Table I.
Subclassification of BCLC B stage hepatocellular carcinoma [Kindai criteria (9)].
| Subclassification | ||||
|---|---|---|---|---|
|
|
||||
| Criteria or clinical strategy | B1 | B2 | B3a | B3b |
| Milan criteria | Beyond | Beyond | Beyond | Beyond |
| Up-to-seven criteria | In | Out | In | Out |
| Child-Pugh score | 5-7 | 5-7 | 8-9 | 8-9 |
| Concept of treatment strategy | Curative | Non-curative, palliative | Curative if within up-to-7 | Palliative, no treatment |
| Treatment option | Resection, ablation, superselective c-TACE | Lenvatiniba | Transplantation, ablation, superselective c-TACE | HAIC, selective DEB-TACE, BSC |
| Alternative | DEB-TACEb, B-TACEc | Sorafeniba, TACE + sorafenib, DEB-TACEd, bland TAE4 followed by MTA | DEB-TACE, B-TACE, HAIC | BSC |
a
Both lenvatinib and sorafenib recommended for patients with liver function of Child-Pugh score 5 and 6;
b
DEB-TACE is recommended for patients with relatively large tumors and Child-Pugh score 7;
c
B-TACE is recommended for fewer tumors;
d
Both DEB-TACE and bland TAE are recommended for huge tumors that are >6 cm (9). BCLC, Barcelona Clinic Liver Cancer; TACE, Transcatheter arterial chemoembolization; c-TACE, Conventional subsegmental lipiodol TACE; HAIC, Hepatic arterial infusion chemotherapy; DEB-TACE, TACE with drug-eluting beads; BSC, Best supportive care; B-TACE, Balloon occluded TACE; MTA, multi-targeted agent.