Updated Barcelona Clinic Liver Cancer (BCLC) treatment strategy for managing hepatocellular carcinoma, 2022

Management of patients with HCC is guided by the BCLC staging system, which takes into account both tumor extent and the severity of the underlying liver disease and defines five prognostic subgroups with respective treatments. Treatment for early-stage tumors is with curative intent, and options include RFA, hepatic resection, and liver transplantation. Patients with intermediate or advanced HCC are candidates for chemoembolization or systemic therapies, respectively.

ECOG: Eastern Cooperative Oncology Group; N1: lymph node metastasis; M1: distant metastasis; DDLT: deceased donor liver transplantation; LDLT: living donor liver transplantation.

* Patients with end-stage liver disease if Child-Pugh class C should first be considered for liver transplantation.

¶ Patients with preserved hepatic function Child-Pugh class A with normal bilirubin and no portal hypertension are optimal candidates for hepatic resection.

Δ Atezolizumab plus bevacizumab has been approved as new first-line treatment for advanced HCC. Nonetheless, sorafenib and lenvatinib are still considered first line options when there is a contraindication for the combination treatment.

From: Llovet JM, Villanueva A, Marrero JA, et al. Trial Design and Endpoints in Hepatocellular Carcinoma: AASLD Consensus Conference. Hepatology 2021; 73 Suppl 1:158-191. https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.31327. Copyright © 2021 American Association for the Study of Liver Diseases. Reproduced with permission of John Wiley & Sons Inc. This image has been provided by or is owned by Wiley. Further permission is needed before it can be downloaded to PowerPoint, printed, shared or emailed. Please contact Wiley's Permissions Department either via email: [email protected] or use the RightsLink service by clicking on the Request Permission link accompanying this article on Wiley Online Library (www.onlinelibrary.wiley.com).

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Updated Barcelona Clinic Liver Cancer (BCLC) treatment strategy for managing hepatocellular carcinoma, 2022