What are the stages of liver cancer?

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Staging means finding out how big the cancer is and if it has spread to other parts of your body. 

Many liver cancer specialists use a combination staging system. This describes:

  • The cancer.
  • The condition and function of the liver.
  • How well the person is. 

This will help your medical team to decide what treatment might be of most benefit.

Staging can be hard to understand, so ask your doctor and nurse for more information if you need it.

Barcelona Clinic Liver Cancer (BCLC) staging system.

The BCLC staging system has 5 stages:

Stage 0 − Small tumour less than 2cm. The person is well and has normal liver function.

Stage A − One tumour less than 5cms, or 2-3 smaller tumours. The person is well and has normal liver function.

Stage B − There are many tumours in the liver. The person is well and their liver function is unaffected.

Stage C − The person is not well and their liver function is not good either. The size and number of tumours may vary but the cancer may have spread to nearby blood vessels and/or lymph nodes. It may also have travelled to other parts of the body.

Stage D − There is severe damage to the liver. The person is not well at all and the cancer has spread beyond the liver.

Sometimes your doctor might describe your cancer as stage from 1-4. A higher number, such as stage 4, means a more serious cancer. Some stages are further divided into stage A and B. 

The Child-Pugh system

The Child-Pugh system has 3 classes that describe how well your liver is working (liver function).

Class A: The liver is working normally

Class B: Mild to moderate liver damage

Class C: Severe liver damage

To decide the class, you will have tests such as blood tests, brain function tests and a check for fluid in your abdomen (tummy area). Based on the results, you will get a score that tells the doctor how well your liver is working (class A, B or C).

TNM staging system

  • T is for tumour and this would usually be described from 1-4
  • N is for node. This would either be No meaning no nodes involved or N1 meaning yes lymph nodes are affected by the cancer.
  • M is for metastases. M0 means no metastases (the cancer hasn’t spread). M1 means there are metastases (cancer has spread to other organs). 

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