HCC Staging: What is New in INASL Guidelines (2023)
- INASL modification provides improvement over the previous BarcelonaClinic Liver Cancer (BCLC) staging in terms of:
- ALBI (Albumin-Bilirubin) score: It is the further clinical assessment of liver reserve which had documented to influence outcome (prognostication to therapy) - transarterial radioembolization (TARE) for BCLC-A (option) - single lesion >5 cm.
- Categorizing BCLC-B: into three groups (B1, B2, B3) based on results of therapeutic response- included expanded criteria for transplant in B1 (more burden than A).
- Defined treatment stage migration and UTP: to allocate further treatment with a possibility of further benefit.
- Down staging in BCLC-B an option: end point successful - Transplant.
- Systemic therapy: for BCLC B3/ALL BCLC-C - 1st line/2nd line/third line.
Dr. Subrat Kumar Acharya
Dr. Subrat Kumar Acharya is an Executive Director Department of Gastroenterology and Hepatology in Fortis Escorts Hospital, Okla, New Delhi (INDIA). He is a renowned gastroenterologist and liver transplant physician, with distinguished career spans more than 4 decades at the prestigious AIIMS, New Delhi from 2004-16 and has retired as Professor and Head, Department of Gastroenterology. His Areas of expertise include all areas of gastroenterology and liver diseases including transplant hepatology and advanced endoscopy. He did MBBS Berhampur University in 1975, DM (Gastroenterology) from the All India Institute of Medical Sciences(AIIMS), New Delhi in 1980, MD (General Medicine) from Utkal University, Orissa in 1992.
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