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SEMINARS IN LIVER DISEASE-VOL. 19, NO. 3, 1999
Prognosis of Hepatocellular Carcinoma:
The BCLC Staging Classification
JOSEP M. LLOVET, M.D., CONCEPCIO BRU, M.D.,
and JORDl BRUIX, M.D.
ABSTRACT The classifications of hepatocellular carcinoma (HCC) currently used are bused on prognostic fac-
tors obtained from studies performed years ago when most tumors were diagnosed at advanced stages and the sur-
vival rates were substantially poor. Recent investigations have reviewed the survival of early tumors properly se-
lected to receive radical therapies and the natural outcome of nonsurgical HCC patients. These data enable a new
staging system to be proposed, the Barcelona Clinic Liver Cancer (BCLC)staging classification, that comprisesfour
stages that select the best candidates for the best therapies currently available. Early stage ( A )includespatients with l.
a
i
~rsymptomaticearly tumors suitable for radical therapies-resection, transplantation or percutaneous treatments. r
e
t
Intermediate stage ( B ) comprises patients with asympto
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