Liver Cancer Overview

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Early Detection, Diagnosis, and Staging TOPICS

Staging of liver cancer

The stage of a cancer is a description of how widespread it is. The stage of a liver cancer is one of the most important factors in looking at treatment options. Not all doctors use the same system to stage liver cancer.

One major system used to describe the stages of liver cancer is the American Joint Committee on Cancer (AJCC) TNM system. Stages are labeled using Roman numerals I through IV (1-4). Some stages are further sub-divided into A and B or even C. For the most part, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more advanced cancer.

The staging systems for most types of cancer depend only on the extent of the cancer, but most patients with liver cancer have damage to the rest of their liver along with their cancer. This means that the liver might not be working as well as it should, which also affects treatment options and the outlook for the patient.

Although the AJCC system defines the extent of liver cancer in some detail, it does not consider liver function. Several other staging systems include both of these factors.

For treatment purposes, doctors often group liver cancers by whether or not they can be entirely cut out. Resectable is the medical term meaning that the cancer can be removed by surgery. For example, if the cancer is in a small part of the liver and if the rest of your liver is healthy, then you might be able to have surgery to remove the cancer. Doctors often call this type of cancer localized resectable.

Sometimes, for various reasons, an earlier-stage cancer cannot be removed by surgery. For example, a person might not have enough healthy liver to remove part of it to get rid of the cancer. These cancers are called localized unresectable.

Cancers that have spread throughout most of the liver or have spread to other organs are called advanced.

Since symptoms of liver cancer often do not appear until the disease is advanced, only a small number of liver cancers are found early enough to be removed with surgery.

Because people with liver cancer often have livers that don’t work well because of cirrhosis, doctors treating liver cancer want to know how well the liver is working. They use a system called the Child-Pugh score, which measures several different substances in the blood, fluid in the belly, and brain function to do this.

Be sure to ask your doctor to explain the stage of your cancer in a way you understand. This will help you both decide on the best treatment for you.


Last Medical Review: 10/07/2013
Last Revised: 02/10/2014