Impact of current staging systems on treatment strategy for HBV-related hepatocellular carcinoma.
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-related death worldwide. HCC incidence has increased over the last few years, with more than half of HCC cases being reported in China, where hepatitis B virus (HBV) infection is the main etiologic factor. The heterogeneity in HCC's worldwide distribution and the differences in its etiology in different locations may result in prognosis estimation and therapeutic decision making being more complicated for HCC patients. In the past decade, several clinical staging systems have been developed based on relevant prognostic factors. Among them, the Barcelona Clinic Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC) staging systems are the only two classification systems that link prognostic classification to treatment indications. In this review, we mainly focus on the use of the BCLC and HKLC staging systems for guiding therapeutic decision making for HCC, the respective advantages and disadvantages of each classification system, and future perspectives for the improvement of the HKLC model.
Department of Hepatopancreatobiliary Surgery, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Xiaopeng
X
Yan
Department of Hepatopancreatobiliary Surgery, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: yudongqiu510@163.com.
Yudong
Y
Qiu
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy* / Q000821:virology; D000066491:Clinical Decision-Making; D003661:Decision Support Techniques; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy* / Q000821:virology; D009367:Neoplasm Staging / Q000379:methods*; D018579:Patient Selection; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors
BCLC system; HKLC system; Hepatocellular carcinoma; Therapeutic decision-making