Advertisement

Liver dysfunction in Barcelona Clinic Liver Cancer-2022 update: Clear as day or still in fog?

  • Anshuman Elhence
    Affiliations
    Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    Search for articles by this author
  • Shalimar
    Correspondence
    Corresponding author. Address: Department of Gastroenterology, Room No 127, Human Nutrition Unit, Old OT block, AIIMS, New Delhi, India 110029.
    Affiliations
    Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
    Search for articles by this author
Published:December 23, 2021DOI:https://doi.org/10.1016/j.jhep.2021.12.016
      We read with great interest the article by Reig and colleagues presenting the 2022 update of one of the most used staging systems for hepatocellular carcinoma (HCC), the Barcelona Clinic Liver Cancer (BCLC) staging system.
      • Reig M.
      • Forner A.
      • Rimola J.
      • Ferrer-Fábrega J.
      • Burrel M.
      • Garcia-Criado A.
      • et al.
      BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update.
      The current version is improved over its predecessor, with further stratification of the heterogenous BCLC-B group, the addition of newer immunotherapy options for the BCLC-C group and consideration of liver transplant (LT) as an option for those with tumor burden acceptable for transplant regardless of their liver dysfunction. However, there remains a lot to be desired, especially regarding the use of liver function in BCLC stage allocation and linking the first treatment option to be considered with the current system.

      Keywords

      Linked Article

      • BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update
        Journal of HepatologyVol. 76Issue 3
        • Preview
          There have been major advances in the armamentarium for hepatocellular carcinoma (HCC) since the last official update of the Barcelona Clinic Liver Cancer prognosis and treatment strategy published in 2018. Whilst there have been advances in all areas, we will focus on those that have led to a change in strategy and we will discuss why, despite being encouraging, data for select interventions are still too immature for them to be incorporated into an evidence-based model for clinicians and researchers.
        • Full-Text
        • PDF
      • Reply to: “Correspondence on the <BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update>”
        Journal of HepatologyVol. 76Issue 5
        • Preview
          We appreciate the interest garnered by the BCLC 2022 model update. The new version has incorporated the evidence-based novelties generated in recent years, while also adding a section devoted to clinical decision making at the time of first evaluation and during a patient’s clinical evolution. No clinical practice guideline or recommendation review will ever have enough granularity to firmly recommend the most beneficial approach for an individual patient.
        • Full-Text
        • PDF
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hepatology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Reig M.
        • Forner A.
        • Rimola J.
        • Ferrer-Fábrega J.
        • Burrel M.
        • Garcia-Criado A.
        • et al.
        BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update.
        J Hepatol. 2022; 76: 681-693
        • Johnson P.J.
        • Berhane S.
        • Kagebayashi C.
        • Satomura S.
        • Teng M.
        • Reeves H.L.
        • et al.
        Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach—the ALBI grade.
        J Clin Oncol. 2015 Feb 20; 33: 550-558
        • Paul S.B.
        • Chalamalasetty S.B.
        • Vishnubhatla S.
        • Madan K.
        • Gamanagatti S.R.
        • Batra Y.
        • et al.
        Clinical profile, etiology and therapeutic outcome in 324 hepatocellular carcinoma patients at a tertiary care center in India.
        Oncology. 2009; 77: 162-171
        • Kuzuya T.
        • Katano Y.
        • Kumada T.
        • Toyoda H.
        • Nakano I.
        • Hirooka Y.
        • et al.
        Efficacy of antiviral therapy with lamivudine after initial treatment for hepatitis B virus-related hepatocellular carcinoma.
        J Gastroenterol Hepatol. 2007 Nov; 22: 1929-1935
        • Li N.
        • Lai E.C.H.
        • Shi J.
        • Guo W.-X.
        • Xue J.
        • Huang B.
        • et al.
        A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection.
        Ann Surg Oncol. 2010 Jan; 17: 179-185
      1. Walling AM, Wenger N.Palliative care for patients with end-stage liver disease - UpToDate [Internet]. [cited 2021 Nov 30]. Available from: https://www.uptodate.com/contents/palliative-care-for-patients-with-end-stage-liver-disease.

        • Bajaj J.S.
        • O’Leary J.G.
        • Tandon P.
        • Wong F.
        • Garcia-Tsao G.
        • Kamath P.S.
        • et al.
        Hepatic encephalopathy is associated with mortality in patients with cirrhosis independent of other extrahepatic organ failures.
        Clin Gastroenterol Hepatol. 2017 Apr; 15: 565-574.e4