Case for a Tunisian Adaptation of the CHC Scores

Hepatocellular carcinoma remains one of the most serious complications of cirrhosis, with a prognosis that remains poor despite advances in treatment. The BCLC (Barcelona Clinic Liver Cancer) classification, widely adopted by European and American medical societies, has established itself as the global standard. In Tunisia, it guides our treatment decisions on a daily basis. However, its application in our context raises legitimate questions: Is this classification truly suited to the epidemiological, etiological, and therapeutic characteristics of the Tunisian context? At the same time, the HKLC (Hong Kong Liver Cancer) classification, developed in the Asian context where hepatitis B is prevalent, has demonstrated its superiority in several studies conducted in Asia and Europe. Could its more nuanced criteria and more aggressive treatment algorithm better meet the needs of our patients?