Fig. 1.

HCC treatment algorithm of the evidence-based Japan Society of Hepatology (JSH) guideline and distribution of patients with 3 hepatic function assessment tools. ^§ Child-Pugh classification may also be used when nonsurgical treatment is considered. ^† Can be selected for tumors with a diameter ≤3 cm. ^‡ Patients aged ≤65 years. * In some cases, liver resection, chemotherapy, and embolization therapy may be selected for patients with Child-Pugh class A along with vascular invasion, while chemotherapy is recommended for patients with Child-Pugh class A disease with extrahepatic metastasis. TACE, transcatheter arterial chemoembolization; MC, Milan criteria (single lesion ≤5 cm or 2–3 lesions each ≤3 cm); LT, liver transplantation; BSC, best supportive care; MVI, major vessels invasion; EHM, extrahepatic metastasis; ALBI grade, albumin-bilirubin grade.