Liver Cancer: Stages

Approved by the Cancer.Net Editorial Board, 05/2017

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Staging a cancer helps determine the prognosis of the disease, which is the chance of recovery, and the types of treatment that are most appropriate. In general, only early-stage liver cancer can be cured.

Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor decide what kind of treatment is best and may help predict a patient's prognosis. There are different stage descriptions for different types of cancer.

As explained in the Introduction, there are 2 types of liver cancer: primary and metastatic. Primary liver cancer begins in the liver. Metastatic (secondary) liver cancer is cancer that has spread from another part of the body to the liver. This section describes the stages of primary liver cancer. For information about the stages of metastatic cancer, read about the type of cancer where it began. For example, lymphoma that has spread to the liver will still be staged as lymphoma.

BCLC staging system

For HCC, doctors often use the Barcelona Clinic Liver Cancer (BCLC) system to describe the cancer and recommend treatment, which are described in more detail in Treatment Options. The BCLC system categorizes HCC based on characteristics of the tumor, liver function, performance status, and cancer-related symptoms.

BCLC stage groupings include:

  • Very early stage. The tumor is smaller than 2 cm. There is no increased pressure in the portal vein. Bilirubin levels are normal. Surgery is usually recommended.

  • Early stage. The tumor is smaller than 5 cm. Liver function varies. There may be no increased pressure in the portal vein, increased portal vein pressure and normal bilirubin levels, or increased portal vein pressure and increased bilirubin levels. People with early-stage disease may be candidates for a liver transplant, surgery, or radiofrequency ablation (RFA).

  • Intermediate stage. The tumor may be large or there may be multiple tumors. Doctors usually recommend regional therapies, such as transarterial chemoembolization.

  • Advanced stage. The tumor has invaded the portal vein or spread to other parts of the body, such as the lungs and bones. Doctors usually recommend targeted therapy.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. You may use the menu to choose a different section to read in this guide.