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Liver and intrahepatic bile ducts - tumor


TNM staging of hepatocellular carcinoma

Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.


● Classification excludes sarcomas and metastases to liver

Primary tumor (T)

TX: primary tumor cannot be assessed
T0: no evidence of primary tumor
T1: solitary tumor without vascular invasion
T2: solitary tumor with vascular invasion or multiple tumors, none more than 5 cm
T3a: multiple tumors more than 5 cm
T3b: single tumor or multiple tumors of any size involving a major branch of the portal vein or hepatic vein
T4: tumor(s) with direct invasion of adjacent organs other than the gallbladder or with perforation of visceral peritoneum

● Vascular invasion includes gross or microscopic involvement
● For T3, a major branch means the right or left portal vein, or right-middle or left hepatic vein
● Multiple tumors includes satellitosis, multifocal tumors and intrahepatic metastases

Regional lymph nodes (N)

NX: regional lymph nodes cannot be assessed
N0: no regional lymph node metastasis
N1: regional lymph node metastasis

Distant metastasis (M)

M0: no distant metastasis
M1: distant metastasis

Stage grouping

I:    T1 N0 M0
II:   T2 N0 M0
IIIA:  T3a N0 M0
IIIB:  T3b N0 M0
IIIC:  T4 N0 M0
IVA:  any T N1 M0
IVB:  any T any N M1

End of Liver and intrahepatic bile ducts - tumor > Miscellaneous > TNM staging of hepatocellular carcinoma

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