TABLE 5.

Important changes in Alberta Hepatocellular Carcinoma (HCC) algorithm compared with the original Barcelona Clinic Liver Cancer (BCLC) staging system

BCLC stage	Alberta HCC algorithm changes
0	Potential role of radiofrequency ablation is recognized
A	Superiority of radiofrequency ablation over percutaneous ethanol injection is recognized
	Liver transplant offered for HCC patients with Child-Turcotte-Pugh class C cirrhosis
B	Expanded role for liver transplant in patients beyond Milan criteria
	Transarterial chemoembolization offered to single and multinodular HCC but avoided in portal vein thrombosis
	Transarterial chemoembolization with doxorubicin-emitting beads can be offered to patients with performance status = 1
	Transarterial radioembolization may be alternative to transarterial chemoembolization, especially in patients with portal vein thrombosis
C	Sorafenib therapy only offered to patients with Child-Turcotte-Pugh class A cirrhosis
D	May progress to end stage because of tumour, performance status or liver function