Revision 16 for 'Liver cancer (BCLC staging)'

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Liver cancer (BCLC staging)

Barcelona clinic liver cancer (BCLC) staging uses a set of criteria to guide management of patients with hepatocellular carcinoma (HCC).

The classification takes the following variables into account 1,2:

The classification system sorts patients into one of four categories:

  • stage 0 (very early stage)
    • asymptomatic early tumors
      • PS 0
      • Child-Pugh A
      • solitary lesion measuring less than 2 cm in diameter
    • management
      • resection
      • if portal hypertension/hyperbilirubinemia, transplant is then recommended  
  • stage A (early stage)
    • asymptomatic early tumors
      • PS 0-2
      • Child-Pugh A to C
      • solitary lesion > 2 cm or early multifocal disease characterized by up to 3 lesions measuring less than 3 cm
    • management
      • usually, resection is viable for single lesions  
      • if multiple lesions, transplant is then recommended  
      • if other clinical comorbidities are present, radiofrequency ablation is then recommended   
  • stage B (intermediate stage)
    • asymptomatic multinodular tumors
      • PS 0
      • Child-Pugh A to C
      • multifocal disease: more than one lesion with at least one over 3 cm, or more than 3 lesions regardless their size
    • intra-arterial therapies (chemoembolisation and radioembolization)
  • stage C (advanced stage)
    • symptomatic tumors and/or invasive tumors
    • sorafenib, phase II trial agents, or palliative treatments
  • stage D (end-stage disease)

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