Table 4. Suggested quality indicators for screening, diagnosis, and management of hepatocellular carcinoma.^46,47 .

Indicators

1. All patients should receive surveillance program by an imaging method every 6 months. 2. Diagnosis should be based on standard protocol by high quality triphasic CT or MRI. 3. All patients with HCC should be evaluated according to BCLC staging system 4. Surgical resection for all patients with single lesion with well-preserved liver function (normal bilirubin and hepatic vein pressure gradient < 10 mmHg or platelet more than 100,000) should be considered. 5. Evaluation for liver transplantation for patients with cirrhosis and within Milan criteria should be done. 6. Evaluation and performance of loco-regional therapy for all patients in liver transplantation waiting list should be done, if waiting time is predicted to be more than 6 months. 7. Consideration of radiofrequency ablation or percutaneous ethanol injection in patients with BCLC stage 0-A, who are not eligible for liver transplant or surgery 8. Considering TACE for all patients with BCLC stage B disease 9. Offering sorafenib for all patients who have Child-Pugh Class A disease with HCC stage BCLC class C and cannot benefit from resection, transplantation, ablation or TACE

HCC: Hepatocellular carcinoma, BCLC; Barcelona Clinic Liver Cancer, TACE; Transarterial chemoembolization, CTP; Child-Pugh Class