Liver Tumors & Cancer

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Liver Cancer Stages

The treatment that your team will recommend for liver cancer will be based on the stage of your cancer, the health of your liver, and your overall health. The stage depends on the following:

  • How many tumors you have
  • How large your tumors are
  • Whether the cancer has grown into blood vessels
  • Whether the cancer has spread to lymph nodes or distant parts of your body

There are four stages of liver cancer.

Stage I Liver Cancer

There’s only one tumor in the liver. It hasn’t grown into any blood vessels and hasn’t spread to lymph nodes or distant parts of the body.

Stage II Liver Cancer

There’s only one tumor, and it has grown into blood vessels; or there are multiple tumors, none more than 5 centimeters (cm) across. The cancer hasn’t spread to lymph nodes or distant parts of the body.

Stage III Liver Cancer

  • Stage IIIA: There are multiple tumors. At least one is more than 5 cm across. The cancer hasn’t spread to lymph nodes or distant parts of the body.
  • Stage IIIB: At least one tumor is growing into major veins of the liver (the portal vein or hepatic vein). The cancer has not spread to lymph nodes or distant parts of the body.
  • Stage IIIC: A liver tumor is growing into a nearby organ other than the gallbladder or into the outer covering of the liver. The cancer has not spread to lymph nodes or distant parts of the body.

Stage IV Liver Cancer

  • Stage IVA: The cancer has spread to nearby lymph nodes but not to distant parts of the body.
  • Stage IVB: The cancer has spread to other parts of the body.

Liver Function

Another important factor in deciding on treatment is how well your liver is working. Your doctor will check your liver function and give it a score (Child-Pugh score or MELD score). Your score is based on the following:

  • Bilirubin level. Bilirubin is a yellow pigment that is made in the liver and excreted in bile and urine. It is measured by testing your blood.
  • Albumin level. Albumin is a protein made in the liver. It is measured by testing your blood.
  • Prothrombin time. This measures how well your liver is making the substances that help your blood clot. It is measured by testing your blood.
  • Creatinine. This measures your kidney function.
  • Ascites. This is a build-up of fluid in your abdomen. Your doctor assigns a score based on the severity of your symptoms.
  • Hepatic encephalopathy. This occurs when your mental functioning is affected by the problems with your liver. Your doctor assigns a score based on the severity of your symptoms.

All of these components are added together for a total score, which determines whether your liver function is class A (normal), class B (mildly abnormal), or class C (severely abnormal).