Diagnosis, the Barcelona Clinic Liver Cancer (BCLC) staging system, tumor node metastasis (TNM) staging, and treatment of HCC

HCC was diagnosed by a combination of tests for serum tumor makers, such as alpha-fetoprotein and des-γ-carboxy prothrombin, and imaging procedures, such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and angiography, or a tumor biopsy (27). We evaluated the clinical stage of HCC using the Barcelona Clinic Liver Cancer (BCLC) staging system (27) and TNM staging based on the Liver Cancer Study Group of Japan criteria (28). We treated the patients according to clinical practice guidelines for HCC of The Japan Society of Hepatology (29).