Hepatocellular carcinoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]

Overview

Hepatocellular carcinoma may be classified according to the histological subtypes. The staging of HCC is based on the TNM staging system.

Classification

• Hepatocellular carcinoma may be classified according to the histological subtypes:
  • Fibrolamellar carcinoma
  • Sarcomatoid HCC
  • Undifferentiated carcinoma
  • Combined HCC-cholangiocarcinoma (HCC-CC)
  • Lymphoepithelioma

Hepatocellular carcinoma

Fibrolamellar carcinoma

Undifferentiated carcinoma

Sarcomatoid HCC

Combined HCC-cholangiocarcinoma (HCC-CC)

Lymphoepithelioma

Staging

According to the TNM staging system, there are four stages of hepatocellular carcinoma based on the tumor size, lymph node involvement, and distant metastasis.

Primary tumor

TX	Primary tumour cannot be assessed
T0	No evidence of primary tumour
T1	A single tumour with no invasion into the blood vessels of the liver
T2	A single tumour with invasion into the blood vessels or multiple tumours, none more than 5 cm in size
T3a	Multiple tumours, with any tumour larger than 5 cm
T3b	The tumour has grown into either the portal or hepatic vein
T4	The tumour has grown into nearby organs (other than the gallbladder) or the tumour has grown into the layer of tissue that covers the organs in the abdomen (visceral peritoneum)

Regional lymph node

NX	Regional lymph nodes cannot be assessed
NX	No regional lymph node metastasis
NX	Regional lymph node metastasis

Distance metastasis

M0	No distant metastasis
M1	Distant metastasis