Staging of primary liver cancer

The stage of a cancer describes its size and whether it has spread from where it first started. Knowing the stage is important. It helps you and your doctors to decide on the best treatment for you.

Doctors may use a number system to stage primary liver cancer (HCC):

Stage 1 – There is one tumour in the liver and the cancer has not spread into any blood vessels in the liver.

Stage 2 – There is one tumour that has spread into a blood vessel. Or there are several tumours but none are bigger than 5cm.

Stage 3 is divided into:

  • 3A – There is more than one tumour and at least one is bigger than 5cm.
  • 3B – The cancer has grown into a major blood vessel in the liver.
  • 3C – The cancer has spread outside the liver into organs nearby (except the gall bladder).

Stage 4 is divided into:

  • 4A – The cancer has spread outside the liver into lymph nodes in that area. Lymph nodes help fight infection. They are sometimes called lymph glands.
  • 4B – The cancer has spread to another part of the body, such as the lungs or bones.

Child-Pugh classification

Doctors will assess how well your liver is working using the Child-Pugh classification system. It gives a score from A to C:

  • A means the liver is working well.
  • C means it is very damaged and is not working well.

The results help doctors decide which treatments are best for your situation. Having certain treatments will depend on how well the liver is able to cope.

Child-Pugh looks at:

  • the level of bilirubin (a waste product of old red blood cells) in the blood
  • the level of albumin (blood protein) in the blood
  • how quickly your blood clots (prothrombin time)
  • whether there is any build-up of fluid in the tummy (ascites)
  • whether liver damage is affecting how the brain is working (encephalopathy).

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