Clinical calculator summary
Original HKLC-9 (2014)
Clinical calculator summary
Original HKLC-9 (2014)
Nine-category Hong Kong Liver Cancer stage assignment using host status, liver function, vascular/metastatic extent, and exact tumor burden.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original 2014 HKLC-9 stage decision tree without adding treatment or prognosis.
- Population:
- Confirmed HCC at initial or pretreatment assessment with complete vascular evaluation.
- Factors:
- ECOG performance status, Child-Pugh class, EVM, IVI, Tumor count, Largest diameter, Diffuse tumor
- Reference:
- Yau et al. Gastroenterology. 2014;146(7):1691-1700.e3. doi:10.1053/j.gastro.2014.02.032. PMID 24583061.
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Original Hong Kong Liver Cancer Staging System (HKLC-9, 2014)
Clinical Context & Background
This route implements the original Hong Kong Liver Cancer staging system (HKLC-9) reported by Yau et al. in 2014. It is not HKLC-II/2.0 and is not a current-treatment recommender.
The decision tree uses exact ECOG performance status, Child-Pugh class, extrahepatic vascular invasion or metastasis (EVM), intrahepatic venous invasion (IVI), raw tumor count, raw largest diameter, and diffuse-tumor status. IVI means first-order or smaller portal branches or hepatic veins. EVM means main portal trunk or inferior vena cava invasion, or extrahepatic metastasis.
The result is a historical stage assignment only. It does not determine treatment, eligibility, prognosis, transplant candidacy, or whether a contemporary pathway should be followed. Western validation has shown transportability limitations, and later HKLC revisions are outside this source lock.
Formula Logic
Original HKLC-9 decision tree: tumor class from raw count, diameter, diffuse status, and IVI; then stage from ECOG, Child-Pugh, EVM, and tumor class.Reference Data
| HKLC-9 stage | Source decision state | Interpretation boundary |
|---|---|---|
| I | Early tumor class; ECOG 0; Child-Pugh A; no EVM | Historical stage only |
| IIa | Early tumor class without Stage I or poor-host criteria; no EVM | Historical stage only |
| IIb | Intermediate tumor class; Child-Pugh A; ECOG 0-1; no EVM | Historical stage only |
| IIIa | Intermediate tumor class; Child-Pugh B; ECOG 0-1; no EVM | Historical stage only |
| IIIb | Locally advanced tumor class; ECOG 0-1; no EVM | Historical stage only |
| IVa | EVM present; Child-Pugh A; ECOG 0-1 | Historical stage only |
| IVb | EVM present; Child-Pugh B; ECOG 0-1 | Historical stage only |
| Va | ECOG 2-4 or Child-Pugh C; early tumor class; no EVM | Historical stage only |
| Vb | ECOG 2-4 or Child-Pugh C; non-early tumor class or EVM | Historical stage only |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use Original Hong Kong Liver Cancer Staging System (HKLC-9, 2014) when strict stage-only interpretation of the original 2014 nine-category HKLC system for confirmed HCC.
- Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.
How To Interpret
- Interpret the displayed result using the calculator-specific formula and reference table, spanning I through Vb.
- A boundary result should prompt input verification and clinical review rather than false precision.
What To Do Next
- Integrate liver reserve, portal hypertension, tumor burden, vascular invasion, extrahepatic disease, performance status, and transplant policy.
- Document the inputs, result, timing, and clinical context so the assessment can be reproduced.
Limitations
- Liver function, HCC stage, imaging category, and transplant criteria are complementary but not interchangeable.
- The result supports clinician judgment and does not independently determine treatment.
Validated Population
patients undergoing liver-function, hepatocellular carcinoma staging, imaging, or transplant assessment
How to apply this result
For a representative case, verify HKLC-9 applicability, ECOG performance status, Child-Pugh class from a contemporaneous assessment, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through visible production controls at HKLC-9 Stages I, IIIb, and Vb.
- Early, locally advanced, IVI, EVM, and poor-host precedence branches produced the expected historical stage-only results on first submission.
- No unexpected N/A, stale control, literal undefined/null value, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/hklc-hcc-staging-2026-08-03.json.
: Local browser remediation
- The fresh-page declined-applicability submission rendered immediately, and intentional Outside scope/Incomplete assessment results now use an HKLC-specific `stage not assigned` receipt instead of a generic missing-or-invalid-input trace.
- Ten source-backed cases passed through visible local browser controls across 11 submissions, covering all nine HKLC-9 stages, early/intermediate/locally advanced classes, EVM, IVI, poor-host branches, and reset/repeat behavior.
- The existing calculator-specific audit passed 760/760. The prior one-time missing result is consistent with the separately handled startup hydration condition; production revalidation remains pending deployment.
Local case-level remediation evidence is retained in validation/browser-production/hklc-hcc-staging.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 9/10 case records passed their expected-versus-observed assertions across 12 visible submissions.
- Overall browser status: failed-calculation-ui-and-console. high: The first selected `Not confirmed` submission produced no result and no validation message. An immediate identical supplemental reproduction returned the correct N/A / Outside scope disposition. | medium: The reproduced correct Outside scope card also displayed `Required input is missing or invalid`, although the selected scope disposition is complete and intentional. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/hklc-hcc-staging.json.
: Full validation
- 760/760 deterministic source-oracle, boundary, stage-tree, invalid-input, scope, UI, trace, panel parity, registry, report, history, and wording checks passed with zero stage mismatch.
- This is source-to-code implementation verification, not independent clinical validation, treatment advice, prognosis, or transplant eligibility.
: Calculation/input correction
- Replaced favorable defaults, Number coercion, collapsed size/count categories, and treatment-linked fallthrough with an exact ten-own-key immutable contract.
- Restored exact D=5 and N=3 equalities, diffuse tumor handling, IVI/EVM separation, all nine HKLC stages, and ordered poor-host/EVM/tumor-class precedence.
- Added neutral Invalid input, Incomplete assessment, and Outside scope outcomes without assigning a stage.
Included in the current validation report.
: Content reconciliation
- Locked the public identity and dedicated guide to original HKLC-9 (2014), removed direct regimen and prognosis claims, and separated HKLC-II/2.0 and current treatment pathways.
- The liver panel now consumes the canonical HKLC engine with separate raw IVI/EVM fields and canonical Child-Pugh class; the panel remains In review pending orchestration/synthesis verification.
Directly linked English content only.
: Public form simplified
- Combined confirmed HCC, initial/pretreatment timing, and complete vascular/metastatic assessment into one early applicability confirmation.
- Retained all seven stage-determining clinical facts, including separate IVI, EVM, diffuse tumor, raw count, and raw diameter; hidden burden values are cleared for diffuse disease.
- The strict ten-key engine and liver-panel projection are unchanged; 760/760 engine checks and the shared 29/29 compact-adapter batch audit passed.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
When should Original Hong Kong Liver Cancer Staging System (HKLC-9, 2014) be used?
Use it for patients undergoing liver-function, hepatocellular carcinoma staging, imaging, or transplant assessment when all required inputs and the intended clinical setting are confirmed.
Can Original Hong Kong Liver Cancer Staging System (HKLC-9, 2014) determine treatment by itself?
No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.
Evidence-based oncology decision support. Verify with clinical guidelines.