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Stage 3

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 3 liver cancer is divided into 2 further stages - stage 3A and 3B.

Stage 3A

There is more than one tumour, and at least one 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). 
 

Diagram showing liver cancer growing into a blood vessel

Or 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 the lymph nodes or any other part of the body.

Diagram showing liver cancer growing into a nearby organ

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 3A is the same as T3, N0, M0 in the TNM staging system. Stage 3B is the same as T4, N0, M0.

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:

Chemoembolisation (TACE)

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.

Radiofrequency ablation (RFA and microwave ablation (MWA)

These treatments use heat to destroy cancer cells in the liver. You can have ablation to treat more than one liver tumour.

Targeted cancer drugs 

Targeted cancer drugs work in different ways to control a cancer. This includes stopping signals that tell cancer cells to divide and grow, and stopping cancer cells from growing new blood vessels (which they need to keep growing).

A targeted cancer drug doctors most often use for primary liver cancer is sorafenib.

Other stages

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

  • 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

  • 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

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

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