ToolsCalculators
Barcelona-Clinic Liver Cancer (BCLC) Staging Classification
Stages HCC and links stage to a treatment strategy.
Barcelona-Clinic Liver Cancer (BCLC) Staging Classification
Child-Pugh class
ECOG performance status
Macrovascular invasion or extrahepatic spread
Tumor burden
ResultBCLC stage 0
Curative local ablation (or resection) for very early single small HCC.
- BCLC stage
- 0
- Typical strategy
- Curative local ablation (or resection) for very early single small HCC.
When to use
- Staging hepatocellular carcinoma and selecting a treatment strategy that links tumor burden, liver function, and performance status.
Formula
Decision rule: Child-Pugh C or ECOG ≥3 → stage D. Else macrovascular invasion/extrahepatic spread OR ECOG 1-2 → stage C. Else (ECOG 0, Child-Pugh A/B, no vascular invasion): single nodule ≤2 cm → stage 0; single >2 cm or 2-3 nodules ≤3 cm → stage A; multinodular beyond up-to-three criteria → stage B.
Pearls and pitfalls
- Stage 0/A/B all require preserved performance status (ECOG 0); any patient with ECOG 1-2 and preserved liver function is classified as stage C regardless of tumor burden or vascular invasion.
- The 2022 update subdivides stage B by tumor burden and liver function to individualize locoregional vs. systemic therapy.
- BCLC is the staging system most widely endorsed by European and US hepatology/oncology guidelines for treatment allocation.