From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world

Table 4 American Joint Committee on Cancer TNM Staging for Liver Tumors (7^th edition, 2010)

Primary tumor (T)
Tx	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Solitary tumor without vascular invasion
T2	Solitary tumor with vascular invasion or multiple tumors, none more than 5 cm
T3a	Multiple tumors more than 5 cm
T3b	Single tumor or multiple tumors of any size involving a major branch of the portal vein or the hepatic vein
T4	Tumors with direct invasion of adjacent organs other than the gallbladder or with perforation of visceral peritoneum
Regional lymph nodes (N)
Nx	Regional lymph nodes cannot be assessed
N0	No regional node metastasis
N1	Regional lymph node metastasis
Distal Metastases (M)
M0	No distant metastasis
M1	Distant metastasis
Anatomic stage/prognostic groups
Stage I	T1	N0	M0
Stage II	T2	N0	M0
Stage IIIA	T3a	N0	M0
Stage IIIB	T3b	N0	M0
Stage IIIC	T4	N0	M0
Stage IςA	Any T	N1	M0
Stage IςB	Any T	Any N	M1
Histologic grade (G)
G1	Well differentiated
G2	Moderately differentiated
G3	Poorly differentiated
G4	Undifferentiated
Fibrosis core (F)
The fibrosis score as defined by Ishak recommended because of its prognostic value in overall survival. This scoring system uses a 0-6 scale
F0	Fibrosis score 0-4 (none to moderate fibrosis)
F1	Fibrosis score 5-6 (severe fibrosis or cirrhosis)