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Viral Hepatitis

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Okuda Staging System

for Health Care Providers

Okuda Staging System - Liver Cancer

The Okuda Staging System classifies patients into three stages based on the following variables.

CriterionCut-Off
  • *Largest cross-section area of tumor to largest cross-sectional area of liver
Tumor size*> 50% = "+", < 50% = "-"
AscitesClinically detectable = "+"; undectectable = "-"
Serum albumin< 3 g/dl = "+"; > = 3 g/dl "-"
Serum bilirubin>3 mg/dl = "+"; < 3 mg/dl = "-"
StageNumber of Criterion
INo positives
IIOne or two positives
IIIThree or four positives

Adapted from: Okuda K, Ohtsuki T, Obata H, et al. Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patientsLink will take you outside the VA website.. Cancer 1985;56:918-928.