The treatment approaches for liver cancer tend to have to take into account more factors than other cancer types, mainly because the liver is one of the most important organs in the body with an extremely complex structure and over 500 different functions, including absorbing substances that are beneficial to our health and releasing toxic substances.
Before deciding on which treatment option is best for the patients, the doctor needs to consider whether the patient has enough remaining liver function to cope with a large scale resection of their liver and avoid liver failure following the procedure. Cancer staging, which is the size, number, location and the extent of the spread of the tumour, is also an important indicator for the devising of an appropriate treatment plan.
As with most cancers, the stages of liver cancer are determined according to how big the tumour has grown and whether or not cancer cells have invaded the blood vessels and spread beyond the liver to other organs. Based on TNM staging system, liver cancer can be divided into Stage I to Stage IV, although there are still some cases that cannot be classified. Stage I and Stage II usually imply the tumour remains small and cancer cells have yet to invade the blood vessels and metastasised to other parts of the body. For Stage III and Stage IV liver cancer, the tumour has already invaded the blood vessels and metastasised to the surrounding organs.
Researchers from the University of Hong Kong (HKU) have developed Asia’s first liver cancer staging system with treatment guidelines, namely the Hong Kong Liver Cancer (HKLC) staging system aimed at the unique risk factors in Asian populations. Based on the patient’s general health conditions, liver function and the progression of the disease, it classifies patients into five stages, rather than the current four in the TNM staging system widely adopted in Western countries. The objective of the new staging system specific to Asia’s populations is to encourage doctors and patients to adopt more proactive treatments to improve survival rates, whereby patients with liver cancer at mid to advanced stages may elect to undergo surgical resection.