title: Usefulness of staging systems and prognostic scores for hepatocellular carcinoma treatments.
abstract: Therapeutic management of hepatocellular carcinoma (HCC) is quite complex owing to the underlying cirrhosis and portal vein hypertension. Different scores or classification systems based on liver function and tumoral stages have been published in the recent years. If none of them is currently "universally" recognized, the Barcelona Clinic Liver Cancer (BCLC) staging system has become the reference classification system in Western countries. Based on a robust treatment algorithm associated with stage stratification, it relies on a high level of evidence. However, BCLC stage B and C HCC include a broad spectrum of tumors but are only matched with a single therapeutic option. Some experts have thus suggested to extend the indications for surgery or for transarterial chemoembolization. In clinical practice, many patients are already treated beyond the scope of recommendations. Additional alternative prognostic scores that could be applied to any therapeutic modality have been recently proposed. They could represent complementary tools to the BCLC staging system and improve the stratification of HCC patients enrolled in clinical trials, as illustrated by the NIACE score. Prospective studies are needed to compare these scores and refine their role in the decision making process.
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Adhoute
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Penaranda
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Raoul
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Le Treut
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bollon
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Hardwigsen
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Castellani
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Perrier
authors.affiliation: Xavier Adhoute, Paul Castellani, Hervé Perrier, Marc Bourlière, Department of Hepato-Gastroenterology, Hôpital Saint-Joseph, 13008 Marseille, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Bourlière
keywords: Barcelona Clinic Liver Cancer staging system; Hepatocellular carcinoma; NIACE; Scoring system; Transarterial chemoembolization