Vauthey et al proposed a TNM classification system for hepatocellular carcinoma using a simplified T designation. This can help reduce the complexity of patient stratification while providing prognostically useful information. The authors are from the M.D. Anderson Cancer Center, Massachusetts General Hospital, Mayo Clinic and Hopital Beaujon in Paris.
Parameters:
(1) simplified T designation (sT)
(2) degree of fibrosis (F)
(3) metastasis to regional lymph nodes (N)
(4) distant metastasis (M)
|
Parameter |
Finding |
Code |
|
primary tumor |
single tumor without vascular invasion |
sT1 |
|
|
single tumor with vascular invasion |
sT2 |
|
|
multiple tumors, all <= 5 cm in diameter |
sT2 |
|
|
multiple tumors, any > 5 cm in diameter |
sT3 |
|
|
tumor involving a major branch of the portal or hepatic vein |
sT3 |
|
fibrosis |
none to moderate (Grades 0 to 4) |
F0 |
|
|
severe or cirrhosis (Grades 5 or 6) |
F1 |
|
regional lymph node metastasis |
absent |
N0 |
|
|
present |
N1 |
|
distant metastasis |
absent |
M0 |
|
|
present |
M1 |
|
Simplified |
Corresponding AJCC |
|
sT1 |
T1, T2c |
|
sT2 |
T2a, T2b, T3, T4a, T4c |
|
sT3 |
T4b |
from Table 5, page 1532
In general, severe fibrosis or cirrhosis has a negative impact on survival within all categories.
|
Simplified T |
Fibrosis |
Probability of 5 Year Survival |
|
sT1 |
F0 |
64% |
|
sT1 |
F1 |
49% |
|
sT2 |
F0 |
46% |
|
sT2 |
F1 |
30% |
|
sT3 |
F0 |
17% |
|
sT3 |
F1 |
9% |
from Table 5, page 1532
|
sTNM |
Stage |
|
sT1 N0 M0 |
I |
|
sT2 N0 M0 |
II |
|
sT3 N0 M0 |
IIIA |
|
any sT, N1, M0 |
IIIB |
|
any sT, any N, M1 |
IV |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
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