Figure 1.

Modified BCLC staging system considering effective therapies in advanced stages (modified and updated from European Association for the Study of the Liver (EASL) guidelines). Management of patients with HCC is guided by the BCLC staging system, which takes into account both tumor extent and the severity of the underlying liver disease and defines 5 prognostic subgroups with respective treatments. Treatment for early-stage tumors is with curative intent, and options include RFA, hepatic resection, and liver transplantation. Patients with intermediate or advanced HCC are candidates for chemoembolization or systemic therapies, respectively. *Patients with end-stage liver disease if Child-Pugh class C should first be considered for liver transplantation. **Patients with preserved hepatic function Child-Pugh class A with normal bilirubin and no portal hypertension are optimal candidates for hepatic resection. ‡Atezolizumab plus bevacizumab has been approved as a new first-line treatment for advanced HCC. Nonetheless, sorafenib and lenvatinib are still considered first-line options when there is a contraindication for the combination treatment. Abbreviations: DDLT, deceased donor liver transplantation; LDLT, living donor liver transplantation; M1, distant metastasis; N1, lymph node metastasis.