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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2015; 21(37): 10604-10608
Published online Oct 7, 2015. doi: 10.3748/wjg.v21.i37.10604
Sub-classification of intermediate-stage (Barcelona Clinic Liver Cancer stage-B) hepatocellular carcinomas
Koichiro Yamakado, Shozo Hirota
Koichiro Yamakado, Shozo Hirota, Department of Radiology, Hyogo College of Medicine, Hyogo 663-8501, Japan
Author contributions: Yamakado K designed this review, analyzed data and wrote the paper; and Hirota S edited the paper.
Conflict-of-interest statement: No authors have conflict of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Koichiro Yamakado, MD, Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan. yama@clin.medic.mie-u.ac.jp
Telephone: +81-798-456362 Fax: +81-798-456361
Received: April 21, 2015
Peer-review started: April 22, 2015
First decision: June 2, 2015
Revised: June 17, 2015
Accepted: September 2, 2015
Article in press: September 2, 2015
Published online: October 7, 2015
Processing time: 160 Days and 2.6 Hours
Abstract

Hepatocellular carcinoma (HCC), the fifth most common cancer in the world, shows increasing incidence worldwide. Curative treatments such as hepatectomy, liver transplantation, and radiofrequency ablation are applied in only 30%-60% of cases. Most remaining patients receive transarterial chemoembolization (TACE). Patients with intermediate-stage HCCs are regarded as good candidates for TACE. However, the intermediate stage includes non-homogeneous patients. Some movements are underway to stratify patients using prognostic factors to identify patient groups exhibiting greater benefit from TACE than other patient groups. This review describes two substaging systems that subclassify intermediate-stage HCCs and discusses the importance of dividing intermediate-stage patients.

Keywords: Hepatocellular carcinoma; Intermediate-stage; Chemoembolization; Child-Pugh score; Prognosis

Core tip: There are movements to divide the intermediate stage of hepatocellular carcinoma (HCC) because of the diversity of intermediate-stage patients. This review describes two substaging systems (Bolondi substaging system and substaging system proposed by Japanese Society of Transcatheter Hepatic Arterial Embolization) that subclassify intermediate-stage HCCs and discusses the importance of dividing intermediate-stage patients.