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Hong Kong Liver Cancer (HKLC) Staging System

The HKLC staging system classifies hepatocellular carcinoma patients into 5 main prognostic groups and provides treatment recommendations, developed from a Hong Kong cohort of 3,856 HCC patients.

Purpose:
Stage HCC patients and guide treatment selection beyond BCLC criteria
Population:
Patients with hepatocellular carcinoma (HCC) including those with hepatitis B
Factors:
ECOG Performance Status, Child-Pugh grade, Tumour extent (intrahepatic), Extrahepatic vascular invasion/metastasis
Reference:
Yau et al., Gastroenterology 2014
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HKLC Staging System

Clinical Context & Background

The HKLC (Hong Kong Liver Cancer) staging system identifies patients with intermediate and locally advanced HCC who may benefit from more aggressive treatments (Resection or TACE) compared to BCLC recommendations. It classifies patients into 5 main stages (I to IV).
Primary Source EvidenceYau T, Tang VY, Yao TJ, Fan ST, Lo CM, Poon RT. Development of Hong Kong Liver Cancer staging system with treatment stratification for patients with hepatocellular carcinoma. Gastroenterology. 2014;146(7):1691-1700.
Formula Logic
Algorithmic classification based on PS, Child-Pugh, Tumor Size/Number, Vascular Invasion, and Metastasis.

Reference Data

StageDescriptionRecommended Treatment
Stage IEarly (Solitary ≤5cm or 2-3 ≤3cm)Resection / Ablation
Stage IIaIntermediate (Solitary >5cm)Resection
Stage IIbIntermediate (Multinodular)TACE
Stage IIIaLocally Advanced (PS 1 or CP B)TACE
Stage IIIbLocally Advanced (Vascular Inv)TACE (or Resection)
Stage IVaMetastaticSystemic Therapy
Stage IVbTerminal (PS >1 or CP C)Supportive Care

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