A 58-year-old man with hepatocellular carcinoma (HCC) has a single tumor of 4 cm within the right hepatic lobe with no vascular invasion, no extrahepatic spread, and Child-Pugh A cirrhosis. ECOG performance status is 0. According to the Barcelona Clinic Liver Cancer (BCLC) staging system, what is the stage and optimal treatment?
- A BCLC Stage A; surgical resection or ablation ✓
- B BCLC Stage 0; radiofrequency ablation
- C BCLC Stage B; transarterial chemoembolization (TACE)
- D BCLC Stage C; sorafenib
Correct answer: A. BCLC Stage A; surgical resection or ablation
Explanation
According to the BCLC staging system, a single HCC >2cm (here 4cm) in a patient with preserved liver function (Child-Pugh A) and good performance status (ECOG 0) is classified as Stage A (early HCC). The recommended curative treatments for BCLC-A HCC are surgical resection, liver transplantation (if meeting Milan criteria), or ablation (radiofrequency or microwave ablation). Resection is preferred in non-cirrhotic livers or well-compensated cirrhosis with adequate future liver remnant. BCLC-B receives TACE, and BCLC-C receives systemic therapy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.