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Cancer Staging Systems

Staging of Liver Cancer

TNM definition

Primary tumor (T)

• TX: Primary tumor cannot be assessed
• T0: No evidence of primary tumor
• T1: Solitary tumor without vascular invasion
• T2: Solitary tumor with vascular invasion or multiple tumors none more than 5 cm
• T3: Multiple tumors more than 5 cm or tumor involving a major branch of the portal or hepatic vein(s)
• T4: Tumor(s) with direct invasion of adjacent organs other than the gallbladder or with perforation of the visceral peritoneum

Regional lymph nodes (N)

• NX: Regional lymph nodes cannot be assessed
• N0: No regional lymph node metastasis
• N1: Regional lymph node metastasis

Distant metastasis (M)

• MX: Distant metastasis cannot be assessed
• M0: No distant metastasis
• M1: Distant metastasis

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Stage grouping

Stage I

• T1, N0, M0

Stage II

• T2, N0, M0

Stage IIIA

• T3, N0, M0

Stage IIIB

• T4, N0, M0

Stage IIIC

• Any T, N1, M0

Stage IV

• Any T, any N, M1

References

1. Liver (including intrahepatic bile ducts). In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 131-8.

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