Update in management of hepatocellular carcinoma in Eastern population

Table 1 Comparison between treatment algorithms of Asian guidelines for hepatocellular carcinoma and Barcelona Clinic for Liver Cancer staging system

	The HKLC staging system[22]	The JSH guidelines[28]	The APASL guidelines[27]	The BCLC staging system[4]
Parameters included	Performance status	Liver function	Liver function	Performance status
	Liver function	Vascular invasion/metastases	Vascular invasion/metastases	Liver function
	Vascular invasion/metastases	Tumour staging	Tumour staging	Vascular invasion/metastases
	Tumour staging			Tumour staging
Definition of vascular invasion	Extrahepatic vascular invasion: main portal vein and inferior vena cava invasion	Portal vein invasion categorized into Vp1-4	Invasion to hepatic/portal vein branches	Portal vein invasion considered as advanced stage
Definition of tumour staging	3 categories: early, intermediate, locally advanced	Categories according to number and size	3 categories: resectable, non-resectable within Milan criteria, non-resectable exceeding Milan criteria	5 categories: very early, early, intermediate, advanced and terminal stages
Criteria for resection	Early tumour, Child A/B and intermediate tumour Child A	Any resectable HCC	Resection can be considered for number ≥ 4 although TACE is the first choice	Only solitary HCC or 3 nodules < 3 cm are subjected to resection
	Left or right portal vein invasion can be considered for resection		HCC with portal invasion at second or more peripheral portal branch can be considered for resection

HKLC: Hong Kong Liver Cancer; JSH: Japan Society of Hepatology; BCLC: Barcelona Clinic for Liver Cancer; HCC: Hepatocellular carcinoma; TACE: Transarterial chemoembolization; APASL: The Asian Pacific Association for the Study of the Liver.