Okuda et al proposed a staging system for primary hepatocellular carcinoma based on clinical, imaging and laboratory findings.
Parameters:
(1) tumor size
(2) ascites
(3) serum albumin
(4) serum total bilirubin
Parameter |
Finding |
Points |
tumor size |
> 50% |
1 |
|
<= 50% |
0 |
ascites |
clinically detectable |
1 |
|
absent |
0 |
serum albumin |
< 3 gm/dL |
1 |
|
>= 3 gm/dL |
0 |
serum total bilirubin |
> 3 mg/dL |
1 |
|
<= 3 mg/dL |
0 |
where:
• 1 indicates "positive", 0 indicates "negative"
• The tumor size in the CT scan is the proportion of the tumor areas in their largest sections relative to the largest cut section of the entire liver.
number of positive findings =
= SUM(points for the 4 parameters)
Interpretation:
• minimum number of findings: 0
• maximum number of findings: 4
Number of Positive Findings |
Clinical Stage |
Median Survival in Months (1984) |
Survival at 2 Years (in 1984) |
0 |
I |
8.1 |
12% |
1 or 2 |
II |
2.1 |
3% |
3 or 4 |
III |
0.7 |
0% |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
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