15/03/2026
BCLC strategy for prognosis prediction and treatment recommendations: The 2026 update
The 2026 BCLC update incorporates recent therapeutic advances in HCC into its recommendations, while preserving simplicity. Each disease stage remains directly linked to its evidence-based first-line treatment option. The BCLC algorithm provides guidance for evaluating patient prognosis and proposes a therapeutic strategy according to the current scientific evidence. Tumour boards require structured methodologies to address clinical complexity. Beyond published evidence, decision-making should incorporate biological, psychosocial, and contextual factors that may affect morbidity, feasibility, and patient vulnerability. Such a multidimensional approach ensures treatments remain evidence-based and patient-centred. The updated clinical decision-making chapter embeds the CUSE (Complexity, Uncertainty, Subjectivity, Emotion) framework. CUSE turns unavoidable doubt into a shared, iterative process to: (i) define the therapeutic goal (survival, tumour control, quality of life, etc.); (ii) grade each option, noting evidence strength and gaps; (iii) align choices with comorbidities, feasibility, oncologic risk, and patient values and goals; and (iv) select a plan with regular check-ins as new information or needs arise.
Review by Maria Reig, Marco Sanduzzi-Zamparelli, Alejandro Forner, Jordi Rimola, Joana Ferrer-Fàbrega, Marta Burrel, Ángeles García Criado, Alba Díaz, Neus Llarch, Gemma Iserte, Meritxell Mollà, Robin K. Kelley, Peter Galle, Vincenzo Mazzaferro, Riad Salem, BRUNO SANGRO, Amit G. Singal, Arndt Vogel, Ted Yanagihara, Carmen Ayuso, Ferran Torres and Jordi Bruix
Full text here: https://www.journal-of-hepatology.eu/article/S0168-8278(25)02571-1/fulltext
EASL - The Home of Hepatology
EASL | The Home of Hepatology
