Once liver cancer is diagnosed, doctors will then determine the status of cancer cell metastasis in order to prepare for subsequent treatment. At this time, the staging of liver cancer becomes an extremely important indicator. This article will introduce you to the types of liver cancer and the staging system of liver cancer.

Classification of liver cancer

Liver cancer can be clinically divided into four main types according to pathological classification:

1. Hepatocellular carcinoma
   Hepatocellular carcinoma (HCC), commonly known as liver cancer (Hepatoma), is a tumor caused by malignant changes in liver cells in the liver. Liver cancer often occurs in patients with chronic hepatitis B and C and patients with damaged liver cirrhosis, accounting for about 85% of adult liver cancers, especially in men.
   
2. Cholangiocarcinoma
   Cholangiocarcinoma occurs in the cells that make up the bile ducts and accounts for about 12% of liver cancers. Cholangiocarcinoma can be divided into “proximal cholangiocarcinoma” and “distal cholangiocarcinoma”. Proximal cholangiocarcinoma occurs near the upper end of the bile duct, close to the gallbladder. Terminal cholangiocarcinoma is located near the lower end of the bile duct.
   
3. Angiosarcoma
   Angiosarcoma, also known as hemangiosarcoma, is an extremely rare cancer that accounts for only 1% of liver cancers. It originates in the blood vessels of the liver and usually occurs in older people aged 70 to 80 years.
   
4. Hepatoblastoma
   Hepatoblastoma is also a very rare type of liver cancer. It mostly occurs in children, usually children under three years old, and mostly boys.

Liver cancer staging

After liver cancer is diagnosed, doctors need to determine the status of cancer cell metastasis so that they can make treatment plans. The staging of liver cancer has become an extremely important indicator.

The smaller the number in the cancer stage, the less metastasis and spread of cancer cells. It can be divided into the early stage, that is, the first period. By analogy, the late period is the fourth period. In English usage, it will be marked with Roman numerals, the first issue is I, and the fourth issue is IV. In order to make the classification more detailed, we will also distinguish different serious conditions in the same stage in English alphabetical order.

There are several different staging systems for liver cancer. The following is the liver cancer staging based on the American Joint Committee on Cancer (AJCC), which is called by its English abbreviation, also known as the TMN cancer staging system:

1. Tumor (T): How old is the tumor? How many tumors are there in the liver? Whether the tumor has spread to the veins in the liver.
   
2. Lymph node (N): Whether cancer cells have spread to surrounding lymph nodes.
   
3. Metastasis (M): whether cancer cells have metastasized to organs further away from the lesion, such as the lungs.

The three abbreviations T, N, and M will also be followed by numbers and other English letters. The later the English alphabet is, or the more numbers there are, the more complete the development of the cancer cells is. The details can be known from the following chart:

1. Liver cancer stage 1
   
   • Stage 1a: A single liver cancer tumor is less than two centimeters in size and has not invaded blood vessels (T1a); cancer cells have not metastasized to surrounding lymph nodes (N0); cancer cells have not metastasized to distant organs (M0).
     
   • Stage 1b: A single liver cancer tumor is more than two centimeters in size and has not invaded blood vessels (T1b); cancer cells have not metastasized to surrounding lymph nodes (No); cancer cells have not metastasized to distant organs (M0).
     
2. Liver cancer stage 2
   
   A single liver cancer tumor is more than two centimeters in size, and the cancer cells have invaded blood vessels, or there are multiple liver cancer tumors, but the size does not exceed five centimeters (T2); the cancer cells have not metastasized to surrounding lymph nodes (N0); the cancer cells Not yet metastasized to distant organs (M0).
   
3. Liver cancer stage 3
   
   • Stage 3a: There are multiple tumors, and at least one of them is larger than 5 centimeters (T3); the cancer cells have not metastasized to surrounding lymph nodes (N0); the cancer cells have not metastasized to distant organs (M0).
     
   • Stage 3b: At least one tumor, regardless of size, has invaded the major branches of the liver’s large veins (portal and hepatic veins) (T4); the cancer has not metastasized to surrounding lymph nodes (N0); the cancer has not metastasized to Distal organ (M0).
     
4. Liver cancer stage 4
   
   • Stage 4a: At least one tumor or multiple tumors (regardless of size) have invaded surrounding lymph nodes (N1); cancer cells have not metastasized to distant organs (M0).
     
   • Stage 4b: There is at least one tumor or multiple tumors (regardless of size) (T1~4); the cancer cells may or may not have invaded surrounding lymph nodes (N1~4); the cancer cells have metastasized to distant lymph nodes Organ (M1).

Liver cancer survival rate and recurrence

Cancer is a disease where the earlier it is detected, the better the treatment effect will be, and its treatment effect, recurrence and survival rate are obviously judged by the occurrence of distant metastasis. (For further details, recommended reading: What is Carcinoma in Situ? Analyzing the Evolutionary History of Cancer) As for liver cancer, the size and number of tumors and whether cancer cells invade the blood vessels or bile ducts of the liver affect the survival rate and prognosis of liver cancer. Key factor.

1. Liver cancer stage 1
   
   • One-year survival rate: 85%
   • Three-year survival rate: 65%
   • Five-year survival rate: 50%
     
2. Liver cancer stage 2
   
   • One-year survival rate: 75%
   • Three-year survival rate: 45%
   • Five-year survival rate: 25%
     
3. Liver cancer stage 3
   
   • One-year survival rate: 25~55%
   • Three-year survival rate: 0~15%
   • Five-year survival rate: 0~8%
     
4. Liver cancer stage 4
   
   • One-year survival rate: 15%
   • Three-year survival rate: 5%
   • Five-year survival rate: 0%
     

Liver cancer recurrence and metastasis

Liver cancer is a cancer with a high recurrence rate. After cancer is resected, it can still metastasize through the following mechanisms, namely “transportal metastasis of the primary tumor” and “multicentric disease in the liver”, in which additional cancers develop from multiple centers of origin and Relapses may occur at:

1. Intrahepatic recurrence (about 85% chance)
   
2. Lungs (the most common organ for distant metastasis of liver cancer)
   
3. Bone
   
4. Lymph nodes
   
5. Adrenal gland
   
6. Skin
   
7. Brain