Role of Liver Function in the Multiparametric Assessment of Hepatocellular Carcinoma

TL;DR

This paper reviews how liver function assessments guide treatment choices for hepatocellular carcinoma, emphasizing the need for a multidisciplinary approach.

Contribution

The paper provides a comprehensive review of liver function metrics and their role in tailoring HCC therapies.

Findings

Liver function assessments like Child–Pugh and MELD are critical for guiding HCC treatment decisions.

Newer metrics such as ALBI grade and liver stiffness measurements enhance individualized care.

A multidisciplinary approach improves outcomes by balancing cancer therapy with liver function preservation.

Abstract

Liver function plays a pivotal role in the management of hepatocellular carcinoma (HCC). Consequently, managing HCC requires a dual focus on both tumour staging and liver function assessment to guide therapeutic decisions. Comprehensive liver function evaluation involves clinical tools such as the Child–Pugh classification and the Model for End-Stage Liver Disease (MELD) score. This is supplemented by newer metrics, including the MELD-Na score, the albumin–bilirubin (ALBI) grade and liver stiffness measurements. These assessments are integral to tailoring treatments, ranging from curative approaches such as surgical resection and liver transplantation to locoregional options (percutaneous ablation, transarterial chemoembolisation and radioembolisation), and systemic therapies. This review explores strategies for balancing the aggressiveness of cancer therapy with the need to preserve hepatic function, particularly in patients with advanced liver dysfunction. A multidisciplinary approach, incorporating expertise from hepatology, oncology, radiology and surgery, is essential for optimising outcomes. Advanced imaging techniques and biochemical markers also improve decision-making and ensure individualised care.