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Early HCC Treatment — RACP Adult Medicine MCQ

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EasyMedical OncologyEarly HCC TreatmentRACP Adult Medicine

A 55-year-old man with chronic hepatitis B cirrhosis develops a 3 cm hepatocellular carcinoma. His Child-Pugh score is A, ECOG performance status is 0, and there is no portal vein invasion or extrahepatic spread. According to the BCLC staging system, what is the recommended curative treatment?

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Correct answer: E — Surgical resection or radiofrequency ablation

Explanation lettering: D = shown as B · E = shown as C · C = shown as D · B = shown as E

BCLC stage A (early HCC) – single tumour ≤5 cm or up to 3 tumours each ≤3 cm, Child-Pugh A-B, ECOG 0 – is amenable to curative treatments: surgical resection (preferred for single tumour with preserved liver function), radiofrequency ablation (for tumours ≤3 cm), or liver transplantation (within Milan criteria). This patient with a single 3 cm HCC, Child-Pugh A, and good performance status is an excellent candidate for resection or ablation.

Reference: Cancer Council Australia – 2020 – HCC Guidelines; AASLD – 2023 – HCC Guidelines