Staging takes into account the size of the tumor, regardless of whether the lymph nodes are affected and whether the cancer cells have spread anywhere else.

Tumor (T)

The main factor that doctors take into account is the size of liver tumors and if cancer cells develop in liver blood vessels.

• T1 – there is only one small tumor that did not grow in the blood vessels;
• T2 – There is only one tumor that has grown in a blood vessel in the liver or there are several tumors, all less than 5 cm, but have not grown in the blood vessels;
• T3 is divided into T3a and T3b: T3a means there are several tumors, at least one of which is greater than 5 cm, and T3b means that at least one tumor has grown in a major branch of one of the main blood vessels (portal vein or hepatic vein);
• T4 means that cancer cells have grown in organs close to the liver (not including the bile of the bladder) or in the lining surrounding the internal organs of the abdomen.

Nodules (N)

• No – there are no cancer cells in nearby lymph nodes;
• N1 – There are cancer cells in the lymph nodes near the liver. If there are cancer cells in the lymph nodes, the cancer is advanced and is a stage 4 liver cancer.

Metastases (M)

• M0 – there are no signs that cancer cells have spread out of the liver;
• M1 – There are cancer cells in other organs of the body, such as the lungs or bones.