According to the specific situation and practice accumulation in China, scholars of hepatocellular carcinoma in China determine the tumor stage based on 6 factors: number, size, vascular invasion, extrahepatic metastasis, liver function Child-Pugh score, and physical status PS score, which can be divided into 7 stages: stage Ia, stage Ib, stage IIa, stage IIb, stage IIIa, stage IIIb, and stage IV.
Early to mid-stage diagnostic staging of tumors
We usually think of stages I a, Ib, and IIa as early, stages IIb, IIIa, and IIIb as intermediate, and stage IV as late. Middle and late stages refer to stages IIb, IIIa, IIIb, and IV.
Stage Ia: single tumor ≤5 cm maximum diameter, no vascular invasion, extrahepatic metastasis; liver function Child-Pugh A/B; PS0~2.
Stage Ib contains 2 conditions:
- Single tumor maximum diameter >5cm, no vascular invasion, extrahepatic metastasis; liver function Child-Pugh A/B; PS0~2.
- Tumor number 2~3, single tumor maximal diameter ≤3cm, no vascular invasion, extrahepatic metastasis; liver function Child-Pugh A/B; PS0~2.
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Stage IIa: 2 to 3 tumors, single tumor maximum diameter >3 cm, no vascular invasion, extrahepatic metastasis; liver function Child-Pugh A/B; PS0~2.
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Stage IIb: ≥4 tumors, regardless of tumor size, no vascular invasion, extrahepatic metastases; liver function Child-Pugh A/B; PS0~2.
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Stage IIIa: tumor status regardless, vascular invasion, no extrahepatic metastases; liver function Child-Pugh A/B; PS0~2.
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Stage IIIb: Tumor status regardless, vascular invasion regardless, extrahepatic metastases; liver function Child-Pugh A/B; PS0~2.
Stage IV: Tumor status regardless, vascular invasion regardless, extrahepatic metastases; liver function Child-Pugh C; PS 0 to 2. Or tumor status regardless, vascular invasion regardless, extrahepatic metastases regardless, liver function regardless, PS 3 to 4.
Stage IV: Tumor status regardless, vascular invasion regardless, extrahepatic metastases regardless, liver function regardless, PS 3 to 4.
For further information on liver function Child-Pugh rating and physical activity status PS score see link:
Early and mid-stage treatment of tumors
Simply speaking, early-stage tumors are treated with surgery, mid-stage tumors are treated with TACE, systemic therapy, etc., and late-stage tumors y are treated with symptomatic supportive care, palliative care, and nursing care.
For further details on the treatment modalities of the four stages of hepatocellular carcinoma see the link:
I Hepatocellular carcinoma
II hepatocellular carcinoma
III hepatocellular carcinoma
IV hepatocellular carcinoma