Skip to content

    Cancer Health Center

    Font Size

    Childhood Liver Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information


    Postsurgical Staging for Childhood Liver Cancer

    A staging system based on operative findings and surgical resectability has been used in the United States to group children with liver cancer. This staging system is used to determine treatment.[11,12,13]

    Hepatoblastoma prognosis by postsurgical stage

    Stages I and II

    In stage I hepatoblastoma, the tumor is completely resected.

    In stage II hepatoblastoma, microscopic residual tumor remains after resection.

    Approximately 20% to 30% of children with hepatoblastoma are stage I or II. Prognosis varies depending on the subtype of hepatoblastoma:

    • Pure fetal histology (4% of hepatoblastomas) have a 3- to 5-year OS rate of 100% with minimal or no chemotherapy.[1,13,14]
    • Non-pure fetal histology, non-small cell undifferentiated stage I and II hepatoblastomas have a 3- to 4-year OS rate of 90% to 100% with adjuvant chemotherapy.[1,6,8,13,15]
    • If any small cell undifferentiated elements are present in stage I or II hepatoblastoma, the 3-year survival rate is 40% to 70%.[1,16]

    Stage III

    In stage III hepatoblastoma, there are no distant metastases and one of the following is true:

    • The tumor is either unresectable or the tumor is resected with gross residual tumor.
    • There are positive lymph nodes.

    Approximately 50% to 70% of children with hepatoblastoma are stage III. The 3- to 5-year OS rate for children with stage III hepatoblastoma is less than 70%.[1,6,8,13,17]

    Stage IV (distant metastases)

    In stage IV hepatoblastoma, there is distant metastasis regardless of the extent of liver involvement.

    Approximately 10% to 20% of children with hepatoblastoma are stage IV. The 3- to 5-year OS rate for children with stage IV hepatoblastoma vary widely based on published reports, from 20% to approximately 60%.[1,6,7,8,13,17]

    Hepatocellular carcinoma prognosis by postsurgical stage of disease at diagnosis

    • Children with stage I hepatocellular carcinoma have a good outcome.[18]
    • Stage II is too rarely seen to predict outcome.
    • Stages III and IV are usually fatal.[10,19]

    Treatment Options Under Clinical Evaluation: COG Hepatoblastoma Risk Groups

    1 | 2 | 3 | 4
    Next Article:

    Today on WebMD

    man holding lung xray
    What you need to know.
    stem cells
    How they work for blood cancers.
    woman wearing pink ribbon
    Separate fact from fiction.
    Colorectal cancer cells
    Symptoms, screening tests, and more.
    Jennifer Goodman Linn self-portrait
    what is your cancer risk
    colorectal cancer treatment advances
    breast cancer overview slideshow
    prostate cancer overview
    lung cancer overview slideshow
    ovarian cancer overview slideshow
    Actor Michael Douglas