Different stages of liver cancer

Liver cancer occurs due to the abnormal growth of malignant cells in the liver. In most cases, those with chronic liver disease are at a higher risk of developing this type of cancer. Non-alcoholic fatty liver disease and chronic hepatitis C are two of the major disorders that precede liver cancer. This form of cancer can be treated, but treatment depends on the stage of the disease and how far the cancerous cells have spread. Read on to learn more about the stages of liver cancer.

Staging systems for liver cancer
There are multiple staging systems in place to determine the stage of liver cancer. Staging helps determine the prognosis and treatment method for the disease, and different doctors use different staging systems. Here are three well-known liver cancer staging systems:

• The American Joint Committee on Cancer (AJCC) TNM system
• The Barcelona Clinic Liver Cancer (BCLC) staging system
• The Cancer of the Liver Italian Program (CLIP) system
• The Okuda system

Among these, the AJCC TNM system is the most commonly used in the country. According to this system, multiple factors must be considered by doctors to determine the liver cancer stage:

• The size of the tumor
  Doctors need to determine how far cancer has grown and whether there is one or more tumors in the liver. Also, doctors check whether cancer has reached the nearby parts like the veins in the liver. This factor is the T in TNM.
• Spread to nearby lymph nodes
  This involves determining whether cancerous cells have spread to the nearby lymph nodes, and this factor is denoted as N in TNM.
• Metastasis
  This factor determines whether cancer has spread to lymph nodes and organs located away from the liver, like the lungs and bones. This factor is the M in TNM.

Stages of liver cancer
The staging of liver cancer is based on the results of various diagnostic tests like biopsies, physical exams, ultrasound, MRI scans, and CT scans. The following are the stages:

• Stage 1A
  This stage is divided into three groups—T1a, N0, and M0. T1a is when a single tumor 2 cm or smaller is found but hasn’t reached any blood vessels. N0 is when the tumor has not spread to any nearby lymph nodes, and M0 denotes that the cancerous cells have not reached any distant structures.
• Stage 1B
  This stage is categorized into T1b, N0, and M0. T1b is when a single tumor larger than 2 cm is diagnosed, but it has not yet grown into any blood vessels. N0 and M0 denote that the cancerous cells have not yet spread to nearby lymph nodes or any distant organs.
• Stage 2
  There are three categories in this stage. In the T2 category of stage 2 liver cancer, a single tumor larger than 2 cm that has grown into the blood vessels is diagnosed. There can also be multiple tumors, but they are smaller than 5 cm each. N0 and M0 denote the same as in the previous stages.
• Stage 3A
  This stage of liver cancer is grouped into three categories: T3, N0, and M0. In T3, multiple tumors are found, and at least one is larger than 5 cm. N0 and M0 denote the same as in the previous stages of the disease.
• Stage 3B
  This stage has three groups. The first, T4, is where at least one tumor has spread to one of the major branches of a large vein in the liver. The other two categories of this stage—N0 and M0—signify that the disease has not yet spread to the nearby lymph nodes and distant organs, respectively.
• Stage 4A
  This stage comprises groups Any T, N1, and M0. This indicates that one or more tumors have reached the nearby lymph nodes. That said, cancer has not spread to distant organs.
• Stage 4B
  This stage is grouped into three categories: Any T, Any N, and M1. Any T implies the presence of one or more tumors of any size. Any N indicates that cancer might or might not have spread to the lymph nodes nearby. M1 implies that the disease has spread to distant sites.