BCLC

Barcelona Clinic Liver Cancer staging

Stages hepatocellular carcinoma by tumor burden, liver function, and performance status to guide treatment and prognosis.

vigenteBarcelona Clinic Liver Cancer group2022CT, MRI, US

Fonte primária 5 categorias

0Stage 0, very early AStage A, early BStage B, intermediate CStage C, advanced DStage D, terminal

Aplicar o BCLC a um achado

Descreva o achado como no laudo. A resposta aponta uma das categorias publicadas, com a probabilidade e o trecho que a decide.

Categorias

Reescritas a partir da fonte e citadas

1 de 5

Stage 0, very early

Very early stage: a single tumor up to 2 cm, no vascular invasion or extrahepatic spread; preserved liver function (Child-Pugh A) and ECOG performance status 0.

CondutaAblation (radiofrequency or microwave) is the usual first option; resection where feasible, and liver transplantation in selected candidates.

RiscoBest prognosis: median survival exceeds 5 years.

verificadoBCLC strategy for prognosis prediction and treatment recommendation: The 2022 updatePMC8866082 (Reig et al., J Hepatol 2022), BCLC 2022 algorithm/summary and treatment-strategy section; criteria corroborated by NCBI Bookshelf NBK569796 BCLC staging table (single <=2 cm, CP A, PS 0).

2 de 5

Stage A, early

Early stage: a solitary tumor of any size, or up to 3 nodules each up to 3 cm, with no macrovascular invasion or extrahepatic spread; preserved liver function (Child-Pugh A-B) and ECOG performance status 0.

CondutaCurative options: resection (preferred without clinically significant portal hypertension), ablation for tumors up to 3 cm, or transplant when high recurrence-risk pathology is present.

RiscoFavorable prognosis: median survival exceeds 5 years.

verificadoBCLC strategy for prognosis prediction and treatment recommendation: The 2022 updatePMC8866082, BCLC 2022 algorithm and treatment-strategy section; criteria corroborated by NBK569796 table (single, or <=3 nodules <=3 cm, CP A-B, PS 0).

3 de 5

Stage B, intermediate

Intermediate stage: multinodular hepatocellular carcinoma exceeding early-stage limits, without macrovascular invasion or extrahepatic spread; preserved liver function and ECOG performance status 0.

CondutaTransarterial chemoembolization is the reference treatment when liver function is preserved; transplant under extended criteria for selected patients, and systemic therapy for extensive or diffuse bilobar disease unsuitable for chemoembolization.

RiscoMedian survival around 2.5 years.

4 de 5

Stage C, advanced

Advanced stage: macrovascular (portal) invasion and/or extrahepatic spread; preserved or compensated liver function (Child-Pugh A-B) and ECOG performance status 1-2.

CondutaFirst-line systemic therapy: atezolizumab plus bevacizumab is the first choice; tremelimumab plus durvalumab, sorafenib, or lenvatinib are alternatives.

RiscoMedian survival around 2 years.

verificadoBCLC strategy for prognosis prediction and treatment recommendation: The 2022 updatePMC8866082, systemic-therapy section; criteria corroborated by NBK569796 table (vascular invasion or extrahepatic spread, CP A-B, PS 1-2).

5 de 5

Stage D, terminal

Terminal stage: end-stage liver function (Child-Pugh C, not transplant-eligible) and/or ECOG performance status 3-4 or major cancer-related symptoms; any tumor burden.

CondutaBest supportive and symptomatic care with palliative-care coordination.

RiscoPoor prognosis: median survival around 3 months.

verificadoBCLC strategy for prognosis prediction and treatment recommendation: The 2022 updatePMC8866082, treatment-strategy section; criteria corroborated by NBK569796 table (any tumor, CP C, PS 3-4).

Lógica de decisão estruturada

{
  "categories": [
    "0",
    "A",
    "B",
    "C",
    "D"
  ]
}

Referência, não é dispositivo médico. Confira a publicação primária vigente. O radiologista que assina o laudo continua autor e responsável.