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World J Gastroenterol. Apr 21, 2014; 20(15): 4141-4150
Published online Apr 21, 2014. doi: 10.3748/wjg.v20.i15.4141
Staging systems of hepatocellular carcinoma: A review of literature
Marcello Maida, Emanuele Orlando, Calogero Cammà, Giuseppe Cabibbo
Marcello Maida, Emanuele Orlando, Calogero Cammà, Giuseppe Cabibbo, Section of Gastroenterology, DIBIMIS, University of Palermo, 90127 Palermo, Italy
Author contributions: All authors contributed to writing the paper and had full control over preparation of manuscript, and approved the final draft manuscript.
Correspondence to: Calogero Cammà, MD, Section of Gastroenterology, DIBIMIS, University of Palermo, P.zza delle Cliniche 2, 90127 Palermo, Italy. calogero.camma@unipa.it
Telephone: +39-91-6552145 Fax: +39-91-6552156
Received: November 1, 2013
Revised: January 17, 2014
Accepted: March 12, 2014
Published online: April 21, 2014
Processing time: 169 Days and 22.6 Hours
Abstract

Hepatocellular carcinoma (HCC) is a major health problem with a high incidence and mortality all over the world. Natural history of HCC is severe and extremely variable, and prognostic factors influencing outcomes are incompletely defined. Over time, many staging and scoring systems have been proposed for the classification and prognosis of patients with HCC. Currently, the non-ideal predictive performance of existing prognostic systems is secondary to their inherent limitations, as well as to a non-universal reproducibility and transportability of the results in different populations. New serological and histological markers are still under evaluation with promising results, but they require further evaluation and external validation. The aim of this review is to highlight the main tools for assessing the prognosis of HCC and the main concerns, pitfalls and warnings regarding its staging systems currently in use.

Keywords: Hepatocellular carcinoma; Natural history; Prognosis; Staging; Barcelona clinic liver cancer

Core tip: Hepatocellular carcinoma is a major health problem, with a heterogeneous natural history that makes it difficult to identify accurate prognostic factors. The aim of this review is to highlight the main tools for assessing the prognosis of HCC and the main concerns, pitfalls and warnings regarding its staging systems currently in use.