TNM staging for hepatocellular cancer

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
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
Fibrosis score (F)*
F0	Fibrosis score 0-4 (none to moderate fibrosis)
F1	Fibrosis score 5-6 (severe fibrosis or cirrhosis)
Anatomic stage/prognostic groups
Stage I	T1	N0	M0
Stage II	T2	N0	M0
Stage IIIA	T3a	N0	M0
Stage IIIB	T3b	N0	M0
Stage IIIC	T4	N0	M0
Stage IVA	Any T	N1	M0
Stage IVB	Any T	Any N	M1

TNM_staging_HCC.htm

Note: cTNM is the clinical classification, pTNM is the pathologic classification.

* The fibrosis score as defined by Ishak is recommended because of its prognostic value in overall survival. This scoring system uses a 0-6 scale.

Used with the permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010) published by Springer New York, Inc.

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TNM staging for hepatocellular cancer