Figure 5:

Flowchart shows proposed update to the Barcelona Clinic Liver Cancer (BCLC) classification. This figure is based on the original BCLC classification and has been modified by adding the enhancing tumor volume (ETV) threshold of 65 cm³ and enhancing tumor burden (ETB) threshold of 4% (yellow box), which precisely stratifies patients with BCLC B and C tumors and potentially improves patient survival and outcome after transarterial chemoembolization. BSC = best supportive care, HCC = hepatocellular carcinoma, PS = performance status. ¹ Liver function defined by Child-Pugh score and class; ³ Candidacy for resection determined by clinical parameters and co-morbidities; ⁴ Therapy determined by multi-disciplinary tumor board; ⁵ Multiple first- and second-line systemic therapy options as outlined by the BCLC 2022 update.