ABSTRACT
Assigning a specific prediction of survival to any patient with HCC is difficult under the best of circumstances. The nature of the disease, the underlying liver function, the performance status of the patients as well as the misleading conclusions with which the relevant literature is replete, all impart their own uncertainty to any survival calculation. The choice of an appropriate staging algorithm can minimize this prognostic inaccuracy and should include a suitable staging system, relevant independent prognostic variables, patient s performance status, comorbid conditions and planned treatment. Furthermore, these factors are interdependent as the choice of a staging system for example depends partly on the planned treatment and/or extent of underlying liver disease. For a physician to be able to provide a patient with a meaningfixl prog nosis, he must be familiar with the literature regarding the most popular staging systems, be able to critically evaluate each paper and know the limitations of each system. He must also be able to incorporate independent prognostic factors in his calculations as well as the expected outcomes of the proposed treatment. There is no such thing as “the best HCC staging system”. A system valid for one patient may be invalid for another thus the staging algorithm must be tailored to each specific patient, disease and treatment combination.
