Okuda staging system for hepatocellular carcinoma

Criteria	Positive	Negative
Tumor size*	>50%	<50%
Ascites	Clinically detectable	Clinically absent
Albumin	<3 g/dL	>3 g/dL
Bilirubin	>3 mg/dL	<3 mg/dL
Stage
I	No positive
II	One or two positives
III	Three or four positives

The Okuda system is commonly used for staging hepatocellular carcinoma. Survival correlates with the Okuda stage in untreated patients (8.3, 2.0, and 0.7 months for stages I, II, and III, respectively).

* Largest cross-sectional area of tumor to largest cross-sectional area of the liver.

Adapted from: Okuda K, Ohtuiki T, Obata H, et al. Cancer 1985; 56:918.

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