Staging

Hepatocellular carcinoma (HCC) is a major global health problem. In the year 2000, HCC was the third leading cause of cancer-related death worldwide, accounting for over half a million deaths (1). The majority of patients with HCC are asymptomatic until the tumor is at an advanced stage. Surveillance programs for patients at risk for HCC can identify individuals with early-stage tumors who, in turn, should be evaluated for curative surgical procedures (e.g., hepatic resection or liver transplantation). Palliative therapies, such as hepatic artery chemoembolization, may be appropriate for patients with advanced disease. Therefore, accurate tumor staging to determine the burden of disease is critical for the management of patients with HCC.