肝细胞癌（HCC）是一个重要的公共卫生问题，其发病率和患病率不断增加，发病率与死亡率之比也很高。 HCC 的预后取决于两个相互竞争的因素，即肿瘤负荷和潜在肝脏疾病的严重程度，这些因素包含在巴塞罗那临床肝癌 (BCLC) 分类中。在缺乏国家 HCC 筛查政策的情况下，评估 HCC 分期以及分期对罗马尼亚首次诊断时的治疗资格的影响。使用前瞻性维护的多中心数据库对诊断时的治疗情况进行分析，该数据库包括 2016 年 6 月至 2020 年 2 月期间来自该国五个最大的三级肝病单位的患者。连续系列包括 477 名患者。 BCLC 类别内的分布如下：极早期 (0) 7.1%、早期 (A) 34.3%、中级 (B) 19.4%、高级 (C) 14.2%、末期 (D) 24.7%。在诊断时，198 人（41.5%）有资格接受治愈性治疗，而 359 人（75.2%）有资格接受疾病缓解治疗。 228 名患者 (47.8%) 在诊断时患有失代偿性肝病，最常见的失代偿事件是腹水 (78.1%)。很大一部分 HCC 病例在发生失代偿事件时被诊断出来，严重限制了治疗潜力。应实施主动诊断策略以提高可行诊断率。

Hepatocellular carcinoma (HCC) is a significant public health issue, with an increasing incidence and prevalence and a high incidence-to-mortality ratio. The prognosis of HCC depends on two competing factors, tumor burden and underlying liver disease severity, encompassed in the Barcelona Clinic Liver Cancer (BCLC) classification. To assess HCC staging and the way staging affects eligibility for treatment at the time of the first diagnosis in Romania in the setting of opportunistic diagnosis, in the absence of a national HCC screening policy.Data regarding HCC staging, underlying liver disease, and eligibility for treatment at the time of diagnosis was analyzed using a prospectively maintained multicentric database, which included patients from the five largest tertiary care hepatology units in the country between June 2016 and February 2020.A consecutive series of 477 patients was included. The distribution within BCLC classes was as follows: very early (0) 7.1%, early (A) 34.3%, intermediate (B) 19.4%, advanced (C) 14.2%, terminal (D) 24.7%. At the time of the diagnosis, 198 (41.5%) were eligible for a curative intent treatment, while 359 (75.2%) were eligible for a disease-modifying therapy. 228 patients (47.8%) had decompensated liver disease at the time of diagnosis, the most common decompensating event being ascites (78.1%).A large proportion of HCC cases are diagnosed at the time of a decompensating event, severely restricting the therapeutic potential. Proactive diagnostic strategies should be implemented to improve the rate of actionable diagnosis.