Metastatic (stage 4) liver cancer

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on June 20, 2022.

Liver cancer, also referred to as hepatic cancer, develops in the tissues of the liver, one of the largest organs of the human body. The liver has a variety of functions, including detoxification, breaking down fats, synthesizing proteins and aiding in digestion.

Metastatic liver cancer, also called stage 4 liver cancer, is an advanced disease that started in the liver but has spread to other parts of the body. By traveling through the lymphatic system or blood vessels, cancerous cells sometimes travel throughout the body, invading new tissues or organs in a process called metastasis.

This article will cover:

What is metastatic liver cancer vs. liver metastases?

Though they are often confused as interchangeable, liver metastases are different from metastatic liver cancer. Liver metastases are cancers that have spread (or metastasized) to the liver from a tumor that started in another part of the body, most commonly the colon or rectum, whereas metastatic liver cancer is cancer that started in the liver and spread (or metastasized) to other areas of the body. The information in this guide is about metastatic liver cancer.

Stage 4 liver cancer symptoms

Liver cancer symptoms often do not appear in the early stages. As a result, liver cancer tends to be diagnosed at a more advanced stage. If the patient has had other diseases of the liver or a family history of liver cancer, he or she has a higher risk of developing liver cancer and should have regular follow-up visits with a doctor. The symptoms of metastatic liver cancer vary depending on where new tumors form. For example, if the liver cancer spreads to the bones, it may cause bone fractures.

Common symptoms of stage 4 liver cancer include:

  • Abdominal pain
  • Pain occurring near the right shoulder blade or in the upper abdomen
  • Loss of appetite, weight loss or nausea
  • Abdominal swelling or bloating in the abdomen
  • Yellowing of the skin and eyes (jaundice)
  • Ongoing fatigue or weakness
  • Unexplained fever

Stage 4 liver cancer substages

Stage 4 liver cancer is classified as substage 4A or 4B. Both classifications refer to a tumor or multiple tumors of any size, and depending on the substage, the treatment options will differ:

  • Stage 4A: The cancer has invaded lymph nodes near the liver, but has not spread to distant locations in the body.
  • Stage 4B: The cancer can be found in distant organs like the bones or lungs.

What to expect

Most liver cancer patients have liver damage that causes the organ not to function properly, which may lead to additional complications. The liver aids in digestion and produces bile, which removes toxins and waste products from the body. For these reasons, when the liver isn’t functioning correctly, the patient may experience severe conditions that may be life-threatening.

Patients with stage 4 liver cancer may experience worsening symptoms such as increasing jaundice, pain, difficulty eating and strong fatigue. Patients should talk to their care teams about ways to manage these symptoms, to help improve their quality of life.

Stage 4 liver cancer treatment options

Once liver cancer spreads and becomes metastatic, it can no longer be treated with surgery because the disease has become so widespread. Instead, chemoembolization, a form of chemotherapy, may be a recommended course of treatment. Targeted therapy may be an option to help slow the tumor's growth. The patient's oncologist will likely also offer therapies focused on easing the symptoms often associated with liver cancer, such as pain, appetite loss and nausea.

Stage 4 liver cancer life expectancy

When liver cancer metastasizes, it most commonly spreads to the lungs and bones. The five-year survival rate for a patient whose liver cancer has spread to surrounding tissue, organs and/or lymph nodes is estimated at 12 percent. The five-year survival rate for a patient whose liver cancer has spread to distant tissue, organs and/or lymph nodes is estimated at 3 percent.

Next topic: What are the stages of liver cancer?

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