# BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update

Source: https://onco.cc/key-papers/paper-bclc-2022-reig-j-hepatol-2022/  
OnCo record `paper-bclc-2022-reig-j-hepatol-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The 2022 Barcelona Clinic Liver Cancer update refines the staging system that links liver cancer stage to treatment, incorporating immunotherapy as first-line systemic therapy, treatment stage migration and a more nuanced view of intermediate-stage disease.

## Summary

Update of the BCLC staging and treatment algorithm for hepatocellular carcinoma covering very early, early, intermediate, advanced and terminal stages, with revised recommendations for resection, ablation, transplantation, transarterial therapies, and systemic therapy led by atezolizumab-bevacizumab and durvalumab-tremelimumab, plus the concepts of treatment stage migration and untreatable progression.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Journal of Hepatology
- Year: 2022
- DOI: 10.1016/j.jhep.2021.11.018
- Authors: Reig M, Forner A, Rimola J, et al.
- What it means: The BCLC stages used on this site's hepatocellular carcinoma pages and their default treatments follow this update.
- Caveats: Combination of locoregional and systemic therapy for intermediate disease (EMERALD-1, LEAP-012) postdates the update.

## Sources

- J Hepatol 2022: https://doi.org/10.1016/j.jhep.2021.11.018
- PubMed: https://pubmed.ncbi.nlm.nih.gov/34801630/

## Connected records

- cancers: [Advanced hepatocellular carcinoma (BCLC C)](https://onco.cc/cancers/hcc-advanced/), [Early hepatocellular carcinoma (BCLC 0 and A)](https://onco.cc/cancers/hcc-early/), [Intermediate hepatocellular carcinoma (BCLC B)](https://onco.cc/cancers/hcc-intermediate/)

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