Liver Cancer: Stages

Approved by the Cancer.Net Editorial Board, 08/2023

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.


What is cancer staging?

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 recommend the best kind of treatment 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 to the liver after starting in another part of the body. 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, lung cancer that has spread to the liver is called "metastatic lung cancer" and will be staged as lung cancer, not liver cancer.

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Barcelona Clinic Liver Cancer (BCLC) staging system

For hepatocellular carcinoma (HCC), doctors often use the BCLC staging system to describe the cancer and recommend treatment options, which are described in more detail in Types of Treatment. The BCLC staging 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 centimeters (cm). There is no increased pressure in the portal vein, which is one of the main blood vessels of the liver. Bilirubin levels, which is the substance that causes jaundice, are normal. Surgery is usually recommended (see Types of Treatment).

  • 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) (see Types of Treatment).

  • Intermediate stage. The tumor may be large or there may be multiple tumors. Doctors usually recommend regional therapies, such as transarterial chemoembolization (see Types of Treatment). 

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

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