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Viral Hepatitis

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Tumor-Node-Metastasis TNM Staging System

for Health Care Providers

Tumor-Node-Metastasis (TNM) Staging System - Liver Cancer

StageTNMRegional LNMDistance Metastasis
IT1N0M0
IIT2N0M0
IIIT1N1M0
T2N1M0
T3N0, N1M0
IVAT4Any NM0
IVBAny TAny NM1
  • LNM: lymph node metastasis
  • T1: solitary <= 2 cm, no vascular invasion
  • T2: i) solitary <= 2 cm, vascular invasion; ii) multiple, one lobe, <= 2 cm, no vascular invasion; or iii) solitary, > 2 cm, no vascular invasion
  • T3: i) solitary, > 2 cm, vascular invasion; ii) multiple, one lobe >= 2 cm, no vascular invasion; or iii) multiple, one lobe, > 2 cm, with or without vascular invasion
  • T4: multiple, more than one lobe, invasion of major branch of portal or hepatic vein
  • N0: no regional lymph node metastasis
  • N1: regional lymph node metastasis
  • M0: no distant metastasis
  • M1: distant metastasis

Adapted from Yu AS and Keeff EB. Management of Hepatocellular Carcinoma. Rev Gastroenterol Disord 2003; 3(i): 8-24.