Table 4.
Subclassification and treatment strategy of intermediate-stage HCC according to the Kinki criteria of the BCLC B substage [27]
| BCLC substage | B1 | B2 | B3 | |
|---|---|---|---|---|
| Child-Pugh score | 5–7 | 5–7 | 8–9 | |
| Beyond Milan and within up-to-7 | in | out | any | |
| in | out | |||
| Substage | B3 A | B3 B | ||
| Concept of treatment strategy | curative intent | non-curative, palliative | curative intent if within up-to-7 | palliative, no treatment |
| Treatment option | resection ablation superselective cTACE |
DEB-TACE1 HAIC2 sorafenib3 |
transplantation ablation superselective cTACE |
HAIC selective DEB-TACE |
| Alternative | DEB-TACE (large, Child-Pugh score 7) B-TACE4 |
cTACE | DEB-TACE B-TACE, HAIC |
BSC |
TACE, transarterial chemoembolizatin; DEB-TACE, TACE with drug-eluting beads; cTACE, conventional TACE; BSC, best supportive care.
1
DEB-TACE is recommended for very large tumours of >6 cm.
2
HAIC (hepatic arterial infusion chemotherapy) is recommended for multiple tumours of >6 cm.
3
Sorafenib is recommended for patients having liver function with a Child-Pugh score of 5 and 6.
4
B-TACE (balloon-occluded TACE) is recommended when there are fewer tumours.