Stages of Childhood Liver Cancer
Key Points for This Section
- After childhood liver cancer has been diagnosed, tests are done to find out if cancer cells have spread within the liver or to other parts of the body.
- There are two staging systems for childhood liver cancer.
- The following stages are used to describe liver cancer that is staged before surgery:
- The following stages are used to describe liver cancer that is staged after surgery:
- There are three ways that cancer spreads in the body.
The process used to find out if cancer has spread within the liver or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.
The following tests and procedures may be used in the staging process:
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Surgery : An operation will be done to look at or remove the tumor. Tissues removed during surgery will be checked by a pathologist.
- Presurgical staging: The stage is based on where the tumor has spread within the four parts (sections) of the liver, as shown by imaging procedures such as MRI or CT. This staging system is called PRETEXT and it is done before the patient has surgery.
- Postsurgical staging: The stage is based on the amount of tumor that remains after the patient has had surgery to look at or remove the tumor.
The liver is divided into 4 vertical sections.
In stage 3, one of the following is true:
- Cancer is found in three sections of the liver and one section does not have cancer.
- Cancer is found in two sections of the liver and two sections that are not next to each other do not have cancer in them.
In stage III:
- the tumor cannot be removed by surgery; or
- cancer that can be seen without a microscope remains after surgery; or
- the cancer has spread to nearby lymph nodes.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.