What Does Staging Mean in Liver Cancer?

Dr. Anjana Pillai, professor of medicine, as well as surgery, and leader of multiple liver programs at UChicago Medicine, explains that staging plays a key role in determining the best treatment for patients with liver cancer in an interview with CURE.

Once imaging confirms a diagnosis, doctors assess the size, number and location of tumors, as well as whether they involve major blood vessels or bile ducts. Additional tests, such as a CT scan of the chest, help determine if the cancer has spread beyond the liver, most commonly to the lungs or bones.

Together, this information forms the basis of staging, which helps clinicians understand how advanced the cancer is and what treatment options are most appropriate. In some cases, such as hepatocellular carcinoma with classic imaging in patients with cirrhosis or chronic hepatitis B, a biopsy may not be necessary, but accurate staging remains essential for guiding care.

Transcript

Why is staging important for patients with liver cancer?

If it looks like someone has a primary liver cancer — and I know we’ll talk more about biopsies — some cancers, like HCC, don’t always need one if the imaging characteristics are very classic, especially in someone with cirrhosis or chronic hepatitis B. For most patients, though, a CT scan or MRI with contrast will show specific features that help confirm the diagnosis.

Once you’ve confirmed that, staging becomes important. Based on the size, number, and location of the tumors, and how far the cancer extends, you’ll also need additional testing — such as a CT scan of the chest — to make sure it hasn’t spread elsewhere. The bones and lungs are the most common places liver cancer can spread.

That’s what we mean by staging: determining the size and number of tumors, whether they invade major blood vessels or bile ducts, and checking if the cancer has spread outside the liver.

Transcript has been edited for clarity and conciseness.

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