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The staging and prognosis of liver cancer

Staging

Working out how far the cancer has spread is called staging and it helps the health care team decide on the best treatment for you. Your doctor will also consider how well the liver is working and record this using the Child-Pugh score. The Child-Pugh score is a scoring system for 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.

The Barcelona Clinic Liver Cancer (BCLC) system is often used to stage HCC. The categories are based on how well you can carry out daily tasks, what the tumour is like, and how well the liver is working. Knowing the stage helps your doctor work out the best treatment.

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

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.

The prognosis tends to be better when liver cancer is still in the early stages, but liver cancer is often found later. Doctors often use statistics when considering someone’s prognosis. Statistics reflect the typical outcome of disease in large numbers of people. While statistics give doctors a general idea about a disease, they won’t necessarily reflect your situation.

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.