<![CDATA[Background: Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer, the sixth most common neoplasm, and the third most common cause of cancer death. Because of the lack of screening for HCC, the findings when the patient first arrives are likely to be in the unresectable category according to the Barcelona Clinic Liver Cancer (BCLC) guideline. Several studies reported that liver resection is a potentially curative therapeutic option for HCC even for intermediate/advanced stage. Herein, we present three intermediate-stage HCC cases treated with liver resection beyond BCLC recommendations. Case Presentation: We report three cases of hepatocellular carcinoma (HCC), respectively at the age of 46, 60, and 70 years old, that were classified as unresectable according to the BCLC guideline. All the patients showed Child-Pugh B on preserved liver function. They also represent large tumors and multiple tumors, which are also responsible for being an unresectable criterion. We considered the limitations of therapeutic options, socioeconomic demographics, national health insurance, and the superior outcomes of liver resection from several studies. We tried to go beyond the limitations by choosing liver resection for the unresectable categories. Conclusion: The BCLC criteria for liver resection should be less stringent. Proper identification by a multidisciplinary team for surgical intervention provides the optimal option for extended survival for intermediate-stage HCC. The objective of the treatment is to enhance patient survival while preserving optimal quality of life.]]>
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