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    Childhood Liver Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Stages of Childhood Liver Cancer

    After childhood liver cancer has been diagnosed, tests are done to find out if cancer cells have spread within the liver or to other parts of the body.

    The process used to find out if cancer has spread within the liver or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

    The following tests and procedures may be used in the staging process for hepatoblastoma and hepatocellular carcinoma:

    • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
    • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
    • Surgery: An operation will be done to look at or remove the tumor. Tissues removed during surgery will be checked by a pathologist.

    There are two staging systems for childhood liver cancer.

    Two staging systems are used for childhood liver cancer:

    • Presurgical staging: The stage is based on where the tumor has spread within the four parts (sections) of the liver, as shown by imaging procedures such as MRI or CT. This staging system is called PRETEXT and it is done before the patient has surgery.
    • Postsurgical staging: The stage is based on the amount of tumor that remains after the patient has had surgery to look at or remove the tumor.

    The following stages are used to describe liver cancer that is staged before surgery:

    The liver is divided into 4 vertical sections.

    PRETEXT Stage 1

    PRETEXT Stage 1. Cancer is found in one section of the liver. Three sections of the liver that are next to each other do not have cancer in them.

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