TNM staging for liver cancer

Staging looks at the size of the cancer (tumour) and whether it has spread anywhere else in the body. There are different staging systems that doctors can use for liver cancer. The TNM staging system is one of these.

TNM stands for Tumour, Node, Metastasis. It describes:

• the size of the primary tumour (T)

• whether the cancer has spread to the ​lymph nodes​ (N)

• whether the cancer has spread to another part of the body (M)

Your doctor gives each letter (T, N and M) a number, depending on how far the cancer has grown.

TNM staging is used for staging ​primary​ liver cancer. Primary liver cancer 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

Treatment

The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

• where the cancer is in your liver

• how well your liver is working

• other health conditions 

• your wishes

For cancer that is only in your liver, it might be possible to remove it with surgery. This might be surgery to remove part of your liver (liver resection) or a liver transplant.

You might have a local treatment into your liver if you can't have surgery. This could be:

• heat treatment to destroy the tumour (radiofrequency ablation or microwave ablation)

• chemoembolisation (TACE) or embolisation (TAE)

• selective internal radiotherapy (SIRT)

• stereotactic ablative radiotherapy (SABR)

For advanced liver cancer you might have targeted or immunotherapy cancer drugs. You may have other treatments, such as painkillers or anti sickness drugs, to help with symptoms.

Find out more about treatment for primary liver cancer

Other stages

• Stage 1

• Stage 2

• Stage 3

• Stage 4

• BCLC staging system