Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.406
Peer-review started: August 28, 2014
First decision: November 3, 2014
Revised: November 23, 2014
Accepted: December 3, 2014
Article in press: December 3, 2014
Published online: March 27, 2015
Hepatocellular carcinoma (HCC) is a major health concern worldwide and the third cause of cancer-related death. Despite advances in treatment as well as careful surveillance programs, the mortality rates in most countries are very high. In contrast to other cancers, the prognosis and treatment of HCC depend on the tumor burden in addition to patient’s underlying liver disease and liver functional reserve. Moreover, there is considerable geographic and institutional variation in both risk factors attributable to the underlying liver diseases and the management of HCC. Therefore, although many staging and/or scoring systems have been proposed, there is currently no globally accepted system for HCC due to the extreme heterogeneity of the disease. The aim of this review is to focus on currently available staging systems as well as those newly reported in the literatures since 2012. Moreover, we describe problems with currently available staging systems and attempts to modify and/or add variables to existing staging systems.
Core tip: Hepatocellular carcinoma is a major health concern worldwide with extreme heterogeneity of the disease. This makes it difficult to identify globally accepted staging systems or treatment algorithms for hepatocellular carcinoma. Clinicians should use currently available staging systems or treatment algorithms carefully while understanding their features and limitations.