Abdominal Imaging

, Volume 39, Issue 5, pp 1070–1087 | Cite as

TNM/Okuda/Barcelona/UNOS/CLIP International Multidisciplinary Classification of Hepatocellular Carcinoma: concepts, perspectives, and radiologic implications

  • Silvana C. Faria
  • Janio Szklaruk
  • Ahmed O. Kaseb
  • Hesham M. Hassabo
  • Khaled M. ElsayesEmail author
Review Paper


Hepatocellular carcinoma (HCC) is a major health problem worldwide. Moreover, the liver cancer field is evolving rapidly, with early diagnosis, new therapies, and a better understanding of HCC’s biology and development. Accurate staging is important for determining prognosis and selecting the most appropriate treatment for each patient. Surgical intervention remains the most effective treatment for HCC and is the only potentially curative modality. However, in HCC patients, overall survival is also independently affected by underlying liver disease and cirrhosis, which in turn affect the applicability and efficacy of treatment. Although several staging classification and prognostic scoring systems have been proposed for determining the stage and prognosis of HCC, no consensus exists on the best classification method. The most common staging classification systems include tumor-node-metastasis stage, Okuda staging, Cancer of the Liver Italian Program score, Barcelona Clinic Liver Cancer staging classification, the French, the Chinese University Prognostic Index, Japanese Integrated Scoring, and the Tokyo score. Radiologists should be aware of the different staging classification systems for HCC and familiar with the system relevant to their respective referring clinicians, as it will provide pertinent radiological evaluation for multidisciplinary management.


Hepatocellular carcinoma Hepatocellular carcinoma staging BCLC CLIP TNM Okuda 


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Silvana C. Faria
    • 1
  • Janio Szklaruk
    • 1
  • Ahmed O. Kaseb
    • 2
  • Hesham M. Hassabo
    • 2
  • Khaled M. Elsayes
    • 1
    Email author
  1. 1.Department of Diagnostic Radiology, Unit 1473The University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Medical Oncology, Unit 1473The University of Texas MD Anderson Cancer CenterHoustonUSA

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