Liver Cancer
The Barcelona Clinic Liver Cancer Staging System may be used to stage adult primary liver cancer.
There are several staging systems for liver cancer. The Barcelona Clinic Liver Cancer (BCLC) Staging System is widely used and is described below. This system is used to predict the patient’s chance of recovery and to plan treatment, based on the following:
- Whether the cancer has spread within the liver or to other parts of the body.
- How well the liver is working.
- The general health and wellness of the patient.
- The symptoms caused by the cancer.
The BCLC staging system has five stages:
- Stage 0: Very early
- Stage A: Early
- Stage B: Intermediate
- Stage C: Advanced
- Stage D: End-stage
Bile Duct Cancer
Intrahepatic bile duct cancer
Stage 0
In Stage 0 intrahepatic bile duct cancer, abnormal cells are found in the innermost layer of tissue lining the intrahepatic bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I
Cancer has formed:
- In an intrahepatic bile duct and the tumor is 5 centimeters or smaller; or
- In an intrahepatic bile duct and the tumor is larger than 5 centimeters.
Stage II
In Stage II intrahepatic bile duct cancer, either of the following is found:
- The tumor has spread through the wall of an intrahepatic bile duct and into a blood vessel; or
- More than one tumor has formed in the intrahepatic bile duct and may have spread into a blood vessel.
Stage III
The tumor has spread:
- Through the capsule (outer lining) of the liver; or
- To organs or tissues near the liver, such as the duodenum, colon, stomach, common bile duct, abdominal wall, diaphragm, or the part of the vena cava behind the liver, or the cancer has spread to nearby lymph nodes.
Stage IV
In stage IV intrahepatic bile duct cancer, cancer has spread to other parts of the body, such as the bone, lungs, distant lymph nodes, or tissue lining the wall of the abdomen and most organs in the abdomen.
Perihilar Bile Duct Cancer
Stage 0
In stage 0 perihilar bile duct cancer, abnormal cells are found in the innermost layer of tissue lining the perihilar bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ or high-grade dysplasia.
Stage I
In Stage I, perihilar bile duct cancer, cancer has formed in the innermost layer of tissue lining the perihilar bile duct and has spread into the muscle layer or fibrous tissue layer of the perihilar bile duct wall.
Stage II
In stage II perihilar bile duct cancer, cancer has spread through the wall of the perihilar bile duct to nearby fatty tissue or to liver tissue.
Stage III
Cancer has spread
- To branches on one side of the hepatic artery or of the portal vein; or
- To one or more of the following:
- The main part of the portal vein or its branches on both sides;
- The common hepatic artery;
- The right hepatic duct and the left branch of the hepatic artery or of the portal vein;
- The left hepatic duct and the right branch of the hepatic artery or of the portal vein; or
- Or to 1 to 3 nearby lymph nodes.