Is it time to reconsider the BCLC/AASLD therapeutic flow-chart?

Tito Livraghi, Giorgio Brambilla, Carlo Carnaghi, Maurizio A. Tommasini, Guido Torzilli

Research output: Contribution to journalArticlepeer-review


Purpose: Recommendations of the Barcelona Clinic Liver Cancer (BCLC) therapeutic flow-chart, endorsed by the American Association for the Study of Liver Diseases (AASLD), are the most applied worldwide. Over recent years, however, several referral centers have questioned some of the BCLC treatment allocations and proposed alternative strategies. The present study plans to review and discuss these suggestions, with the aim to evaluate whether there are well-grounded reasons to reconsider some of the BCLC/AASLD recommendations. Methods: A search was made into the MEDLINE database, focusing on randomized controlled trials, meta-analysis reviews, case-control studies, concordant clinical trials on novel therapies and studies reporting the opinion of respected experts. Their results and conclusions were compared stage by stage with BCLC/AASLD recommendations. Results: I n stage 0 (very early, or single

Original languageEnglish
Pages (from-to)868-876
Number of pages9
JournalJournal of Surgical Oncology
Issue number7
Publication statusPublished - Dec 1 2010


  • Barcelona Clinic Liver Cancer
  • chemoembolization
  • hepatic resection
  • hepatocellular carcinoma
  • intra-arterial therapy
  • liver transplantation
  • molecular targeted therapy
  • percutaneous ablation therapy
  • percutaneous ethanol injection
  • percutaneous radio-frequency ablation

ASJC Scopus subject areas

  • Surgery
  • Oncology


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