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Understanding the Grade and Stage of Liver Cancer

Understanding the Grade and Stage of Liver Cancer

When you are diagnosed with liver cancer, your doctor needs to know the stage of the disease. The stage tells how much and how far the disease has spread. The cancer's stage is one of the most important factors in deciding the best treatment.

The American Joint Committee on Cancer has developed a standard method to determine how much a cancer has grown. This method is known as the TNM system.

Here is what the letters mean in the TNM system:

  • T shows to what extent a tumor has spread inside the liver and nearby areas.

  • N indicates whether the lymph nodes in the area of the original tumor are cancerous.

  • M indicates whether the cancer has spread (or metastasized) to other organs in the body, such as the lungs or bones.

Once your doctor knows your T, N, and M status, he or she uses this information to put together your stage grouping. Stage grouping is used to determine your overall disease stage. Stage grouping is shown in Roman numerals from I (the earliest stage) to IV (the most advanced stage).

  • Stage I. There is a single mass in the liver that has not spread to any blood vessels.

  • Stage II. There is a single mass in the liver that has invaded blood vessels. Or there are multiple tumors in the liver, but they are less than 5 centimeters (approximately 2 inches) in width.

  • Stage IIIA. There are many tumors in the liver and at least one is larger than 5 centimeters (approximately 2 inches). None of the tumors has spread to the lymph nodes or to areas outside of the liver. 

  • Stage IIIB. The cancer has spread to one of the main blood vessels in the liver (the portal or hepatic veins), but it has not reached the lymph nodes or other organs. 

  • Stage IIIC. There are tumors that have spread to nearby organs (other than the gallbladder which lies directly underneath the liver) or at least one tumor has extended into the outer layer of tissue that covers the liver. The cancer has not spread to the lymph nodes or distant organs. 

  • Stage IVA. Tumors of any size have spread into lymph nodes near the liver. The cancer has not yet reached distant organs.

  • Stage IVB. The tumor has spread to distant organs, such as the lungs, bones, or brain. Invasion into nearby blood vessels and lymph nodes may or may not be evident. 

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