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The stages of primary liver cancer

Men and women discussing liver cancer

This page tells you about the number stages of primary liver cancer. You can find the following information

 

A quick guide to what's on this page

The stages of primary liver cancer

The stage of a cancer tells the doctor how far it has grown. It is important because decisions about treatment are often made according to the stage of a cancer. There are different ways of staging cancers. The numbered staging system for primary liver cancer has 4 main stages.

  • Stage 1 means your cancer is a single tumour. There are no cancer cells in the blood vessels, lymph nodes or in any other part of the body
  • Stage 2 means a single tumour may have grown into blood vessels or there may be several small tumours (less than 5cm) in the liver. But the cancer has not spread to your lymph nodes or any other part of your body
  • Stage 3 is divided into 3 further groups – stage 3A, 3B and 3C. Stage 3A means that the tumours are a bit bigger (more than 5cm) but have not spread into the lymph nodes or blood vessels. Stage 3B means that the cancer has spread into one of the main blood vessels of the liver (the portal vein or hepatic vein), but not to any other part of your body. Stage 3C means that the cancer has spread to the area around the liver but not to any other part of the body
  • Stage 4 is divided into 2 further groups – stage 4A and stage 4B. Stage 4A means the cancer has spread to the lymph nodes. Stage 4B means that the cancer has spread to other organs in the body, such as the lungs or bones.

CR PDF Icon You can view and print the quick guides for all the pages in the treating liver cancer section.

 

 

What staging is

The stage of a cancer tells the doctor how far it has grown. It is important because decisions about treatment are often made according to the stage of the cancer. The tests and scans you have to diagnose your cancer will give some information about the stage. Staging shows whether the cancer is contained within the liver or whether it has spread elsewhere.

 

Number stages of liver cancer

When doctors plan treatment for liver cancer they not only have to consider the size of the tumour and if it has spread, but also how well the liver is working. So doctors have developed a number of different staging systems to help with this.

There is information about the TNM and Barcelona Clinic Liver Cancer (BCLC) staging systems and the Child-Pugh system on the next page, and more about staging generally in the about cancer section.

This page describes the 4 number stages of liver cancer. The stage of cancer depends on

  • The size of the tumour
  • Whether the cancer has grown into blood vessels – this is important because it is easier for cancer cells to get into the bloodstream and spread if the tumour is closely involved with the blood vessels
  • Whether cancer has spread to lymph nodes or other organs in the body
 

Stage 1

There is a single tumour and the cancer has not spread to the blood vessels, lymph nodes or any other part of the body.

Diagram showing stage 1 liver cancer

 

Stage 2

At this stage the cancer has not spread to the lymph nodes or any other part of the body. It can be either

  • A single tumour that has grown into blood vessels of the liver

Diagram 1 of 2 showing stage 2 liver cancer

  • Several tumours that are less than 5cm but have not grown into the blood vessels

Diagram 2 of 2 stage 2 liver cancer

 

 

Stage 3

This stage is divided into 3 further groups – stage 3A, 3B and 3C.

Stage 3A
There is more than one tumour, and at least 1 of them is larger than 5cm. At this stage the cancer has not spread to the lymph nodes or any other part of the body. 

Diagram showing stage 3A liver cancer

Stage 3B
The cancer has grown into one of the main blood vessels of the liver (the portal vein or hepatic vein). But cancer cells have not spread into the lymph nodes or to any other part of your body.

Diagram showing stage 3B liver cancer

Stage 3C
The cancer has spread into organs close to the liver (not including the gallbladder), or through the lining that wraps around the internal organs of the abdomen (the visceral peritoneum). It has not spread to lymph nodes or any other part of the body.

Diagram showing stage 3C liver cancer

 

Stage 4

This stage is divided into 2 further stages - stage 4A and 4B.

Stage 4A
The cancer is any size and there may be more than one tumour. It may have grown into blood vessels or the organs around the liver. It has spread to lymph nodes but not to other parts of the body.

Diagram showing stage 4A liver cancer

Stage 4B
The cancer is any size and there may be more than one tumour. It may have grown into blood vessels or the organs around the liver. It may or may not have spread into lymph nodes, but has spread to another part of the body such as the lungs or bones.

Diagram showing stage 4B liver cancer

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Updated: 15 October 2013