Stage 2 liver cancer

The stage of primary Open a glossary item 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 2 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 2 means in the TNM system. This system describes:

  • the size of the primary tumour (T)
  • whether the cancer has spread to the lymph nodes Open a glossary item (N)
  • whether the cancer has spread to another part of the body (M)

What is stage 2 liver cancer?

Stage 2 liver cancer has not spread to the lymph nodes or other areas of the body.

It means that there is a single tumour that is more than 2 cm, and it has grown into blood vessels of the liver.

Diagram 1 of 2 showing stage 2 liver cancer

Or it means that there are two or more tumours in the liver and they are all less than 5cm.

Diagram 2 of 2 showing stage 2 liver cancer

In TNM staging, stage 2 is the same as T2, N0, M0.

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 2 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 other cancer related symptoms

The treatments for stage 2 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 your liver. The rest of your liver must be working well.

A liver transplant

Your doctor may recommend a liver transplant if you have:  

  • a single tumour no more than 5cm across
  • a single tumour that is 5 to 7cm across and has not grown for at least 6 months
  • no more than 5 small tumours, each no larger than 3cm across   
  • a level of alpha fetoprotein (AFP) Open a glossary item less than 1000  

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.

Research and clinical trials

Researchers are always trying to improve the treatment and quality of life for people with liver cancer.

Other stages

  • AJCC Cancer Staging Manual, 8th edition
    American Joint Committee on Cancer
    Springer, 2017

  • British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults
    A Suddle and others
    Gut, 2024. Volume 0. Pages 1-34

  • BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update
    M Reig and others
    Journal of Hepatology, 2022. Volume 76. Pages 681-693

  • Liver Transplantation: Selection Criteria and Recipient Registration

    NHS Blood and Transplant, 2023

  • Stereotactic Ablative Radiotherapy (SABR) for Hepatocellular Carcinoma (Adults)
    NHS England, 2016

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk if you would like to see the full list of references we used for this information.

Last reviewed: 
25 Mar 2025
Next review due: 
24 Mar 2028

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