Japanese Guidelines for Treatment of Hepatocellular Carcinoma

Child-Pugh Score Online Calculator: Link

The algorithm is based on three factors

1. Severity of liver damage (by Child-Pugh score)
2. Number of tumors
3. Diameter of tumors

Based on this algorithm:

• Resection is considered if only one tumor of any size or two-to-three tumors of any size
• Ablation is considered if 1) single tumor of less than 2 cm + Child-Pugh class 'B', 2) two-to-three tumors of equal or less than 3 cm.
• Embolization is considered when 1) 4 or more tumors, 2) two-to-three tumors of > 3 cm
• Interventional radiology Rx is considered in patients with class 'A' or 'B', not class 'C'

Reference:

Kokudo N, Makuuchi M. Evidence-based clinical practice guidelines for hepatocellular carcinoma in Japan: the J-HCC guidelines. J Gastroenterol 2009;44[Suppl XIX]:119-121.