- The Issues for Improving Prognosis in Intermediate Stage of Hepatocellular Carcinoma
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Yang Jae Yoo, Ji Hoon Kim
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J Liver Cancer. 2014;14(2):80-88. Published online September 30, 2014
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DOI: https://doi.org/10.17998/jlc.14.2.80
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Abstract
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- Hepatocellular carcinoma (HCC) is one of major malignant tumor with heterogeneity and
poor prognosis. In contrast to other solid malignant tumors, the prognosis of HCC is affected
by not only progression of tumor itself but also residual liver function. Therefore, diverse
staging systems are developed in HCC and there was no universal consensus for best staging
system. However, Barcelona Clinic Liver Cancer (BCLC) system, which was endorsed by
Western expert guidelines, is most commonly used staging system. BCLC system defined
intermediate stage as single tumor more than 5cm, 2-3 tumor more than 3cm or ≥ 4 tumor
at any size with Child-Pugh A or B and performance status 0-1 and allocated transarterial
chemoembolization (TACE) as primary treatment for this stage. Intermediate stage include
heterogeneous patients population and inevitably showed diverse prognosis. Among HCC
patients, about 20% belonged to intermediate stage and intermediate stage means relatively
little progressed stage, fair liver function and performance status. Therefore, improvement of
survival of intermediate HCC patients may be a cornerstone leading improvement of survival
of overall HCC patients. Hence, the strategy for optimal classification and treatment modality
for intermediate HCC patients at pre and post treatment to improve prognosis in this patients
will be discussed in this review. (J Liver Cancer 2014;14:80-88)
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