Table 2.

Factors influencing the use of liver biopsy in hepatocellular carcinoma

1 Poor accuracy of contrast-enhanced methods in the diagnosis of HCC, especially in small lesions

2 The risks of LB, which are more severe in patients with cirrhosis and coagulopathy

3 Inadequate sampling of HCC lesions, especially in cases with very small or very large ones

4 The complex system of staging, treatment, and patient allocation to various therapy regimens (BCLC); the correct assessment of prognosis is important in the allocation of therapy, and is based mainly on pathology data

5 Modern therapies sometimes have limited applicability (transplantation), cost and effectiveness (systemic treatment); information resulting from histological analysis is necessary in order to increase effectiveness and personalize treatment

LB: Liver biopsy; HCC: Hepatocellular carcinoma; BCLC: Barcelona clinic liver cancer staging.