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The staging and prognosis of liver cancer

Staging

The stage of a cancer describes how large it is, where it is and whether it has spread in the body. Knowing the stage of the liver cancer helps doctors plan the best treatment for you.

Barcelona Clinic Liver Cancer (BCLC) staging system

The BCLC system is often used to stage HCC. The stages are based on how well you can carry out daily tasks, what the tumour is like and how well the liver is working. Your doctor will record how well the liver is working using the Child–Pugh score.

0 (very early)single tumour less than 2 cm; Child–Pugh A
A (early)single tumour greater than 2 cm or up to 3 tumours less than 3 cm; Child–Pugh A–B
B (intermediate)many tumours in the liver; Child–Pugh A–B
C (advanced)the tumour has grown into one of the main blood vessels of the liver, or spread to the lymph nodes or other body organs; Child–Pugh A–B
D (end-stage)Child–Pugh C with any size tumour

Child–Pugh score

A system for scoring how well the liver is working based on the level of damage caused by cirrhosis.

Aliver is working well and cirrhosis is less advanced
Bliver is working moderately well
Cliver is not working well and cirrhosis is advanced

Prognosis

Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor, but it is not possible for anyone to predict the exact course of the disease. To work out your prognosis, your doctor will consider:

  • test results
  • the type of liver cancer
  • the stage of the cancer and how fast it is growing
  • whether you have cirrhosis and how well the liver is working
  • how well you respond to treatment
  • other factors such as your age, fitness and overall health.

Discussing your prognosis and thinking about the future can be challenging and stressful. It is important to know that although the statistics for liver cancer can be frightening, they are an average and may not apply to your situation. Talk to your doctor about how to interpret any statistics that you come across.

The prognosis tends to be better when liver cancer is still in the early stages, but liver cancer is often found later. A liver transplant or surgery to remove the cancer (liver resection) may be an option to treat some people with primary liver cancer. Other treatments for primary liver cancer can significantly improve survival and can relieve symptoms to improve quality of life.

This information is reviewed by

This information was last reviewed June 2020 by the following expert content reviewers: Dr David Yeo, Hepatobiliary/Transplant Surgeon, Royal Prince Alfred, Chris O’Brien Lifehouse Cancer Centre and St George Hospitals, NSW; Dr Lorraine Chantrill, Head of Department Medical Oncology, Illawarra Shoalhaven Local Health District, NSW; Michael Coulson, Consumer; Dr Sam Davis, Interventional Radiologist, Staff Specialist, Royal Brisbane and Women‘s Hospital, QLD; Prof Chris Karapetis, Network Clinical Director (Cancer Services), Southern Adelaide Local Health Network, Head, Department of Medical Oncology, Flinders Medical Centre and Flinders University, SA; Dr Howard Liu, Radiation Oncologist, Princess Alexandra Hospital, QLD; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Lina Sharma, Consumer; Dr Graham Starkey, Hepato-Biliary and General Surgeon, Austin Hospital, VIC; Catherine Trevaskis, Gastrointestinal Cancer Specialist Nurse, Canberra Hospital and Health Services, ACT; Dr Michael Wallace, Western Australia Liver Transplant Service, Sir Charles Gairdner Hospital,