Stages of liver cancer
The stage of liver cancer tells you how big it is and whether it has spread to other parts of the body. This helps your doctor recommend the best treatment for you.
Primary liver cancer is different to cancer that spreads to your liver from somewhere else in your body. This is called secondary liver cancer or liver metastases.
Find out about secondary liver cancer
Doctors use different systems to stage liver cancer. This page is about stage 4 cancer, which is part of the number staging system. This system has 4 stages, stage 1 to stage 4.
This page also tells you what stage 4 means in the TNM system. This system describes:
the size of the primary tumour (T)
whether the cancer has spread to the (N)
whether the cancer has spread to another part of the body (M)
Find out about the TNM staging system for liver cancer
Stage 4 liver cancer is divided into 2 further stages - stage 4A and 4B.
Stage 4A means the cancer is any size and there may be more than one tumour. It may have grown into blood vessels or the organs around the liver. It has spread to lymph nodes but not to distant parts of the body. In TNM staging, stage 4A is the same as Any T, N1, M0.
Stage 4B means the cancer is any size and there may be more than one tumour. It may have grown into blood vessels or the organs around the liver. It may or may not have spread into lymph nodes. It has spread to another part of the body such as the lungs or bones. In TNM staging this is the same as Any T, Any N, M1.
The number and TNM staging systems describe the size and position of liver cancer. However, people with liver cancer often have scarring of the liver (cirrhosis). So doctors also need a system that describes how well your liver is working and your health (your performance status). Then they can decide what treatment would be best. For this, doctors use a system called the Barcelona Clinic Liver Cancer (BCLC) strategy.
Unfortunately when liver cancer is advanced, treatment won't be able to cure it. Treatment for stage 4 aims to control the cancer, relieve symptoms and give you a good quality of life.
Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Other drugs help the immune system to attack cancer. They are called immunotherapies.
You might have a combination of these drugs, or treatment with a single drug. Examples include:
atezolizumab and bevacizumab
lenvatinib
sorafenib
You may also have other treatments to control specific symptoms such as sickness and pain.
Researchers are always trying to improve the treatment and quality of life for people with liver cancer.
Last reviewed: 26 Mar 2025
Next review due: 27 Mar 2028
The stage of a cancer tells you how big it is and how far it’s spread. It helps your doctor decide which treatment you need.
There are different types of cancer that start in the liver. The most common type is hepatocellular carcinoma (HCC).
Your treatment for liver cancer depends on the stage of your cancer and how well your liver is working. The most common treatments are surgery, heat treatment, drug treatments and radiotherapy.
There is support available to help you cope with a diagnosis of liver cancer, life during treatment and life after cancer.
Primary liver cancer is cancer that started in the liver. This section is mainly about the most common type of liver cancer, hepatocellular carcinoma (HCC).
Secondary liver cancer is when a cancer that started somewhere else in the body has spread to the liver. It is also called liver metastases.
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