.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Data on immunotherapy drugs unavailable.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Cyprus
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines, country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Some patients are treated by multidisciplinary medical teams or “onco-teams”
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in non-specialised clinics, approximately 10-20% in a local setting.
Transplants	Transplants are not performed in liver cancer patients. Cyprus is not a member of Eurotransplant, a national organ dissemination system exists. Living-donor liver transplants are not performed.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Data unavailable.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

Czech Republic
Guidelines for liver cancer treatment	Respondents were only familiar with ESMO or EASL guidelines, not both. Country specific guidelines exist and are updated every 1-3 years, and mostly match ESMO and EASL guidelines. Adherence to guidelines is 100%. Link to guidelines: https://www.linkos.cz/lekar-a-multidisciplinarni-tym/personalizovana-onkologie/modra-kniha-cos/aktualni-vydani-modre-knihy/29-6-primarni-nadory-jater-zlucniku-a-zlucovych-cest-c22-24/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. 1-10% of patients are treated in non-specialised clinics, over 50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. The Czech Republic is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and partly reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Denmark
Guidelines for liver cancer treatment	Respondents were only familiar with EASL guidelines. Country specific guidelines exist and are updated every 4-5 years, they mostly match EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://www.dmcg.dk/Kliniske-retningslinjer/kliniske-retningslinjer/lever-galdevejscancer/hepatocellulart-carcinom--udredning-og-behandling-af-primar-levercancer/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, 1-5 of such centres exist. Over 50% of patients are treated in expert centres, 1-10% are treated in non-specialised clinics, 10-20% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Denmark is not a member of Eurotransplant, a national organ dissemination system exists. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and partly reimbursed.
Registries	2-4 centralised registries exist, which are accessible to clinicians and researchers.
Qol	QoL data are not collected.

Finland
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. 20-50% of patients are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Denmark is a member of Scandiatransplant. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

France
Guidelines for liver cancer treatment	50% of respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist but are not known by all, these are updated every 4-5 years, and mostly match ESMO and EASL. Adherence to guidelines is around 50-75%. Please look up AFEF recommendations for guidelines.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, approximately 10 such centres exist. Over 50% of patients are treated in expert centres, 1-10% are treated in non-specialised clinics, 10-20% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. France is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in expert centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	2-4 centralised registries exist, which are accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Germany
Guidelines for liver cancer treatment	64% of respondents were familiar with ESMO and EASL guidelines, 18% only with ESMO guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-5 years, and mostly match ESMO and EASL. Adherence to guidelines is around 50-75%. Link to guidelines: https://www.leitlinienprogramm-onkologie.de/leitlinien/hcc-und-biliaere-karzinome/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, more than 10 such centres exist. 10-50% of patients are treated in expert centres, approximately 50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. Germany is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in HCC and organ transplant expert centres.
Resections	Resections are performed. Resections are performed in all/most hospitals.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in expert centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Greece
Guidelines for liver cancer treatment	80% of respondents were familiar with ESMO and EASL guidelines, 20% of respondents were only familiar with ESMO guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. No link to guidelines available
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Around 50% of patients are treated in specialised clinics, around 50% are treated in non-specialised clinics, 1-10% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is usually more than 6 months. Greece is not a member of Eurotranplant. Living-donor liver transplants are not performed. Transplants are only performed in specialised clinics.
Resections	Resections are performed. Resections are mostly performed in specialised clinics, sometimes in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	2-4 centralised registries exist, which are accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Hungary
Guidelines for liver cancer treatment	50% of respondents were familiar with ESMO and EASL guidelines, 50% only with EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://akjournals.com/view/journals/650/162/Supplement-2/article-p2.xml
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Data on what percentage of patients are treated in which setting unavailable.
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. Hungary is a member of Eurotransplant, a national organ dissemination system exists. Living-donor liver transplants are not performed. Transplants are only performed in expert centres.
Resections	Resections are performed. Data on where resections are performed unavailable.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists, which is accessible to clinicians and researchers.
Qol	Data unavailable.

Ireland
Guidelines for liver cancer treatment	Respondents were only familiar with EASL guidelines, country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, up to 5 such centres exist. Over 50% of patients are treated in expert centres, 20-50% are treated in non-specialised clinics, 10-20% in a local setting
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. Ireland is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in expert centres.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists. Data unavailable on whether this is accessible to researchers and clinicians.
Qol	QoL data are not collected.

Italy
Guidelines for liver cancer treatment	44% of respondents were aware of both ESMO and EASL guidelines, 28% were only aware of EASL guidelines, 28% were only aware of ESMO guidelines. Country-specific guidelines exist but are not known by all. These are updated every 1-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://www.iss.it/-/snlg-gestione-paziente-con-epatocarcinoma
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, approximately 5-10 such centres exist. Over 50% of patients are treated in expert centres, 20-50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is around 6 months or more. Italy is not a member of Eurotransplant, a national organ dissemination system exists. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is performed in all/most hospitals
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	2-4 centralised registries exist, which are not accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Latvia
Guidelines for liver cancer treatment	40% of respondents were aware of both ESMO and EASL guidelines, 20% only aware of ESMO guidelines. Country-specific guidelines exist but are not known by all. These are updated every 4-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines not known. Link to guidelines: https://www.spkc.gov.lv/lv/registretas-2011gada/4fd9886a71dd31.pdf
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised clinics, 10-20% are treated in non-specialised clinics, 1-10% in a local setting.
Transplants	Transplants are rarely performed; the waiting list is more than 6 months. Latvia is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	Some EMA approved systemic therapies are available and partly or fully reimbursed. Immunotherapy drugs are available but not reimbursed.
Registries	Only 1 centralised registry exists, which is not accessible to clinicians and researchers.
Qol	QoL data are not collected.

Lithuania
Guidelines for liver cancer treatment	Respondents were only familiar with ESMO guidelines. Country-specific guidelines exist, which are updated every 4-5 years. They mostly match ESMO guidelines. Adherence to guidelines is 100%. Link to guidelines not available.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised centres, 1-10% are treated in non-specialised clinics, 1-10% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Lithuania is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in specialised clinics.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

Netherlands
Guidelines for liver cancer treatment	Respondents were only familiar with EASL guidelines. Country-specific guidelines exist, data unavailable on how regularly these are updated. Data on adherence to guidelines unavailable. Guidelines mostly match EASL guidelines. Link to guidelines not available.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, approximately 1-5 such centres exist. Data on what percentage of patients are treated in which setting unavailable.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. The Netherlands is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: Yes TACE is only performed in expert centres.
Systemic	Data on EMA approved systemic therapies unavailable. Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists ,which is accessible to clinicians and researchers.
Qol	QoL questionnaires are common with every hospital visit and during treatment.

Poland
Guidelines for liver cancer treatment	67% of respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-3 years. They do not match ESMO and EASL guidelines. Adherence to guidelines is 100%. No link to guidelines available
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Some patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, more than 10 such centres exist. 20-50% of patients are treated in expert centres, 20-50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months. Poland is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: Yes TACE is only performed in specialised clinics.
Systemic	Some or all EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and fully or partly reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Portugal
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines Country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Some or most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. 20-50% of patients are treated in specialised clinics, 20-50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months. Portugal is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	All EMA approved systemic therapies are available and partly reimbursed. Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

Romania
Guidelines for liver cancer treatment	60% of respondents were familiar with ESMO and EASL guidelines, 20% were only familiar with EASL guidelines, 20% only with ESMO guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-3 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-100%. Link to guidelines: https://cnas.ro/protocoale-terapeutice/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. 50% or more of patients are treated in specialised clinics, 50% or more are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are not regularly performed; the waiting list is more than 6 months. Romania is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are mostly performed in specialised clinics but also in low volume hospitals.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and partly reimbursed
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Slovakia
Guidelines for liver cancer treatment	67% of respondents were familiar with ESMO and EASL guidelines, 33% were only familiar with EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 6-10 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://www.herba.sk/index.php/metodick%C3%A9-listy (Žigrai M, Skladaný L, et al. Manažment liečby hepatocelulárneho karcinómu.)
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Some or most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised clinics, 20-50% are treated in non-specialised clinics, 1-10% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Slovakia is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	Some or all EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available.
Registries	There are between 1 and 4 centralised registries. Data on the accessibility of these is inconclusive.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Slovenia
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-3 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://szgh.si/clani-2/gastroenterolog/december-2018-letnik-22-stevilka-3/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, more than 1-5 such centres exist. Over 50% of patients are treated in expert centres, 1-10% are treated in non-specialised clinics, 10-20% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months. Slovenia is a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant and liver cancer expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in expert centres.
Systemic	Some or all EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists, which is accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Spain
Guidelines for liver cancer treatment	67% of respondents were familiar with ESMO and EASL guidelines, 33% were only familiar with EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 4-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: DOI: 10.1016/j.medcli.2020.09.022
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Some or most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Spain is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is performed in all/most hospitals.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Sweden
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist and are updated every 1-3 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: click here
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. Sweden is a member of Scandiatransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	All EMA approved systemic therapies are available and partly reimbursed. Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists, which is accessible to clinicians and researchers.
Qol	Data unavailable.

United Kingdom
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist. These are updated every 6-10 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 100%. Link to guidelines not available.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Data unavailable
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, more than 1-5 such centres exist. 20-50% of patients are treated in expert centres, over 50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. UK is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in HCC expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	All EMA approved systemic therapies are available and partly reimbursed. Immunotherapy drugs are available and reimbursed.
Registries	5-6 centralised registries exist, which are accessible to clinicians and researchers.
Qol	QoL questionnaires are common with every hospital visit and during treatment.

Austria
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist and are updated every 1-5 years, and mostly match ESMO and EASL guidelines. Adherence to guidelines is around 50%. Link to guidelines: https://www.oeggh.at/wp-content/uploads/2023/06/Hepatologie_Onkologie_-hcc_.pdf
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Some patients are treated by multidisciplinary medical teams or “onco-teams”
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised clinics, 20-50% in non-specialised clinics, 10-20% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months, sometimes more. Austria is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: Yes TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Belgium
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines, country specific guidelines exist but not known by all, these are updated every 1-3 years, and mostly match ESMO and EASL. Adherence to guidelines is around 50-75%. No link to country specific guidelines available.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Multidisciplinary treatment Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer” 20-50% of patients are treated in specialised clinics/expert centres, approximately 50% in non-specialised clinics, approximately 50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months, sometimes more. Belgium is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible:Yes Advanced-stage HCC: No TACE is performed in all/most hospitals.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry for liver cancer patients exists, which is accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Bulgaria
Guidelines for liver cancer treatment	77% of respondents (were familiar with ESMO and EASL guidelines, 23% only with EASL guidelines. Country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Approximately 50% of patients are treated in a local setting, further data unavailable.
Transplants	Transplants are rarely performed; the waiting list is more than 6 months. Bulgaria is a member of Europtransplant. Living-donor liver transplants are rarely performed, or not at all. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

Croatia
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines, country specific guidelines do not exist.
CT and MRI scans	All respondents were familiar with ESMO and EASL guidelines, country specific guidelines do not exist.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Approximately 50% of patients are treated in non-specialised clinics, approximately 50% in a local setting.
Transplants	Data unavailable on how commonly transplants are performed in liver cancer patients. Croatia is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): No Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: Yes TACE is performed in all/most hospitals.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Data on immunotherapy drugs unavailable.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Cyprus
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines, country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Some patients are treated by multidisciplinary medical teams or “onco-teams”
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in non-specialised clinics, approximately 10-20% in a local setting.
Transplants	Transplants are not performed in liver cancer patients. Cyprus is not a member of Eurotransplant, a national organ dissemination system exists. Living-donor liver transplants are not performed.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Data unavailable.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

Czech Republic
Guidelines for liver cancer treatment	Respondents were only familiar with ESMO or EASL guidelines, not both. Country specific guidelines exist and are updated every 1-3 years, and mostly match ESMO and EASL guidelines. Adherence to guidelines is 100%. Link to guidelines: https://www.linkos.cz/lekar-a-multidisciplinarni-tym/personalizovana-onkologie/modra-kniha-cos/aktualni-vydani-modre-knihy/29-6-primarni-nadory-jater-zlucniku-a-zlucovych-cest-c22-24/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. 1-10% of patients are treated in non-specialised clinics, over 50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. The Czech Republic is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and partly reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Denmark
Guidelines for liver cancer treatment	Respondents were only familiar with EASL guidelines. Country specific guidelines exist and are updated every 4-5 years, they mostly match EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://www.dmcg.dk/Kliniske-retningslinjer/kliniske-retningslinjer/lever-galdevejscancer/hepatocellulart-carcinom--udredning-og-behandling-af-primar-levercancer/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, 1-5 of such centres exist. Over 50% of patients are treated in expert centres, 1-10% are treated in non-specialised clinics, 10-20% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Denmark is not a member of Eurotransplant, a national organ dissemination system exists. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and partly reimbursed.
Registries	2-4 centralised registries exist, which are accessible to clinicians and researchers.
Qol	QoL data are not collected.

Finland
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. 20-50% of patients are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Denmark is a member of Scandiatransplant. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

France
Guidelines for liver cancer treatment	50% of respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist but are not known by all, these are updated every 4-5 years, and mostly match ESMO and EASL. Adherence to guidelines is around 50-75%. Please look up AFEF recommendations for guidelines.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, approximately 10 such centres exist. Over 50% of patients are treated in expert centres, 1-10% are treated in non-specialised clinics, 10-20% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. France is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in expert centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	2-4 centralised registries exist, which are accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Germany
Guidelines for liver cancer treatment	64% of respondents were familiar with ESMO and EASL guidelines, 18% only with ESMO guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-5 years, and mostly match ESMO and EASL. Adherence to guidelines is around 50-75%. Link to guidelines: https://www.leitlinienprogramm-onkologie.de/leitlinien/hcc-und-biliaere-karzinome/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, more than 10 such centres exist. 10-50% of patients are treated in expert centres, approximately 50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. Germany is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in HCC and organ transplant expert centres.
Resections	Resections are performed. Resections are performed in all/most hospitals.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in expert centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Greece
Guidelines for liver cancer treatment	80% of respondents were familiar with ESMO and EASL guidelines, 20% of respondents were only familiar with ESMO guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. No link to guidelines available
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Around 50% of patients are treated in specialised clinics, around 50% are treated in non-specialised clinics, 1-10% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is usually more than 6 months. Greece is not a member of Eurotranplant. Living-donor liver transplants are not performed. Transplants are only performed in specialised clinics.
Resections	Resections are performed. Resections are mostly performed in specialised clinics, sometimes in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	2-4 centralised registries exist, which are accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Hungary
Guidelines for liver cancer treatment	50% of respondents were familiar with ESMO and EASL guidelines, 50% only with EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://akjournals.com/view/journals/650/162/Supplement-2/article-p2.xml
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Data on what percentage of patients are treated in which setting unavailable.
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. Hungary is a member of Eurotransplant, a national organ dissemination system exists. Living-donor liver transplants are not performed. Transplants are only performed in expert centres.
Resections	Resections are performed. Data on where resections are performed unavailable.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised centres.
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists, which is accessible to clinicians and researchers.
Qol	Data unavailable.

Ireland
Guidelines for liver cancer treatment	Respondents were only familiar with EASL guidelines, country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, up to 5 such centres exist. Over 50% of patients are treated in expert centres, 20-50% are treated in non-specialised clinics, 10-20% in a local setting
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. Ireland is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in expert centres.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists. Data unavailable on whether this is accessible to researchers and clinicians.
Qol	QoL data are not collected.

Italy
Guidelines for liver cancer treatment	44% of respondents were aware of both ESMO and EASL guidelines, 28% were only aware of EASL guidelines, 28% were only aware of ESMO guidelines. Country-specific guidelines exist but are not known by all. These are updated every 1-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://www.iss.it/-/snlg-gestione-paziente-con-epatocarcinoma
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, approximately 5-10 such centres exist. Over 50% of patients are treated in expert centres, 20-50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is around 6 months or more. Italy is not a member of Eurotransplant, a national organ dissemination system exists. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is performed in all/most hospitals
Systemic	All EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	2-4 centralised registries exist, which are not accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Latvia
Guidelines for liver cancer treatment	40% of respondents were aware of both ESMO and EASL guidelines, 20% only aware of ESMO guidelines. Country-specific guidelines exist but are not known by all. These are updated every 4-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines not known. Link to guidelines: https://www.spkc.gov.lv/lv/registretas-2011gada/4fd9886a71dd31.pdf
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised clinics, 10-20% are treated in non-specialised clinics, 1-10% in a local setting.
Transplants	Transplants are rarely performed; the waiting list is more than 6 months. Latvia is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	Some EMA approved systemic therapies are available and partly or fully reimbursed. Immunotherapy drugs are available but not reimbursed.
Registries	Only 1 centralised registry exists, which is not accessible to clinicians and researchers.
Qol	QoL data are not collected.

Lithuania
Guidelines for liver cancer treatment	Respondents were only familiar with ESMO guidelines. Country-specific guidelines exist, which are updated every 4-5 years. They mostly match ESMO guidelines. Adherence to guidelines is 100%. Link to guidelines not available.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised centres, 1-10% are treated in non-specialised clinics, 1-10% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Lithuania is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in specialised clinics.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

Netherlands
Guidelines for liver cancer treatment	Respondents were only familiar with EASL guidelines. Country-specific guidelines exist, data unavailable on how regularly these are updated. Data on adherence to guidelines unavailable. Guidelines mostly match EASL guidelines. Link to guidelines not available.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, approximately 1-5 such centres exist. Data on what percentage of patients are treated in which setting unavailable.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. The Netherlands is a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are performed in low volume hospitals as well.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: Yes TACE is only performed in expert centres.
Systemic	Data on EMA approved systemic therapies unavailable. Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists ,which is accessible to clinicians and researchers.
Qol	QoL questionnaires are common with every hospital visit and during treatment.

Poland
Guidelines for liver cancer treatment	67% of respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-3 years. They do not match ESMO and EASL guidelines. Adherence to guidelines is 100%. No link to guidelines available
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Some patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, more than 10 such centres exist. 20-50% of patients are treated in expert centres, 20-50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months. Poland is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: Yes TACE is only performed in specialised clinics.
Systemic	Some or all EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and fully or partly reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Portugal
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines Country specific guidelines do not exist.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Some or most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. 20-50% of patients are treated in specialised clinics, 20-50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months. Portugal is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	All EMA approved systemic therapies are available and partly reimbursed. Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL data are not collected.

Romania
Guidelines for liver cancer treatment	60% of respondents were familiar with ESMO and EASL guidelines, 20% were only familiar with EASL guidelines, 20% only with ESMO guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-3 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-100%. Link to guidelines: https://cnas.ro/protocoale-terapeutice/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. 50% or more of patients are treated in specialised clinics, 50% or more are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are not regularly performed; the waiting list is more than 6 months. Romania is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are mostly performed in specialised clinics but also in low volume hospitals.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and partly reimbursed
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Slovakia
Guidelines for liver cancer treatment	67% of respondents were familiar with ESMO and EASL guidelines, 33% were only familiar with EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 6-10 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://www.herba.sk/index.php/metodick%C3%A9-listy (Žigrai M, Skladaný L, et al. Manažment liečby hepatocelulárneho karcinómu.)
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Some or most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised clinics, 20-50% are treated in non-specialised clinics, 1-10% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Slovakia is not a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	Some or all EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available.
Registries	There are between 1 and 4 centralised registries. Data on the accessibility of these is inconclusive.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Slovenia
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 1-3 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: https://szgh.si/clani-2/gastroenterolog/december-2018-letnik-22-stevilka-3/
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are less widely available, they are initially performed for accurate diagnosis but not for monitoring/follow-up.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, more than 1-5 such centres exist. Over 50% of patients are treated in expert centres, 1-10% are treated in non-specialised clinics, 10-20% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is approximately 6 months. Slovenia is a member of Eurotransplant. Living-donor liver transplants are not performed. Transplants are only performed in organ transplant and liver cancer expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in expert centres.
Systemic	Some or all EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists, which is accessible to clinicians and researchers.
Qol	QoL questionnaires are not generally used, only in clinical trials.

Spain
Guidelines for liver cancer treatment	67% of respondents were familiar with ESMO and EASL guidelines, 33% were only familiar with EASL guidelines. Country specific guidelines exist but are not known by all. These are updated every 4-5 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: DOI: 10.1016/j.medcli.2020.09.022
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Some or most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. Spain is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is performed in all/most hospitals.
Systemic	Some EMA approved systemic therapies are available and reimbursed (free of charge for the patient). Immunotherapy drugs are available and reimbursed.
Registries	None
Qol	QoL questionnaires are not generally used, only in clinical trials.

Sweden
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist and are updated every 1-3 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 50-75%. Link to guidelines: click here
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Most patients are treated by multidisciplinary medical teams or “onco-teams”.
Where treatment takes place	No certification system for calling hospitals/clinics “expert centres for liver cancer” exists. Over 50% of patients are treated in specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is more than 6 months. Sweden is a member of Scandiatransplant. Living-donor liver transplants are performed. Transplants are only performed in organ transplant expert centres.
Resections	Resections are performed. Resections are only performed in specialised clinics.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: Yes Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	All EMA approved systemic therapies are available and partly reimbursed. Immunotherapy drugs are available and reimbursed.
Registries	One centralised registry exists, which is accessible to clinicians and researchers.
Qol	Data unavailable.

United Kingdom
Guidelines for liver cancer treatment	All respondents were familiar with ESMO and EASL guidelines. Country specific guidelines exist. These are updated every 6-10 years. They mostly match ESMO and EASL guidelines. Adherence to guidelines is 100%. Link to guidelines not available.
CT and MRI scans	CT scans are regularly performed in HCC patients, both for diagnosis and monitoring. MRI scans are regularly performed in HCC patients, both for diagnosis and monitoring.
Multidisciplinary treatment	Data unavailable
Where treatment takes place	There is a certification system for calling hospitals/clinics “expert centres for liver cancer”, more than 1-5 such centres exist. 20-50% of patients are treated in expert centres, over 50% are treated in non-specialised clinics, 20-50% in a local setting.
Transplants	Transplants are regularly performed; the waiting list is less than 6 months. UK is not a member of Eurotransplant. Living-donor liver transplants are performed. Transplants are only performed in HCC expert centres.
Resections	Resections are performed. Resections are only performed in expert centres.
TACE	Intermediate-stage HCC (multinodular asymptomatic tumours without vascular invasion or extrahepatic spread): Yes Early-stage HCC where surgical options or ablation are not possible: No Advanced-stage HCC: No TACE is only performed in specialised clinics.
Systemic	All EMA approved systemic therapies are available and partly reimbursed. Immunotherapy drugs are available and reimbursed.
Registries	5-6 centralised registries exist, which are accessible to clinicians and researchers.
Qol	QoL questionnaires are common with every hospital visit and during treatment.