Understand liver cancer

The most common type of primary liver cancer in adults is hepatocellular
carcinoma (HCC). Primary liver cancer refers to cancer that starts in the liver.

The information on this page may help you gain better understanding of your liver cancer diagnosis. Being prepared may help when making important decisions with your doctor.

What is liver cancer?

Liver Cancer Stages

Liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. The liver is one of the largest organs in the body. It has 2 lobes and fills the upper right side of the abdomen inside the rib cage. Three of the many important functions of the liver are:

  • To filter harmful substances from the blood so they can be passed from the body in stools and urine.
  • To make bile to help digest fat that comes from food.
  • To store glycogen (sugar), which the body uses for energy.

This page provides information on cancer that begins in the liver (primary liver cancer). Cancer that begins in other parts of the body and spreads to the liver (secondary liver cancer) is not covered here.

Stages of liver cancer

From the National Cancer Institute (NCI)

The information below is based on information originally published by the National Cancer Institute (NCI), the US government’s main agency for cancer research.

There are several types of staging systems for liver cancer, and not all doctors use the same system. Common types of staging systems used are the American Joint Committee on Cancer (AJCC) system and the Barcelona Clinic Liver Cancer (BCLC) system.

Find more information below and get the information that may help during your next conversation with your doctor.

The American Joint Committee on Cancer (AJCC) Staging System

In the United States, the AJCC Staging System is the most common system used to classify the spread of liver cancer. It is described in 4 stages ranging from I (1) to IV (4), with stage IV (4) being the most severe.

Stage I (1) is divided into Stage IA and IB.

In stage IA

  • There is a single tumor 2 centimeters or smaller that hasn’t grown into blood vessels.
  • It has not spread to nearby lymph nodes or distant sites.

In stage IB

  • There is a single tumor larger than 2 centimeters that hasn’t grown into blood vessels.
  • It has not spread to nearby lymph nodes or distant sites.

In Stage II (2), one of the following is found:

  • There is a single tumor larger than 2 centimeters that has grown into blood vessels.
  • It has not spread to nearby lymph nodes or distant sites.

Or stage II can be

  • There are multiple tumors but none are larger than 5 centimeters.
  • It has not spread to nearby lymph nodes or distant sites.

Stage III (3) is divided into Stage IIIA and IIIB.

In stage IIIA

  • There are multiple tumors, with at least 1 tumor larger than 5 centimeters.
  • It has not spread to nearby lymph nodes or distant sites.

In stage IIIB

  • There is at least 1 tumor of any size and cancer is found:
    • in a major vein around the liver (the portal or hepatic vein), or
    • in nearby organs other than the gallbladder, or
    • in the outer layer of the liver (visceral peritoneum).
  • It has not spread to nearby lymph nodes or distant sites.

Stage IV (4) is divided into Stage IVA and IVB.

In Stage IVA

  • There are 1 or more tumors of any size and cancer has spread to nearby lymph nodes but not to distant sites.

In Stage IVB

  • There are 1 or more tumors of any size and cancer may have spread to nearby lymph nodes. Cancer has spread to other parts of the body, such as the bones or lungs.

Learn about a possible treatment option for certain patients with a type of advanced liver cancer who have been previously treated with a specific therapy.

The Barcelona Clinic Liver Cancer (BCLC) Staging System

The BCLC Staging System is widely used and is described below. This system is used to predict the patient’s chance of recovery and to plan treatment, based on the following:

  • Whether the cancer has spread within the liver or to other parts of the body.
  • How well the liver is working.
  • The general health and wellness of the patient.
  • The symptoms caused by the cancer.

The BCLC staging system has 5 stages:

  • Stage 0: Very early
  • Stage A: Early
  • Stage B: Intermediate
  • Stage C: Advanced
  • Stage D: End-stage

The following groups are used to plan treatment.

BCLC stages 0, A, and B

  • Treatment to cure the cancer is given for BCLC stages 0, A, and B.

BCLC stages C and D

  • Treatment to relieve the symptoms caused by liver cancer and improve the patient’s quality of life is given for BCLC stages C and D. Treatments are not likely to cure the cancer.