According to the Barcelona Clinic Liver Cancer (BCLC) classification, a patient with a single hepatocellular carcinoma nodule of 4 cm in diameter, preserved liver function (Child-Pugh A), no portal hypertension, and good performance status (ECOG 0) is classified as:

• A BCLC stage B — intermediate, eligible for TACE
• B BCLC stage 0 — very early, ablation only
• C BCLC stage A — eligible for liver transplant only
• D BCLC stage A — eligible for curative therapy (resection or ablation) ✓

Explanation

BCLC stage A includes patients with a single HCC (or up to 3 nodules ≤3 cm each), Child-Pugh A/B liver function, and ECOG performance status 0. A single 4 cm nodule with Child-Pugh A function and no portal hypertension places this patient in BCLC A, eligible for potentially curative therapies including surgical resection, radiofrequency ablation, or liver transplantation (if within Milan criteria). BCLC 0 is reserved for single nodules ≤2 cm. Stage B requires multinodular disease beyond transplant criteria. Transplant is one option, not the only option.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.