Workup steps (8)

• 1lab Alpha-fetoprotein (serum)
  Diagnostic + prognostic + monitoring biomarker for HCC.
• 2imaging CT chest + abdomen + pelvis with IV contrast
  CRC staging — detects nodal and distant (liver, lung, peritoneal) metastases.
• 3lab Liver Function Tests
  Assess hepatic function — baseline + during BR cycles + DAA therapy + HBV reactivation monitoring.
• 4consult Child-Pugh classification calculation
  Composite of bilirubin + albumin + INR + ascites + encephalopathy → A (5-6) / B (7-9) / C (10-15). Determines HCC therapy eligibility.
• 5lab Complete Blood Count with Differential
  Baseline cytopenia assessment and ongoing monitoring of myelosuppression.
• 6imaging Esophagogastroduodenoscopy with varices assessment
  Mandatory pre-atezo+bev screening for varices in HCC + cirrhosis. High-risk varices need ligation/banding before initiation.
• 7lab Hepatitis B Serology Panel
  Mandatory before any anti-CD20 therapy or rituximab-containing regimen — identify HBV reactivation risk.
• 8lab HCV Antibody (Anti-HCV)
  Скринінг на HCV. Якщо позитивний → confirm з HCV RNA quantitative (TEST-HCV-RNA). Mandatory для лімфомного workup (HCV-associated MZL, B-cell lymphomas) і перед anti-CD20.

MDT brief