Diagnostic and Therapeutic Approaches to Hepatocellular Carcinoma: Understanding the Barcelona Clínic Liver Cancer Protocol

Abstract

Each year, hepatocellular carcinoma is diagnosed in more than half a million people worldwide and it is the fifth most common cancer in men and the seventh most common cancer in women. This article reviews the Barcelona-Clínic Liver Cancer protocol for the diagnosis, staging, and treatment of this disease, and four cases are presented for the discussion of the therapeutic approach. Understanding the diagnostic and therapeutic approaches to this disease is essential, especially if we keep in mind the quintessential basics of prevention and early detection.

Hepatocellular carcinoma in non-alcoholic fatty liver disease with and without cirrhosis

“…HCC represents the fifth most common neoplasm and the second largest cause of cancer mortality worldwide [2,31,32] . Despite its increasing incidence and the development of new therapies, overall 5-year survival is still low, no more than 30% [33,34] . NAFLD is considered to be the third cause for HCC in the USA [35] .…”

Predicting mortality for hepatorenal syndrome with liver‐specific scores

“…Clinical data were obtained and each case was individually assessed. Standardised imaging criteria were used for the diagnosis of hepatocellular carcinoma 19,20 . Hepatic encephalopathy was defined and stratified according to West‐Haven criteria 21 .…”

“…Standardised imaging criteria were used for the diagnosis of hepatocellular carcinoma. 19,20 Hepatic encephalopathy was defined and stratified according to West-Haven criteria. 21 Infection was defined as either a positive culture or radiological evidence of infection.…”

Clinical Management of Liver Cancer in India and Other Developing Nations: A Focus on Radiation Based Strategies

“…One of its salient features is the matching of tumor prognosis with treatment strategy, making specific recommendations for each stage. This system provides overall prognosis of the patient based on three major criteria: (1) tumor staging from morphology, portal invasion, metastasis and liver involvement, (2) patient's performance status (PS) assessment on a 0-4 scale based on well-being and motility and (3) liver function grading from A-C on the Child-Pugh (C-P) score, a points system that tracks biochemical parameters, physiological kinetics and clinical factors [48]. A simplified representation of the BCLC staging system is provided in Fig.…”