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Stage 2

Staging looks at the size of the cancer (tumour) and whether it has spread anywhere else in the body. There are different staging systems doctors can use for liver cancer. The Number staging system is one of these. It divides liver cancer into 4 main stages, from 1 to 4.

Stage 2 liver cancer means that there is a single tumour that is more than 2 cm, and it has grown into blood vessels of the liver.
 

Diagram 1 of 2 showing stage 2 liver cancer

Or it means that there are several tumours in the liver and they are all less than 5cm.
 

Diagram 2 of 2 showing stage 2 liver cancer

Stage 2 liver cancer has not spread to the lymph nodes or other areas of the body.

TNM stages

Doctors may use another staging system called the TNM staging system. 

  • T describes the size of the tumour
  • N describes whether there are cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body (M - for metastasis)

Your doctor gives each letter a number depending on how far the cancer has grown.

Stage 2 liver cancer is the same as T2, N0, M0 in the TNM staging system.

Other staging systems

The Number and TNM staging systems describe the size and position of liver cancer. However, because people with liver cancer often have scarring of the liver (cirrhosis), doctors also need a system that describes how well the liver is working and how well the person is overall (their performance status). Then they can decide what treatment would be best. For this, they use a system such as the Barcelona Clinic Liver Cancer (BCLC) staging system.

Treatment

The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

  • where the cancer is
  • how well your liver is working
  • other health conditions

You might have:

Surgery to remove part of your liver

Depending on the size of the cancer and where it is in your liver, you might be able to have surgery to remove part of your liver (liver resection). The rest of your liver must be healthy.

A liver transplant

In some cases, your doctor may recommend a liver transplant.

You might be able to have a liver transplant if you have:  

  • a single tumour no more than 5cm across
  • a single tumour 5 to 7cm across and has not grown for at least 6 months
  • 3 small tumours, each no larger than 3cm across   

You may have to wait a long time to receive a transplant. You might have other treatments to help control the cancer while you are on the transplant list.

Chemoembolisation (chemotherapy directly into your liver) 

Chemoembolisation is also called trans arterial chemoembolisation (TACE). It means having chemotherapy directly to the area of your liver that contains the cancer and then blocking off the blood supply to the tumour.

You usually have this treatment if you can't have surgery, or to help control the cancer while you are waiting for a liver transplant. In some cases, you may have this treatment to shrink a tumour so that it then becomes small enough to remove with surgery.

Radiofrequency ablation (RFA) and microwave ablation (MWA)

These treatments use heat to destroy cancer cells. You might have ablation treatment if you can't have surgery, or to help control the cancer while you are waiting for a liver transplant.

Other stages

Last reviewed: 
14 Jan 2019
  • AJCC Cancer Staging Manual, 8th edition
    American Joint Committee on Cancer
    Springer, 2017

  • EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
    European Association for the Study of the Liver
    Journal of Hepatology, 2018. Volume 69, Pages 182-236

  • Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    A Vogel and others
    Annals of Oncology, 2018. Volume 29, Supplement 4, Pages 238-255

  • Cancer: Principles and Practice of Oncology (10th edition)
    VT DeVita, TS Lawrence, SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

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