Liver Cancer Stages
Liver cancer stages can help the doctor decide the path of the treatment of the liver cancer patient. Liver cancer grows slowly from a small tumor to large tumor and thereafter it starts spreading to the nearby organs. Initially, liver cancer affects the liver from inside or outside or ducts connecting the liver and is called as primary liver cancer. This starts growing as cancer cells divide rapidly and invade the other parts of the liver. At this stage, the liver cancer is said to malignant. As the liver cancer spreads from liver to other organs, it is said to be metastasized.
Liver cancer stages provide a system of classifying cancer tumors. Liver cancer staging system provides details about the following aspects of liver cancer:
Worldwide live cancer is staged in various ways. The common staging systems that describe liver cancer stages are,
All of these systems consider factors such as extent and size of tumor, its ability to metastasize, its growth rate and impact on liver function. For all systems, diagnostics tests are carried out first which include blood tests, x-ray tests, Urine tests, MRI (Magnetic Resonance Imaging) and CT scans
TNM system: TNM system is attributed to the American Joint Committee on Cancer (AJCC).It can be described as:
Barcelona Clinic Liver Cancer Staging, Okuda System and Cancer of the Liver Italian Program staging system (CLIP) are similar to one another and are widely followed in different countries. They too use a system similar to TNM system of staging of liver cancer. Besides the TNM ratings they also rely on factors such as cirrhosis of liver and patient degree of physical activity
Cirrhosis in liver cancer: Cirrhosis in liver cancer is a useful measure to predict the liver cancer stages. Cirrhosis can be pointed by Child-Pugh Score. It considers the following factors:
A point system is used to predict the staging of cirrhosis, for example, 5-6 points indicate 85% survival chances after 2 years whereas 10-15 points indicate low survival chances after 2 years (as low as 35%)
Note on BCLC: BCLC is used commonly to stage hepatocellular carcinoma (HCC). It uses combination of Child-Pugh system, performance status ranking, tumor size and liver function observations to stage the liver cancer.
Child-Pugh system indicates cirrhosis. A (5-6 points), B (7-9 points), C (10-15 points), D (>15) status is used to mark the cirrhosis of liver. For example, A indicates lower cirrhosis and the start phase of HCC and D indicates extremely high cirrhosis and the end stage of HCC
Performance status tests indicate ability of the patient to perform normal activities. For example, 0 is used to indicate no impact on day to day activities but a 4 rating indicates high disability or confinement to bed.
Remarks are also added in the BCLC system, which point to presence of bilirubin, essential proteins and hypertension.
Liver cancer stages thus outline the nature of the tumor and its impact on the patient. Stages of liver cancer are crucial in determining the course of treatment for the patient.