Step 1 — Tumor Characteristics
Enter the available information about the tumor
Estimated BCLC 2025 Stage
Western Tumor Board — Potential Pathways
Based on EASL 2025 + NCCN 2025 + BCLC 2025
Asian Tumor Board — Potential Pathways
Based on CNLC 2024/2025 + Chinese clinical practice
Where East and West Diverge
Treatment Eligibility Assessment
Scenario Simulation (Educational — Not Predictive)
Based on published data — not an individual prediction
Missing Data Affecting Accuracy
❓ Frequently Asked Questions About the HCC Treatment Pathway
The BCLC (Barcelona Clinic Liver Cancer) system is the most widely used staging system for liver cancer. It classifies patients into 5 stages (0, A, B, C, D) based on tumor size, number of tumors, liver function (Child-Pugh), and performance status (ECOG). Each stage has different treatment options. The latest BCLC 2025 version added the CUSE Framework and ALBI Grade for more precise personalization.
Western guidelines (EASL/NCCN/BCLC) tend to favor systemic therapy (Atezolizumab+Bevacizumab) for advanced cases. Asian guidelines (CNLC) favor a more interventional approach including Conversion Therapy (targeted therapy + immunotherapy + TACE/HAIC) to convert unresectable tumors into resectable ones. China conducts the largest number of clinical trials for cellular therapies (CAR-T, TCR-T).
HAIC (Hepatic Arterial Infusion Chemotherapy) is a continuous infusion of chemotherapy through the hepatic artery lasting hours or days. TACE is chemotherapy injection + arterial embolization. HAIC is used more frequently in Asia for PVTT (Portal Vein Tumor Thrombosis) and high tumor burden. Chinese protocols combining HAIC + Lenvatinib + PD-1 show response rates of 60-70%.
Milan Criteria: (1) Single tumor ≤5 cm, or (2) Up to 3 tumors each ≤3 cm, (3) No extrahepatic spread, (4) No vascular invasion. Patients within these criteria have a 5-year survival of 70-80% after transplant. Patients Beyond Milan can achieve Downstaging through therapy and then become eligible for transplant.
Yes. Even BCLC C (advanced) has options: Atezolizumab+Bevacizumab (median survival 19.2 months), Durvalumab+Tremelimumab, Lenvatinib. In Asia: Conversion Therapy can convert 50% of advanced cases to resectable. Clinical trials (CAR-T, TCR-T) offer hope for refractory cases.
Immunotherapy (Atezolizumab+Bevacizumab) is the global first-line standard for advanced HCC (BCLC C). It achieves a 30% response rate and median survival of 19.2 months. Durvalumab+Tremelimumab (dual immunotherapy) is an additional option. Immunotherapy is also used in Asian combination protocols (immunotherapy + targeted therapy + TACE/HAIC).
Conversion Therapy is a treatment strategy aimed at shrinking unresectable tumors so they become eligible for surgical resection. The typical Chinese protocol: Targeted Therapy (Lenvatinib) + Immunotherapy (PD-1) + TACE or HAIC. Success rates reach 50% conversion to curative surgery, with long-term survival.