Staging of primary liver cancer in adults

by Specialist

After primary liver cancer is diagnosed in adults, tests are used primarily to determine whether the cancer has spread within the liver or to other parts of the body.

The process used to determine whether the cancer has spread within the liver or to other parts of the body is called staging.The information assembled during staging determines the stage of the disease.Determining the stage of the disease is important for the choice of treatment options.The following tests and items can be used for staging:

  • CT exam : An exam that produces a series of detailed images of parts of the body such as the chest, abdomen, and pelvis from different angles.These pictures are generated by a computer connected to an X-ray machine.The dye may be given intravenously or orally to help organs or tissues appear more clearly.This test is also known as computed tomography, computerized tomographic imaging, or computerized axial tomography.
  • Magnetic resonance imaging: A test that uses electromagnetic, radio waves and a computer to generate a series of detailed images of certain areas of the body.This test is also called magnetic resonance imaging (MRI).
  • Positron emission tomography: A test used to find malignant tumor cells in the body.A small amount of radioactive glucose (sugar) is injected into a vein.The PET scanner is rotated around the body and scanned to produce images of the areas of the body where the glucose is being used.Malignant tumor cells are more active and take in more glucose than normal cells, so they are brighter in the image.

    There are three ways that cancer can spread in the body.

    Cancer can spread through the tissues, the lymphatic system, and the blood.

  • Tissue.The cancer grows from the starting site and invades adjacent areas.
  • Lymphatic system.Cancer spreads from the site of origin into the lymphatic system.Cancer cells spread through the lymphatic vessels to other parts of the body.
  • Blood.Cancer spreads from the primary site into the bloodstream.Cancer spreads to other parts of the body through blood vessels.

    Cancer can spread from the primary site to other parts of the body.

    When cancer cells spread to another part of the body, it is called metastasis.Cancer cells can leave the site of their growth (the primary tumor) and migrate to other sites through the lymphatic system or blood.

  • Lymphatic system.Cancer cells enter the lymphatic system, migrate through the lymphatic vessels, and form a tumor in another part of the body (metastasis).
  • Blood.Cancer cells enter the bloodstream, migrate through blood vessels, and form a tumor in another part of the body (metastasis).

    Metastases are the same type of tumor as the primary tumor.For example, if a primary liver cancer metastasizes to the lungs, the cancer cells in the lungs are actually liver cancer cells.The tumor is a metastatic liver cancer, not a lung cancer.

    Many cancer deaths are caused by tumors that have metastasized from the primary site to other tissues or organs. This is called metastatic cancer.This animation shows how cancer cells metastasize from the primary site to other parts of the body.

    The Barcelona Clinical Liver Cancer Staging System can be used to stage primary liver cancer in adults.

    There are multiple staging systems for liver cancer.The Barcelona Clinical Liver Cancer Staging System (BCLC) is widely used, as described below.This system is used to predict patient prognosis and select treatment options based on:

  • Whether the cancer has spread within the liver or to other parts of the body.
  • Whether the liver is functioning well.
  • The patient’s health status.
  • The symptoms caused by the cancer.

    The BCLC staging system is divided into 5 stages:

  • Stage 0: Very early stage
  • Stage A: Early stage
  • Stage B: Intermediate stage
  • Stage C: Late stage
  • Stage D: End-stage

    Treatment plans are based on the following staging groups.

    BCLC stages 0, A, and B

    The treatment of BCLC stages 0, A, and B is aimed at eradication.

    Stages C and D of BCLC

    Stages C and D of BCLC are treated to reduce symptoms caused by liver cancer and to improve the patient’s quality of life.Treatments have been difficult to cure liver cancer.