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BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update
Open accessAbstract
There have been major advances in the armamentarium for hepatocellular carcinoma (HCC) since the last official update of the Barcelona Clinic Liver Cancer prognosis and treatment strategy published in 2018. Whilst there have been advances in all areas, we will focus on those that have led to a change in strategy and we will discuss why, despite being encouraging, data for select interventions are still too immature for them to be incorporated into an evidence-based model for clinicians and researchers. Finally, we describe the critical insight and expert knowledge that are required to make clinical decisions for individual patients, considering all of the parameters that must be considered to deliver personalised clinical management.
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Lanza, C., Ascenti, V., Amato, G. V., Pellegrino, G., Triggiani, S., Tintori, J., Intrieri, C., Angileri, S. A., Biondetti, P., Carriero, S., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14020314 · Cited by 42
“Despite these developments, guidelines like the BCLC, AASLD, EASL, ESMO, and APASL recommend TACE over HAIC for HCC [9,98].”
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Katariya, N., Lizaola‐Mayo, B., Chascsa, D. M. H., Giorgakis, E., Aqel, B. A., Moss, A. A., Usón, P. L. S., Borad, M. J., & Mathur, A. K. (2022) · Cancers · doi:10.3390/cancers14092056 · Cited by 41
Shi, Z., Duan, Y., Cui, F., Wu, Z.-J., Li, M.-P., Song, P., Peng, Q., Ye, W.-T., Yin, K.-L., Kang, M., et al. (2023) · Journal of Experimental & Clinical Cancer Research · doi:10.1186/s13046-023-02716-y · Cited by 43
“However, RFA is not favored in cases with tumors larger than 2 cm, as this group has a lower rate of complete response and a higher recurrence rate than the group with smaller tumors [10].”
BackgroundBergamini, C., Leoni, I., Rizzardi, N., Melli, M., Galvani, G., Coadǎ, C. A., Giovannini, C., Monti, E., Liparulo, I., Valenti, F., et al. (2023) · Journal of Experimental & Clinical Cancer Research · doi:10.1186/s13046-023-02718-w · Cited by 42
“Despite the combination of atezolizumab with bevacizumab is currently the first choice first-line treatment [61], not all patients can benefit from immunotherapy and, in the latter cases, sorafenib and lenvatinb represent the first line treatments of choice [62].”
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HCC-Related lncRNAs: Roles and Mechanisms
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“Additionally, targeted therapies, including tyrosine kinase inhibitors (TKIs), like sorafenib and lenvatinib, continue to be integral in systemic HCC treatment [16].”
BackgroundEmerging role of molecular diagnosis and personalized therapy for hepatocellular carcinoma
Wang, M.-D., Diao, Y., Yao, L., Fan, Z., Wang, K.-C., Wu, H., Gu, L., Xu, J., Li, C., Lv, G., et al. (2024) · iLiver · doi:10.1016/j.iliver.2024.100083 · Cited by 42
“Moreover, HCC often develops in the context of chronic liver disease, which further complicates the management of this malignant tumor [5,6].”
Artificial intelligence in interventional radiology: Current concepts and future trends
Lesaunier, A., Khlaut, J., Dancette, C., Tselikas, L., Bonnet, B., & Boeken, T. (2024) · Diagnostic and Interventional Imaging · doi:10.1016/j.diii.2024.08.004 · Cited by 50
Complete Response to Locoregional Therapy Plus Immunotherapy for Hepatocellular Carcinoma
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Shuen, T. W. H., Alunni‐Fabbroni, M., Öcal, E., Malfertheiner, P., Wildgruber, M., Schinner, R., Pech, M., Benckert, J., Sangro, B., Kuhl, C. K., et al. (2022) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-22-0569 · Cited by 41
Self-citationAngiogenesis and Hepatocellular Carcinoma: From Molecular Mechanisms to Systemic Therapies
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“IATs are the most widely used treatment for unresectable HCC, being the recommended first-line therapy for patients with intermediate-stage disease [72,73].”
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Hepatocellular Carcinoma in Non-alcoholic Fatty Liver Disease: Current Progresses and Challenges
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Critical Analysis of the Updated Barcelona Clinic Liver Cancer (BCLC) Group Guidelines
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Contrast-enhanced ultrasound-based AI model for multi-classification of focal liver lesions
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Provision of Interventional Radiology Services 2023
Morgan, R., Haslam, P. J., McCafferty, I., Bryant, T., Clarke, C. G. D., McPherson, S. J., Wells, D., Gupta, Y., See, T. C., Lakshminarayan, R., et al. (2023) · CardioVascular and Interventional Radiology · doi:10.1007/s00270-023-03600-0 · Cited by 38
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Current Trends in Surgical Management of Hepatocellular Carcinoma
Angeli‐Pahim, I., Chambers, A., Duarte, S., & Zarrinpar, A. (2023) · Cancers · doi:10.3390/cancers15225378 · Cited by 40
“Overall, minimally invasive procedures reduce surgical stress, improve patient recovery, and should be considered whenever feasible [5].”
BackgroundMethodInfluentialZhao, H., Ling, Y., He, J., Dong, J., Mo, Q., Wang, Y., Zhang, Y., Hongbin, Y., & Tang, C. (2024) · Drug Resistance Updates · doi:10.1016/j.drup.2024.101084 · Cited by 38
Metadata
- Authors
- Reig, M., Forner, A., Rimola, J., Ferrer-Fàbrega, J., Burrel, M., Garcia-Criado, Á., Kelley, R. K., Galle, P. R., Mazzaferro, V., Salem, R., Sangro, B., Singal, A. G., Vogel, A., Fuster, J., Ayuso, C., & Bruix, J.
- Affiliations
- Hospital Clínic de Barcelona (ES)
- University of California, San Francisco (US)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- University of Milan (IT)
- Northwestern University (US)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (ES)
- The University of Texas Southwestern Medical Center (US)
- Medizinische Hochschule Hannover (DE)
- Corresponding author
- Bruix, Jordi
- ORCID
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2022-03
- Volume
- 76
- Issue
- 3
- Pages
- 681-693
- ISSN
- 0168-8278 (ISSN-L)
- PMC
- PMC8866082
- OpenAlex
- W3213277274
- Cited by
- 4,319
- References
- 136
- Citations by year
- 2026: 684 · 2025: 1071 · 2024: 1166 · 2023: 962 · 2022: 424
- FWCI
- 83.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Fundación Científica de la Asociación Española Contra el Cáncer (PI044031)
- National Institutes of Health (R01 R01 MD012565, PI18/00768)
- Horizon 2020 Framework Programme (952103)
- Instituto de Salud Carlos III (AC16/00065, PI18/0358, PI15/00145, PI18/00542, PI19/00742, PI18/00768)
- European Association for the Study of the Liver
- Horizon 2020
- Topics
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
- Health Sciences › Medicine › Oncology › Renal cell carcinoma treatment
- Keywords
- hepatocellular carcinoma, Barcelona Clinic Liver Cancer staging, outcome prediction, treatment guidelines, evidence-based clinical decision-making
- MeSH terms
- Female, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Male, Middle Aged, Neoplasm Staging, Prognosis, Severity of Illness Index
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