Importance of critical tumor features in multidisciplinary multi-parametric assessment of HCC

Abstract

Hepatocellular carcinoma (HCC) is a complex malignancy that necessitates a multidisciplinary approach to optimize diagnosis, treatment, and management. The Barcelona Clinic Liver Cancer (BCLC) staging system remains a cornerstone for clinical decision making, yet its real-world application often requires a more personalized strategy. A multi-parametric framework integrating tumor morphology, biological markers, imaging characteristics, and inflammatory responses has gained traction in refining therapeutic selection. Key factors such as tumor location, size, and vascular involvement critically impact treatment feasibility and efficacy. Biomarkers like alpha-fetoprotein (AFP) provide prognostic value, while novel markers such as des-gamma-carboxy prothrombin (DCP) enhance risk stratification for curative therapies. Inflammation-based indices, including neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, contribute to recurrence and survival predictions. Advanced imaging modalities, such as positron emission tomography (PET), offer valuable insights into tumor biology and treatment response, guiding both surgical and non-surgical interventions. Despite its promise, implementing this multi-parametric, patient-tailored approach in clinical practice presents challenges, including variability in biomarker reliability, accessibility of advanced imaging, and the need for interdisciplinary coordination. Overcoming these limitations requires seamless collaboration among hepatologists, oncologists, radiologists, and surgeons to integrate diverse data streams into cohesive treatment algorithms. By leveraging individualized, data-driven strategies, this evolving paradigm aims to improve patient outcomes and advance precision medicine in HCC care.

Keywords

Hepatocellular carcinoma / barcelona clinic liver cancer / tumor markers / alpha-fetoprotein / des-gamma-carboxy prothrombin / inflammation-based indices / neutrophil-to-lymphocyte ratio / positron emission tomography

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