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J Liver Cancer > Volume 14(2); 2014 > Article
Journal of the Korean Liver Cancer Study 2014;14(2):80-88.
DOI: https://doi.org/10.17998/jlc.14.2.80    Published online September 30, 2014.
The Issues for Improving Prognosis in Intermediate Stage of Hepatocellular Carcinoma
Yang Jae Yoo, Ji Hoon Kim
Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
Correspondence:  Ji Hoon Kim,
Email: kjhhepar@naver.com
Copyright ©2014 by The Korean Liver Cancer Association
Abstract
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)
Key Words: Hepatocellular carcinoma; Prognosis; Intermediate stage
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