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

Author: Deepali Jain, M.D. (see Authors page)

Revised: 6 December 2017, last major update February 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: TNM staging[TI] hepatocellular carcinoma

Cite this page: Jain, D. TNM staging of hepatocellular carcinoma. website. Accessed March 24th, 2018.
Definition / general
  • 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