Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Table 7 Criteria for unresectability of HCC

Local tumor invasion

Bilateral hepatic duct involvement up to secondary biliary radicles

Encasement or occlusion of the main portal vein

Unilateral tumor extension to secondary biliary radicles with contralateral portal vein or hepatic artery encasement or occlusion

Hepatic lobar atrophy with contralateral portal vein or hepatic artery encasement or occlusion

Hepatic lobar atrophy with contralateral tumor extension to secondary biliary radicles

Metastatic disease

Lymph node metastases beyond the hepatoduodenal ligament (N2 lymph nodes)1

Distant metastasis (e.g. lung, liver, peritoneal)

¹Peripancreatic, periduodenal, periportal, celiac, or superior mesenteric lymph nodes.