|
Stages of Childhood Liver Cancer
| Key Points for This Section
|
|
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.
There are 2 staging systems for childhood liver cancer:
- Postsurgical (after surgery) 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. Postsurgical staging is used for most childhood liver cancer.
- Presurgical (before surgery) staging: The stage is based on where the tumor has spread within the four parts (quadrants) of the liver, as shown by imaging procedures such as MRI or CT. This staging system, called PRETEXT, may be used for childhood hepatoblastoma.
The following tests and
procedures may be used in the staging process:
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, 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).
- Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
- 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 three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used after surgery:
Stage I
In stage I, all of the cancer was removed by surgery.
Stage II
In stage II, all of the cancer that can be seen without a microscope was removed by surgery. A small amount of cancer remains in the liver, but it can be seen only with a microscope or the tumor cells may have spilled into the abdomen during surgery.
Stage III
In stage III:
- the tumor cannot be removed by surgery; or
- cancer that can be seen without a microscope remains after surgery; or
- the cancer has spread to nearby lymph nodes.
Stage IV
In stage IV, the cancer has spread to other parts of the body.
The following stages are used for childhood hepatoblastoma before surgery:
PRETEXT Stage 1
In stage 1, the cancer is found in one quadrant of the liver.
PRETEXT Stage 2
In stage 2, cancer is found in two quadrants of the liver that are next to each other.
PRETEXT Stage 3
In stage 3, cancer is found in three quadrants of the liver that are next to each other or two quadrants that are not next to each other.
PRETEXT Stage 4
In stage 4, cancer is found in all four quadrants.
Back to Top
< Previous Section | Next Section > |
