Liver (ICD10 C22.0)

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Introduction

This is the data sheet for TNM 9th edition staging of the liver (ICD10 C22.0).

For more detailed information regarding TNM staging, please see pages 82-84 of the UICC TNM 9 book.

Stage groupings

Stage Group	T stage	N stage	M stage
Stage IA	T1a	N0	M0
Stage IB	T1b	N0	M0
Stage II	T2	N0	M0
Stage IIIA	T3	N0	M0
Stage IIIB	T4	N0	M0
Stage IVA	Any T	N1	M0
Stage IVB	Any T	Any N	M1

Note:

The Barcelona Clinic Liver Stage (BCLS), frequently used in the management of HCC, is a prognostic group system incorporating liver function and performance status. (BCLC strategy for prognostic prediction and treatment recommendation: The 2022update. Reig, Maria et al., Journal of Hepatology, Volume 76, Issue 3, 681- 693.)

TNM clinical classification

T - primary tumour

T value	Description
cTX	Primary tumour cannot be assessed
cT0	No evidence of primary tumour
cT1a	Solitary tumour 2 cm or less in greatest dimension with or without vascular invasion
cT1b	Solitary tumour more than 2 cm in greatest dimension without vascular invasion
cT2	Solitary tumour with vascular invasion more than 2 cm dimension or multiple tumours, none more than 5 cm in greatest dimension
cT3	Multiple tumours any more than 5 cm in greatest dimension
cT4	Tumour(s) involving a major branch of the portal or hepatic vein with direct invasion of adjacent organs (including the diaphragm), other than the gallbladder or with perforation of visceral peritoneum

N - regional lymph nodes

N value	Description
cNX	Regional lymph nodes cannot be assessed
cN0	No regional lymph node metastasis
cN1	Regional lymph node metastasis

M - distant metastasis

M value	Description
cM0	No distant metastasis
cM1	Distant metastasis - This includes metastasis to non-regional lymph nodes, including periaortic, pericaval, superior mesenteric artery and/or coeliac artery lymph nodes.

TNM pathological classification

pT - primary tumour

The pT and pN categories correspond to the cT and cN categories as per above.

pN - regional lymph nodes

pN value	Description
pN0	Histological examination of a regional lymphadenectomy specimen will ordinarily include 3 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0