Abstract
Staging for hepatocellular carcinoma (HCC) has been unsatisfactory for many years. Several staging systems have recently been described. Only one, reported by the Cancer of the Liver Italian Program (CLIP) group, has been prospectively internally validated, and validated externally by retrospective studies. There has been no consensus about which of the several systems is appropriate, nor has any system been widely accepted. Staging systems have been reported by groups from Italy, France, Spain, and Hong Kong, as well as international groups. Staging systems reported from Japan have not been published in the peer-reviewed literature, and are therefore not described. Recently, a consensus conference examined the existing staging systems and recommended a two-part staging process. When initially assessing patients with HCC, the CLIP staging system should be used. For those who undergo surgery, once the pathologic specimen is available a second pathologic staging, as described by the American Joint Committee on Cancer, should be used.
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