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Karademir. Hepatoma Res 2018;4:58 Hepatoma Research
DOI: 10.20517/2394-5079.2018.40

Review Open Access

Staging of hepatocellular carcinoma

Sedat Karademir

Department of General Surgery, Section of HPB Surgery and Organ Transplantation, Ankara Guven Hospital, Ankara 06540, Turkey.

Correspondence to: Prof. Sedat Karademir, Department of General Surgery, Section of HPB Surgery and Organ Transplantation, Ankara
Guven Hospital, Ankara 06540, Turkey. E-mail: sedatkarademir@gmail.com

How to cite this article: Karademir S. Staging of hepatocellular carcinoma. Hepatoma Res 2018;4:58.
http://dx.doi.org/10.20517/2394-5079.2018.40

Received: 16 Apr 2018 First Decision: 29 Jun 2018 Revised: 13 Aug 2018 Accepted: 22 Aug 2018 Published: 26 Sep 2018
Science Editor: Guang-Wen Cao Copy Editor: Yuan-Li Wang Production Editor: Zhong-Yu Guo

Abstract
Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths in the world. In contrast to other
cancers, survival of patients with HCC is determined by the extent of the tumor in addition to underlying liver
disease and its functional reserve. From risk factors to management, HCC reveals a considerable geographic and
institutional variation throughout the world. Although many staging and/or scoring systems have been proposed,
each prognostic system has several benefits and limitations on its own. Therefore, there is currently no globally
accepted system for HCC due to the extreme heterogeneity of the disease. In this review, currently available
staging systems for assessing the prognosis of HCC, their uses, limitations, and future prospects are revisited.

Keywords: Hepatocellular cancer, staging and scoring systems, risk factors, survival

INTRODUCTION
Cancer staging systems are important for identification of appropriate therapies and prediction of prognosis
for individual patients. Staging in cancer also helps to create a common language in clinical investigations and
[1]
research . Since last 2 decades, several staging systems have been proposed for hepatocellular carcinoma (HCC).
However, no single system has been universally accepted. Each staging system reflects the features of its own
patient population that has been studied on. From risk factors to the treatment given for HCC, considerable
geographic and institutional variations exist worldwide. In addition to heterogeneity of the tumor, in each
country, availability of surveillance programs, quality of medical technology and accessibility to treatment may
influence the prognosis of HCC patients. A staging system which is found to be useful in Western countries
may not be similarly suitable for Eastern population. However, external validation of a proposed system for
different patient groups worldwide is crucial to reach a common guideline for the management of HCC. So, the

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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