Staging of primary liver cancer

Staging Back to top

Generally, primary liver cancer is divided into four stages:

Stage 1

The cancer is small and hasn’t spread into surrounding structures.

Stage 2 or 3

The cancer has spread into surrounding structures.

Stage 4

The cancer has spread to other distant parts of the body.

If the cancer has grown into any major blood vessels in the liver, the cancer cells are able to spread to other parts of the body. If the cancer has spread to distant parts of the body, this is known as secondary (metastatic) cancer.

If the cancer comes back after initial treatment it’s known as recurrent cancer.

Child-Pugh staging system Back to top

Sometimes doctors also want to assess how well the liver is working when primary liver cancer is first diagnosed.

The Child-Pugh staging system looks at:

• the level of bilirubin (old red blood cells) in the blood
• the level of albumin (blood protein) in the blood
• how quickly your blood clots (prothrombin time)
• if there’s any fluid collection in the abdomen (ascites)
• brain function.

The results can help doctors decide what the best treatment options are for you. 

Grading Back to top

The grade of a cancer gives doctors an idea of how quickly it may develop. To find out the grade of your cancer, your doctors will look at a sample of the cancer cells under the microscope.

It may be graded as:

Grade 1 (low grade)

The cancer cells tend to grow slowly, look similar to normal cells (are ‘well differentiated’) and are less likely to spread than higher grade cancers.

Grade 2 (moderate grade)

The cells look more abnormal and grow more quickly than low-grade cancers.

Grade 3 (high grade)

The cancer cells grow quickly, look very abnormal (are ‘poorly differentiated’) and are more likely to spread than low-grade cancers.