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Using the BCLC (Barcelona Clinic liver cancer) score for hepatocellular carcinoma (HCC) staging
BCLC stagerr Performance status (PS) Tumour status, tumour stage Okuda stage
(see below)
Liver function status
Stage A: early HCC  
A1 0 Single, less than 5 cm I No portal hypertension and normal bilirubin
A2 0 Single, less than 5 cm I Portal hypertension and normal bilirubin
A3 0 Single, less than 5 cm I Portal hypertension and abnormal bilirubin
A4 0 3 tumours, less than 3 cm I to II Child-Pugh A-B
Stage B: intermediate HCC 0 Large multinodular I to II Child-Pugh A-B
Stage C: advanced HCC 1 to 2* Vascular invasion or extrahepatic spread* I to II Child-Pugh A-B
Stage D: end stage HCC 3 to 4** Any III** Child-Pugh C**
Stages A and B: all criteria should be fulfilled.
Stage C: at least one criterion; *PS 1-2 or vascular invasion/extrahepatic spread.
Stage D: at least one criterion; **PS 3-4 or Okuda stage III/Child-Pugh C.
Okuda stagerr
  0 points 1 point
Tumour size Less than 50% of liver Greater than 50% of liver
Ascites No Yes
Albumin (g/L) Greater than or equal to 30 Less than 30
Bilirubin (micromol/L) Less than 50 Greater than or equal to 50
Okuda stage I: 0 points.
Okuda stage II: 1 or 2 points.
Okuda stage III: 3 or 4 points.

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29 Mar 2024