Liver Cancer Overview

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Early Detection, Diagnosis, and Staging TOPICS

How is liver cancer staged?

Staging is the process of finding out how widespread the cancer is when it is found. The stage of a liver cancer is an important factors in looking at treatment options. It also can help predict outlook for survival. 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). 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. Some stages are further sub-divided into A and B or even C.

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.

  • If you are healthy enough to have surgery and the cancer is resectable the cancer is called potentially resectable
  • If the cancer is small enough to be treated by liver transplant it is called potentially transplantable.
  • If the cancer cannot be removed by surgery but hasn’t spread outside the liver, it is called unresectable.
  • If the cancer would be resectable but the patient isn’t healthy enough for surgery (and can’t get a liver transplant), it is called inoperable with only local disease.
  • Cancers that have spread outside the liver to lymph nodes or other organs are called metastatic or advanced.

Because people with liver cancer often have livers that don’t work well because of cirrhosis, the doctors treating your liver cancer will need to know how well the rest of your 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.

If you have liver cancer, ask your doctor to explain its stage in a way that you understand. This can help you take a more active role in making informed decisions about your treatment.


Last Medical Review: 11/19/2014
Last Revised: 12/09/2014