Liver Cancer Staging
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Cancer Staging
Dr. Timothy McCay explains what the stages of cancer mean and how this information is determined. He also discusses why determining the stage of cancer is critical to treatment planning.
The results of diagnostic tests, which may include blood tests and imaging tests, are summarized into a staging system that rates the progression of the cancer. The American Joint Committee on Cancer (AJCC) TNM system is the most widely accepted method for staging liver cancer. This system bases the staging criteria on the evaluation of the tumor size (T), the involvement of the lymph nodes (N) and whether the cancer has metastasized (M). Other systems have been developed that also take into account other factors, such as the function of the liver. However, the staging guidelines described here are based on the current AJCC TNM system.
TNM Stage Grouping of Liver Cancer
The AJCC TNM system is a method of evaluating three primary factors: T, N and M. Tumors are rated on a numerical scale, 0-4, where higher scores indicate a more severe condition. To describe the involvement of the lymph nodes (N) and the spread of the cancer (M), 1's and 0's are used where "0" indicates there is no observed spread or involvement of the lymph nodes and "1" indicates that cancer has either been found in the regional lymph nodes or elsewhere in the body. The factors are combined into the following stage groupings:
- Stage I Liver Cancer: The primary tumor has not grown into any blood vessels. There is no evidence of any other tumors elsewhere in the liver or body. (Example: T1, N0, M0)
- Stage II Liver Cancer: The primary tumor has grown into the blood vessel, but there are no other tumors. Or, there may be several small tumors, all less than 2 inches (5 cm) in diameter. (Example: T2, N0, M0)
- Stage III Liver Cancer: This stage is grouped depending on how the tumor has grown and spread. Some tumors may be larger than 2 inches. If there are several tumors, or, if one tumor has grown into a portal vein or the hepatic vein, it is categorized as a Stage IIIA liver cancer. Stage IIIB indicates that the cancer has grown into a nearby organ, such as the gallbladder or into the outer covering of the liver. If the lymph nodes are involved, it is considered Stage IIIC. (Example: Any T, N1, M0)
- Stage IV Liver Cancer: The cancer may be any size and has spread beyond the liver to other parts of the body. (Example: Any T, Any N, M1)
Understanding Liver Cancer Staging
Liver cancer can cause damage to the tissues and limit the function of the liver. The AJCC TNM system does not take into account how the function of the liver may have an effect on the patient or the prognosis. The liver provides a very important function for the body, aiding in digesting and detoxification. Reduced liver function could result in severe and even life-threatening conditions. Furthermore, reduced liver function may have implications when choosing treatment options. Some of these staging methods are:
- Barcelona-Clinic Liver Cancer (BCLC) system
- Cancer of the Liver Italian Program (CLIP) system
- Okuda system
Knowing where the cancer is and how much it has grown are important factors to consider when selecting treatment. In some cases, the tumor may be resectable (removable by surgery). However, in many cases, a combination of conventional treatment methods, including radiation and chemotherapy, are used to target liver cancer. Staging is the first step to understanding how to treat the cancer.
At Cancer Treatment Centers of America (CTCA), our Oncology Information Specialists give clear explanations about staging and viable treatment options. Call 800-615-3055 to talk with our Oncology Information Specialists about liver cancer treatment at CTCA. Or, chat online. We're available 24 hours a day, every day.
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