Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 27, 2015; 7(3): 406-424
Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.406
Staging systems for hepatocellular carcinoma: Current status and future perspectives
Akiyoshi Kinoshita, Hiroshi Onoda, Nao Fushiya, Kazuhiko Koike, Hirokazu Nishino, Hisao Tajiri
Akiyoshi Kinoshita, Hiroshi Onoda, Nao Fushiya, Kazuhiko Koike, Hirokazu Nishino, Division of Gastroenterology and Hepatology, the Jikei University Daisan Hospital, Tokyo 201-8601, Japan
Hisao Tajiri, Division of Gastroenterology and Hepatology, Department of Internal Medicine, the Jikei University School of Medicine, Tokyo 105-0003, Japan
Author contributions: All authors contributed to writing the paper and approved the final draft manuscript.
Conflict-of-interest: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Akiyoshi Kinoshita, MD, Division of Gastroenterology and Hepatology, the Jikei University Daisan Hospital, 4-11-1 Izumihon-cho, Komae- shi, Tokyo 201-8601, Japan. aki.kino@jikei.ac.jp
Telephone: +81-03-34801151 Fax: +81-03-34806688
Received: August 27, 2014
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
Processing time: 216 Days and 1.9 Hours
Abstract

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.

Keywords: Hepatocellular carcinoma; Staging system; Scoring system; Prognosis

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.