The American Cancer Society estimates the diagnosis of more than 24,000 new cases of liver cancer in the United States in 2010 and approximately 18,900 deaths from the disease. Most people with liver cancer have late-stage disease at the time of diagnosis because liver cancer rarely causes symptoms in the early stages of the illness. Medical professionals use several different staging systems to evaluate the extent of, and prognosis associated with, liver cancer. People in the last stages of liver cancer have incurable disease, typically associated with debilitating symptoms.
AJCC Stages IVa and IVb
Stage IV is the most advanced form of liver cancer, according to the American Joint Committee on Cancer, or AJCC, staging system. The AJCC system utilizes three factors to determine liver cancer stage: the size, number and location of the liver tumors; spread to the lymph nodes; and spread to distant body organs. Doctors use the AJCC liver cancer stage to determine what treatments are most likely to benefit the patient.
Stage IV liver cancer is subdivided into stages IVa and IVb, notes the American Cancer Society. Spread to nearby lymph nodes, but not to distant organs constitutes stage IVa liver cancer. Stage IVb liver cancer indicates spread to distant organs, such as the lungs or bones. Liver cancer spread to the lymph nodes or distant organs indicates that the disease has progressed to an incurable stage.
Advanced Liver Cancer
In determining the course of treatment for liver cancer, medical professionals often simplify the AJCC stages into three groups: localized cancers that can be surgically removed; localized cancers that cannot be surgically removed; and advanced cancers, which are inoperable. Advanced liver cancer includes AJCC stages IVa and IVb.
Although potentially curative surgery is not an option for people with advanced liver cancer, other forms of treatment may provide symptom relief, slow disease progression and possibly extend the patient's life.
Child-Pugh Class C
The National Cancer Institute reports that nearly all cases of liver cancer in the United States occur in people who have underlying cirrhosis. Liver function varies among people with cirrhosis and is an important factor in the choice of treatment and prognosis for people with liver cancer.
The Child-Pugh scoring system groups patients into classes--denoted A, B and C--based on their liver function. People in class A have little evidence of liver malfunction, whereas patients in class C have severe liver failure. Child-Pugh class B represents an intermediate group of patients with mild to moderate liver failure. Patients with class C cirrhosis have end-stage liver disease and a limited life expectancy. These patients are usually too debilitated and ill to undergo treatment for liver cancer, according to the American Cancer Society.
References
- American Cancer Society: Cancer Facts and Figures 2010
- American Cancer Society: Can Liver Cancer Be Found Early?
- American Cancer Society: How is Liver Cancer Staged?
- National Cancer Institute: What You Need to Know About Liver Cancer
- "Clinical Oncology, Third Edition"; Martin D. Abeloff, M.D., et al., Editors; 2004
