Stages of liver cancer
The stage of liver cancer tells you how big it is and whether it has spread to other parts of the body. This helps your doctor recommend the best treatment for you.
There are different staging systems that doctors can use for liver cancer. One of these is the Barcelona Clinic Liver Cancer (BCLC) strategy. The BCLC looks at:
the number and size of tumours in your liver
your general health and fitness - this is called your performance status or PS
your levels of a tumour marker called alpha fetoprotein (AFP)
how well your liver is working (liver function) including a system called the Child-Pugh score
The BCLC strategy is for staging . HCC is different to cancer that spreads to your liver from somewhere else in your body. This is called secondary liver cancer or liver metastases.
Find out about secondary liver cancer
When deciding on treatment your doctor has to think about how well your liver is working. This is especially the case if you have liver damage (cirrhosis). Unfortunately, people with severe liver damage may be too unwell to have treatment for their cancer.
Your doctor can use different tests to find out how well your liver is working. These include:
testing the amount of albumin and bilirubin in your blood (ALBI score)
tests of how well you kidneys and liver are working together (MELD score)
looking at liver tests and symptoms together (Child-Pugh score)
The Child-Pugh score looks at the following 5 things that tell how well the liver is working:
bilirubin levels in the blood
albumin levels in the blood (albumin is a protein made by the liver)
how quickly the blood clots (prothrombin time)
if there is fluid in the abdomen (ascites)
if the liver disease is affecting brain function (encephalopathy)
Each one is given a number score, and based on that score, people fall into 1 of 3 classes:
class A means the liver is working normally
class B means mild to moderate damage
class C means there is severe liver damage - unfortunately you may be too sick to have treatment for the cancer
Last reviewed: 25 Mar 2025
Next review due: 24 Mar 2028
The stage of a cancer tells you how big it is and how far it’s spread. It helps your doctor decide which treatment you need.
There are different types of cancer that start in the liver. The most common type is hepatocellular carcinoma (HCC).
Your treatment for liver cancer depends on the stage of your cancer and how well your liver is working. The most common treatments are surgery, heat treatment, drug treatments and radiotherapy.
There is support available to help you cope with a diagnosis of liver cancer, life during treatment and life after cancer.
Primary liver cancer is cancer that started in the liver. This section is mainly about the most common type of liver cancer, hepatocellular carcinoma (HCC).
Secondary liver cancer is when a cancer that started somewhere else in the body has spread to the liver. It is also called liver metastases.
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