JLE

Hépato-Gastro & Oncologie Digestive

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Usefulness of pronostic scoring systems of hepatocellular carcinoma? Volume 23, issue 3, Mars 2016

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Authors
1 Hôpital Saint Joseph,
service d’hépato-gastroentérologie,
26 Bd Louvain,
13008 Marseille, France
2 Hôpital Européen,
laboratoire Alpha Bio,
département bio-statistiques,
Marseille, France
* Tirés à part

Hepatocellular carcinoma (HCC) therapeutic management is quite complex due to the underlying cirrhosis and portal hypertension. Different classification systems and scores in order to establish a more accurate prognosis and a better guidance for therapeutic management have been published in recent years. However, there is still no “universally” recognized classification. In Europe and the USA, the Barcelona Clinic Liver Cancer (BCLC) staging system has become the reference classification system. It associates stage stratification with a treatment algorithm. BCLC stage B and BCLC stage C HCC includes a broad spectrum of tumors, with only one therapeutic option. In clinical practice, many patients are treated beyond the scope of these recommendations. Some authors propose to extend the indications for surgery to include more advanced HCC and others to expand the scope of indications for transarterial chemoembolization. Prognostic scores that could be applied to any therapeutic modality have been recently proposed. They could be an additional tool to the BCLC staging system by improving the stratification of HCC patients (in clinical trials) and therefore the treatment decision-making process. Prospective studies are needed.