About the staging of liver cancer
The stage of 
liver cancer tells you how big it is and whether it has spread to other parts of the body. This helps your doctor recommend the best treatment for you. You have tests after being diagnosed to help stage your cancer.
Primary liver cancer is different to cancer that spreads to your liver from somewhere else in your body. This is called secondary liver cancer or liver metastases.
Staging systems for liver cancer
There are different staging systems your doctor can use for :
- BCLC strategy and Child-Pugh system
- TNM staging system
- number staging system
BCLC strategy and Child-Pugh system
Doctors often use the Barcelona Clinic Liver Cancer (BCLC) staging system to help make treatment decisions for HCC. This system looks at the number and size of liver tumours, as well as how well your liver is working, your general health and your cancer related symptoms.
When deciding on treatment your doctor has to think about how well your liver is working. This is especially the case if you have liver damage (cirrhosis). Doctors use the Child-Pugh system and other blood tests and scans to score how well your liver is working. Unfortunately, people with severe liver damage may be too unwell to have treatment for their cancer.
TNM staging
The TNM staging system stands for tumour, node and metastases.
- T describes the size of the tumour (cancer) and if there is more than one tumour in the liver
- N describes whether there are any cancer cells in the
lymph nodes - M describes whether the cancer has spread to a different part of the body
Your doctor gives each letter (T, N and M) a number, depending on how far the cancer has grown.
The tests and scans you have to diagnose your cancer give some information about the stage. But your doctor may not be able to tell you the exact stage until after your surgery, if you are able to have it.
Number staging system
The number staging system divides liver cancer into 4 main stages, from 1 to 4. Stage 1 is an early cancer. Stage 4 is advanced, which means the cancer has spread to the lymph nodes or another part of the body.
Whether your cancer can be removed with surgery
Your doctor might also classify liver cancer depending on whether they can remove it (resectable) or not (unresectable).
Surgery to remove cancer that is only in the liver includes removing part of the liver (resection) or a liver transplant. If you can’t have surgery, you may have other treatments to help control the cancer.
