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 International Union Against Cancer and the American Joint Committee on Cancer have 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 how much 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 to other organs (metastasized) in the body, such as the lungs or bones.

Once your doctor knows your T, N, and M stages, 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 does not invade 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 2.5 inches).

• Stage IIIA. There are many tumors in the liver that are larger than 5 centimeters (approximately 2.5 inches). Or the tumor has spread to a major branch of the portal or hepatic veins.

• Stage IIIB. There are tumors in the liver that have spread to organs next to the liver (other than the gallbladder) or a tumor that has grown into other organs in the abdomen.

• Stage IIIC. Stage IIIC involves any of the above. Also, the tumor has spread to nearby lymph nodes.

• Stage IV. Stage IV involves any of the above, with or without spread to the lymph nodes. Also, the tumor has spread to distant organs of the body, such as the lungs or bones.