Overview of Current Hepatocellular Carcinoma Staging Systems Is There an Optimal System?

Over the last 4 decades, multiple HCC staging systems have been developed, with the aim of guiding treatment and defining prognosis. Because of the heterogeneity of HCC, as well as rapid advances in diagnostic and therapeutic tools, staging algorithms and eligibility criteria are currently more complex. Recent advances in neoadjuvant therapy, downstaging, and adjuvant therapy have come to change some paradigms; however, this has been accompanied by new questions that need to be answered. To date, there is no perfect or universal staging system; however, as evidence advances, models will continue to be refined. Even so, individualized decision making and a multidisciplinary approach will continue to play a key role.

Automated summary

Over the past 40 years, multiple staging systems have been developed for hepatocellular carcinoma (HCC) to guide treatment and determine prognosis. However, the heterogeneity of HCC and advances in diagnostic and therapeutic tools have made staging algorithms and eligibility criteria more complex. Recent advances in neoadjuvant therapy, downstaging, and adjuvant therapy have challenged traditional paradigms but also raised new questions. Although there is no perfect or universal staging system yet, models will continue to be refined as evidence advances. Individualized decision making and multidisciplinary approaches will play key roles in the management of HCC.