Stage 1 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.
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
Doctors use different systems to stage liver cancer. This page is about stage 1 cancer, which is part of the number staging system. This system has 4 stages, stage 1 to stage 4.
This page also tells you what stage 1 means in the TNM system. This system describes:
- the size of the primary tumour (T)
- whether the cancer has spread to the
lymph nodes (N) - whether the cancer has spread to another part of the body (M)
What is stage 1 liver cancer?
Stage 1 liver cancer has not spread to the lymph nodes or anywhere else in the body. It is divided into stage 1A and stage 1B.
Stage 1A means there is a single tumour in the liver that is 2cm or less, and it has not grown into the blood vessels. This is the same as T1a, N0, M0 in the TNM staging system.
Stage 1B means there is a single tumour that is more than 2cm, and it has not grown into the blood vessels. This is the same as T1b, N0, M0 in the TNM staging system.
Other staging systems
The number and TNM staging systems describe the size and position of liver cancer. However, people with liver cancer often have scarring of the liver (cirrhosis). So doctors also need a system that describes how well your liver is working and your health (your performance status). Then they can decide what treatment would be best. For this, doctors use a system called the Barcelona Clinic Liver Cancer (BCLC) strategy.
Treatment for stage 1 liver cancer
The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
- where the cancer is
- how well your liver is working
- your general health, level of fitness and cancer related symptoms
The treatments for stage 1 include:
Surgery to remove part of your liver
You might have an operation to remove part of your liver (liver resection). This depends on the size of the cancer and where it is in the liver. To have this type of surgery the rest of your liver must be working well.
A liver transplant
Your doctor may recommend a liver transplant if you have scarring of the liver (cirrhosis) and you are well enough. You may have to wait a long time to receive a transplant. You might have other treatments to help control the cancer while you are on the transplant list.
Embolisation treatment
Embolisation is a treatment that blocks or reduces the blood supply to the cancer.
You might have trans arterial embolisation (TAE) to cut off the blood supply to the cancer. Your doctor does this by injecting a substance such as a gel or tiny beads to block the liver's blood supply.
Some people have chemotherapy directly to the area of your liver that contains the cancer before the blood supply is blocked. This is called chemoembolisation or trans arterial chemoembolisation (TACE).
You usually have this treatment if you can't have surgery, or to help control the cancer while you are waiting for a liver transplant. Or you may have this treatment to shrink a tumour so that it then becomes small enough to remove with surgery.
Heat or radiotherapy treatments
There are different types of treatment. These include:
- radiofrequency ablation (RFA)
- microwave ablation (MWA)
- stereotactic ablative radiotherapy (SABR)
- selective internal radiotherapy treatment (SIRT)
These treatments use heat or radiation to destroy cancer cells. You might have one of these treatments if you can't have surgery, or to help control the cancer while you are waiting for a liver transplant.
Percutaneous ethanol injection (PEI)
This treatment uses alcohol to destroy cancer cells. It is not a common treatment for liver cancer. You might have PEI if you can't have surgery, or to control the cancer while you are waiting for a transplant.
Research and clinical trials
Researchers are always trying to improve the treatment and quality of life for people with liver cancer.
