Hepatocellular carcinoma (HCC) is a type of cancer that starts as a growth of cells in the liver. The liver is an organ that sits just under the rib cage on the right side of the belly. It helps the body digest food and get rid of waste products, among other tasks.

Hepatocellular carcinoma is the most common type of liver cancer. It starts in liver cells called hepatocytes. Hepatocellular carcinoma happens most often in people with chronic liver conditions, such as cirrhosis caused by hepatitis B or hepatitis C infection.

Hepatocellular carcinoma happens when liver disease or something else changes the cells in the liver. The changes cause the cells to make many more diseased cells that form a growth called a tumor. The tumor can hurt healthy liver tissue and grow into nearby blood vessels. The cells can break away and spread to other parts of the body.

Hepatocellular carcinoma is one of the most serious cancers. It may not cause symptoms right away, which means it can grow without being detected. It also tends to happen in people with serious liver disease, which may make treatment more difficult.

Treatment often depends on how advanced the cancer is and how well the liver is working. Hepatocellular carcinoma treatment may include surgery to remove the cancer or a liver transplant. Other treatments may include ablation, embolization, radiation therapy, immunotherapy and targeted therapy.

Hepatocellular carcinoma differs from another kind of liver cancer called intrahepatic cholangiocarcinoma. This other type starts in the bile ducts in the liver, rather than in the liver tissue. They are both kinds of liver cancer, but they have different risk factors and treatments. Another type of liver cancer called hepatoblastoma mostly affects young children. These are all types of malignant neoplasms of the liver, which is a medical term that means cancer in the liver.

Types

Hepatocellular carcinoma doesn't have types. Fibrolamellar carcinoma is sometimes described as a subtype or variant of hepatocellular carcinoma because both cancers are thought to start in hepatocytes. But fibrolamellar carcinoma acts differently than most hepatocellular carcinomas. Healthcare professionals don't agree on whether hepatocellular carcinoma and fibrolamellar carcinoma are related or not.

Fibrolamellar carcinoma happens most often in young adults who don't have liver disease. It's most often treated with surgery. Fibrolamellar carcinoma often doesn't cause high levels of alpha-fetoprotein (AFP) in the blood, as most hepatocellular carcinomas do.

Symptoms

Hepatocellular carcinoma might not cause symptoms that are noticed right away. This disease happens most often in people with liver scarring, called cirrhosis, caused by hepatitis B or hepatitis C infection. In these people, the cancer symptoms might be the same as the cirrhosis symptoms.

Hepatocellular carcinoma doesn't cause early symptoms. A healthcare professional might detect early signs of the disease, such as:

• Results that are higher than expected on a blood test that looks for alpha-fetoprotein (AFP), which might be done as part of liver cancer screening in someone with a high risk of the disease.
• Growths, called nodules, on the liver, which might be detected on an ultrasound imaging test that's done as part of liver cancer screening.

If signs and symptoms of hepatocellular carcinoma develop, it usually means the disease is advanced. Symptoms may include:

• Losing weight without trying.
• Loss of appetite.
• Upper abdominal pain.
• A growth in the abdomen.
• Yellowing of the skin and the whites of the eyes. This is called jaundice. It happens when a substance called bilirubin builds up in the blood.

When to see a doctor

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

Causes

The main causes of hepatocellular carcinoma are liver scarring, called cirrhosis, and infection with hepatitis B virus or hepatitis C virus. But not everyone with this type of cancer has a serious liver condition. It's not clear what causes hepatocellular carcinoma in people who don't have liver disease.

Hepatocellular carcinoma happens when cells in the liver called hepatocytes develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.

Risk factors

There are many factors that can increase the risk of hepatocellular carcinoma. The most common risk factors are liver scarring, called cirrhosis, and infection with the hepatitis B virus or hepatitis C virus. There are many other conditions that can hurt the liver and raise the risk of hepatocellular carcinoma.

Risk factors for hepatocellular carcinoma include:

• Older age. Hepatocellular carcinoma is more common in older adults.
• Infection with hepatitis B virus or hepatitis C virus. Ongoing or previous infection with the hepatitis B virus or hepatitis C virus increases the risk of hepatocellular carcinoma.
• Cirrhosis. Cirrhosis is a progressive and irreversible condition that causes scar tissue to form in the liver. It increases the chances of developing hepatocellular carcinoma.
• Certain inherited liver diseases. Some liver diseases that can run in families may increase the risk of hepatocellular carcinoma. Examples include hemochromatosis and Wilson's disease.
• Excess fat in the liver. Metabolic dysfunction-associated steatotic liver disease, which used to be called nonalcoholic fatty liver disease, happens when fat builds up in the liver. People with this condition are at an increased risk of hepatocellular carcinoma.
• Diabetes. People with this blood sugar condition have a greater risk of hepatocellular carcinoma than those who don't have diabetes.
• Obesity. People with obesity have a higher risk of cirrhosis and excess fat in the liver. These conditions increase the risk of hepatocellular carcinoma.
• Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops, such as grains and nuts, can become contaminated with aflatoxins, which can end up in foods made of these products.
• Excessive alcohol consumption. Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase the risk of hepatocellular carcinoma.
• Smoking cigarettes. People who smoke cigarettes are at an increased risk of hepatocellular carcinoma.

Complications

Hepatocellular carcinoma can spread to other parts of the body. When it spreads, it most often goes to the:

• Lungs.
• Lymph nodes in the abdomen.
• Bones.
• Adrenal glands.
• Brain.

The medical term for spread is metastasize. When this cancer spreads, healthcare professionals call it metastatic hepatocellular carcinoma.

Prevention

Reduce your risk of cirrhosis

Cirrhosis is scarring of the liver, and it increases the risk of hepatocellular carcinoma. You can reduce your risk of cirrhosis if you:

• Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
• Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. Eat fewer calories and slowly increase the amount of exercise.

Get vaccinated against hepatitis B

Infection with the hepatitis B virus increases the risk of hepatocellular carcinoma. You can reduce your risk of hepatitis B by receiving the hepatitis B vaccine. The vaccine can be given to almost anyone, including infants, children, adults and older adults.

Take measures to prevent hepatitis C

Infection with the hepatitis C virus increases the risk of hepatocellular carcinoma. No vaccine for hepatitis C exists, but you can reduce your risk of infection.

• Know the health status of any sexual partner. Don't engage in unprotected sex unless you're certain your partner isn't infected with hepatitis B, hepatitis C or any other sexually transmitted infection. If you don't know the health status of your partner, use a condom every time you have sexual intercourse.
• Don't use intravenous drugs, but if you do, use a clean needle. Reduce your risk of hepatitis C by not injecting legal or illegal drugs that may be sold on the streets. But if that isn't an option for you, make sure any needle you use is sterile, and don't share it. Contaminated needles are a common cause of hepatitis C infection. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
• Seek safe, clean shops when getting a piercing or tattoo. Needles that may not be properly sterilized can spread the hepatitis C virus. Before getting a piercing or tattoo, check out the shops in your area and ask staff members about their safety practices. If employees at a shop won't answer your questions or don't take your questions seriously, take that as a sign that the facility isn't right for you.

Seek treatment for hepatitis B or C infection

Treatments are available for hepatitis B and hepatitis C infections. Research shows that treatment can reduce the risk of hepatocellular carcinoma.

Ask about liver cancer screening

For most people, screening for liver cancer hasn't been proved to reduce the risk of dying of liver cancer, and it isn't generally recommended. People with conditions that increase the risk of liver cancer might consider screening. People with an increased risk include those who have:

• Hepatitis B infection.
• Hepatitis C infection.
• Liver cirrhosis.

Talk about the pros and cons of screening with your healthcare team. Together you can decide whether screening is right for you based on your risk. Hepatocellular carcinoma screening typically involves a blood test and an abdominal ultrasound every six months.

Diagnosis

To diagnose hepatocellular carcinoma, a healthcare professional might do a physical exam and ask questions about your health history. Other tests and procedures might include imaging tests, blood tests and removing some cells for testing.

Imaging tests

Imaging tests make pictures of the body. They can show the location and size of a hepatocellular carcinoma. Tests might include:

• Ultrasound.
• Computerized tomography (CT) scan.
• Magnetic resonance imaging (MRI) scan.
• Positron emission tomography (PET) scan.

Liver function tests

Blood tests can give your healthcare team clues about what's causing your symptoms. These might include tests that measure how well the liver is working, such as:

• Alanine transaminase (ALT) test.
• Aspartate transaminase (AST) test.
• Alkaline phosphatase (ALP) test.
• Albumin test.
• Bilirubin test.
• Prothrombin time (PT) test.

Tumor marker test

Tumor marker tests look for chemicals made by the cancer cells. The alpha-fetoprotein (AFP) blood test is a tumor marker test used for hepatocellular carcinoma.

AFP is a protein made by liver cells as a baby grows in the womb. Blood levels of AFP drop soon after birth. For most people, a high level of AFP in the blood isn't typical, except during pregnancy.

When liver cells are injured, they may make AFP as they try to repair themselves. This raises AFP levels in the blood. For most people with hepatocellular carcinoma, the cancer causes very high AFP levels. Having high AFP doesn't mean someone has cancer, though. There are other things that can cause it, such as pregnancy, acute liver injury and liver fibrosis.

Healthcare teams may use AFP test results along with other results to decide whether a growth in the liver might be cancer. They might track AFP levels over time to see whether treatment is working.

Biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. For hepatocellular carcinoma, the biopsy uses a needle to get the tissue sample. During a liver biopsy, a healthcare professional puts a needle through the skin and into the cancer. The health professional uses the needle to draw out a sample of cells from the liver.

The sample is tested in a lab to see if it is cancer. Other special tests give more details about the cancer cells. Your healthcare team uses this information to make a treatment plan.

Not everyone needs a biopsy to diagnose hepatocellular carcinoma. Sometimes healthcare teams make the diagnosis using the results of other tests.

Treatment

Treatment for hepatocellular carcinoma depends on the location and the extent of the cancer. Treatment also may depend on the condition of the liver. Surgery may be used to remove the cancer. In some people, a liver transplant may be an option. Other treatments may include ablation, embolization, radiation therapy, immunotherapy and targeted therapy.

Which treatments are best for you will depend on your cancer and your overall health. Here's a look at common approaches to hepatocellular carcinoma treatment.

• When there is one or a few areas of cancer in the liver, treatment might involve surgery to remove the cancer, when possible. In people with liver cirrhosis, surgery might involve removing the liver and replacing it with one from a donor.
• When cancer is only in the liver and surgery isn't possible, healthcare professionals might use other procedures to treat the cancer. These might include ablation treatments, embolization procedures and radiation therapy. If the cancer involves many parts of the liver, medicines might help control it or slow its growth.
• When the cancer spreads or grows beyond the liver, treatment often involves medicines to help control it or slow its growth.
• When there is multifocal cancer, treatment may depend on how much of the liver is involved. Multifocal means there is more than one area of cancer in the liver. If the areas of cancer are near each other, surgery to remove the cancerous parts of the liver might be possible. If the cancer involves more of the liver, transplant might be an option. If a lot of the liver is affected by cancer, treatment might involve medicines.
• When there is cirrhosis and cancer, treatment can be difficult because advanced liver disease can make cancer treatments harder to take. If the liver is working well, liver transplant might be an option. This treatment can cure the cancer and the cirrhosis. In people who aren't healthy enough for surgery, other liver procedures and medicines may help control the cancer.

Surgery

Treatment for hepatocellular carcinoma may start with surgery to remove part of the liver including the cancer or the whole liver with a transplant. Surgery options include:

• Surgery to remove the cancer. A partial hepatectomy is used for people whose cancer is in one part of the liver. This surgery removes the cancer and some healthy tissue around it. Whether this is an option for you depends on the location of your cancer within the liver, how well your liver functions and your overall health.
• Liver transplant surgery. Sometimes surgery to remove the cancer is combined with a liver transplant. A surgeon removes the cancer and all of the liver. Then the surgeon puts a healthy liver from a donor into the body. A liver transplant may be an option in otherwise healthy people whose cancer hasn't spread beyond the liver. Other treatments may be used to treat the cancer while waiting for a transplant.

Surgery carries a risk of bleeding and infection. After a liver transplant you typically take medicine to prevent complications from receiving a liver from a donor. There may be side effects of this medicine, such as having a weakened immune system.

Other liver procedures

Other procedures on the liver can help treat hepatocellular carcinoma. These treatments may be used in people who can't have surgery to remove the cancer. These other liver procedures for hepatocellular carcinoma include:

• Radiofrequency ablation. Radiofrequency ablation uses electric current and heat to hurt the cancer cells. During this procedure, a healthcare professional places small needles into the cancer. The needles deliver hot temperatures that hurt the cancer cells.
• Cryoablation. Cryoablation uses cold to hurt the cancer cells. During the procedure, a healthcare professional places small needles into the cancer. The needles deliver cold temperatures that hurt the cancer cells.
• Chemoembolization. Chemoembolization gives chemotherapy medicines directly to the cancer. It also uses medicine that blocks the flow of blood to the cancer. Blocking the blood flow to the cancer may cause the cancer to shrink, grow more slowly or not grow at all.
• Radioembolization. Radioembolization uses tiny beads that hold radiation. The healthcare team puts the beads into a blood vessel that goes to the liver. The beads give off radiation directly to the cancer.
• Radiation therapy. Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. The beams can target the cancer in the liver.

The side effects of these procedures depend on what procedure you're having and how much of the liver is being treated.

Immunotherapy

Immunotherapy for cancer is a treatment with medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells.

Immunotherapy may be used after surgery to kill any remaining cancer cells. For those with advanced hepatocellular carcinoma that can't be removed with surgery, immunotherapy may be an option.

Immunotherapy side effects depend on which medicine you take. Side effects may include high blood pressure, nausea, cough and feeling very tired.

Targeted therapy

Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.

Targeted therapy may be used after surgery to kill any remaining cancer cells. For those with advanced hepatocellular carcinoma that can't be removed with surgery, targeted therapy may be an option.

Targeted therapy side effects depend on which medicine you take. Side effects may include high blood pressure, feeling very tired, diarrhea and joint pain.

Palliative care

Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. A healthcare team that may include doctors, nurses and other specially trained health professionals provides palliative care. The care team's goal is to improve quality of life for you and your family.

Palliative care specialists work with you, your family and your care team. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time you're getting strong cancer treatments, such as surgery, chemotherapy, immunotherapy, targeted therapy or radiation therapy.

The use of palliative care with other treatments can help people with cancer feel better and live longer.

Lifestyle and home remedies

If you've been diagnosed with hepatocellular carcinoma, take care of your body by helping it feel as good as possible during treatment. Be active when you can, get enough rest, and choose a healthy diet.

Stay active

Physical activity is often the best treatment to manage fatigue. To give yourself more physical energy, exercise every day. Exercise prevents muscle loss and helps manage fatigue. Ask your healthcare team about programs in your community. Choose activities you enjoy and can easily do:

• Take a walk around the block. Exercise outside if it is safe for you.
• Do aerobic exercise to lessen cancer-related fatigue. Stick with a regular program. This is more important than how hard or how long you exercise. Aerobic exercise includes walking or using gym equipment, such as an exercise bike. Save energy for daily aerobic exercise.
• Try strengthening exercises. Exercising with weights, bands or even your body weight also can fight fatigue.
• Pace yourself. On days when you have more energy, do not push it. Stick to your routine to help manage your fatigue.
• Explore low-impact exercises. Yoga, tai chi and Pilates can help fatigue that comes from the cancer.

Get the rest you need

Difficult symptoms can affect how you sleep. But your body needs restful sleep to work well. Lack of sleep can make you more easily irritated and less able to cope with pain and stress. Talk to your care team if you have sleep problems.

Eat a healthy diet

A healthy diet rich in fruits, vegetables, whole grains and lean protein can help you:

• Keep up your energy so that you can exercise and be active.
• Manage your symptoms.
• Improve your overall well-being.

Coping and support

With time, you'll find ways to cope with feelings that happen after a cancer diagnosis. Until then, here are some ideas for coping with hepatocellular carcinoma.

Learn enough about cancer to make decisions about your care

Ask your healthcare team about your cancer, including your test results, treatment options and, if you like, your prognosis. As you learn more about hepatocellular carcinoma, you may become more confident in making treatment decisions.

Keep friends and family close

Keeping your close relationships strong can help you deal with hepatocellular carcinoma. Friends and family can provide the practical support you may need, such as helping take care of your home if you're in the hospital. And they can serve as emotional support when you feel overwhelmed by having cancer.

Find someone to talk with

Find someone who is willing to listen to you talk about your hopes and worries. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.

Ask your healthcare team about support groups in your area or contact the American Cancer Society. Find support online through Mayo Clinic Connect, which is a community where you can connect with others for support, practical information and answers to everyday questions.

Preparing for an appointment

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

If your healthcare professional thinks you might have hepatocellular carcinoma, you may be referred to a doctor who specializes in diseases of the liver, called a hepatologist. If a cancer diagnosis is made, you also may be referred to a doctor who specializes in treating cancer, called an oncologist.

Because appointments can be brief, it's a good idea to be prepared. Here's some information to help you get ready.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down symptoms you have, including any that may not seem related to the reason for which you scheduled the appointment.
• Write down important personal information, including major stresses or recent life changes.
• Make a list of all medicines, vitamins or supplements you're taking and the doses.
• Take a family member or friend along. Sometimes it can be very hard to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
• Write down questions to ask your healthcare team.

Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For hepatocellular carcinoma, some basic questions to ask include:

• Do I have hepatocellular carcinoma?
• What is the stage of my hepatocellular carcinoma?
• Has my hepatocellular carcinoma spread to other parts of my body?
• Will I need more tests?
• What are the treatment options?
• How much does each treatment increase my chances of a cure or prolong my life?
• What are the potential side effects of each treatment?
• How will each treatment affect my daily life?
• Is there one treatment option you believe is the best?
• What would you recommend to a friend or family member in my situation?
• Should I see a specialist?
• Are there any brochures or other printed material that I can take with me? What websites do you recommend?
• What will determine whether I should plan for a follow-up visit?

Don't hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

• When did your symptoms begin?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?

Your healthcare team uses the results from diagnostic tests and procedures to give your cancer a stage. The stage tells your healthcare team about how severe your cancer is and how well your liver is working.

There are different systems used for hepatocellular carcinoma staging. Some use numbers and some use letters. One system that is commonly used is called the Barcelona Clinic Liver Cancer Staging System. This system has five stages. It uses the number 0 for the earliest stage of cancer and letters A through D for the other stages.

Using this staging system, the stages of hepatocellular carcinoma are:

• Stage 0, also called very early stage. Stage 0 hepatocellular carcinoma means there is one growth of cancer cells, called a tumor, in the liver that is smaller than 2 centimeters (a little more than 3/4 inch). The tumor has not spread to blood vessels or outside the liver.
• Stage A, also called early stage. Stage A hepatocellular carcinoma means there is one tumor in the liver that is larger than 2 centimeters (a little more than 3/4 inch). Or it may mean that there are up to three tumors that are each smaller than 3 centimeters (a little more than 1 inch). The tumors have not spread to blood vessels or outside the liver.
• Stage B, also called intermediate stage. Stage B hepatocellular carcinoma means there are more tumors than stage A and they may be larger. The tumors may affect different parts of the liver. The tumors have not spread to blood vessels or outside the liver.
• Stage C, also called advanced stage. Stage C hepatocellular carcinoma means the tumors have grown to involve the blood vessels or the cancer cells have spread beyond the liver. When cancer spreads away from where it started, it's called metastatic cancer.
• Stage D, also called end stage. Stage D hepatocellular carcinoma means the liver is not healthy enough to have treatment. This is because cirrhosis is so severe. The healthcare team might focus on comfort care, rather than trying to cure the cancer.

If you've been diagnosed with hepatocellular carcinoma, one of the first things you might wonder about is the survival rate for this type of cancer. Survival rates come from following a large group of people with the same diagnosis for a set amount of time. Cancer survival rates often state what percentage of that group is still living five years after a cancer diagnosis.

The U.S. National Cancer Institute gives survival rates for all liver cancers together. These rates include people with hepatocellular carcinoma and also those with intrahepatic cholangiocarcinoma, which is cancer that happens in the bile ducts inside the liver. Using this data, the survival rates are given by the extent of the cancer.

• Localized liver cancer, which means the cancer is only in the liver, has a five-year survival rate of about 38%. This means that for every 100 people with this diagnosis, about 38 would be expected to be living five years after diagnosis.
• Regional liver cancer, which means the cancer may have spread to nearby lymph nodes, has a five-year survival rate of about 13%.
• Distant liver cancer, which means the cancer has spread to other parts of the body, is also called metastatic liver cancer. The five-year survival rate is about 4%.

These numbers include people with different kinds of liver cancer and different treatments, including some who didn't have treatment. Keep in mind that these numbers are based on people who were diagnosed more than five years ago. They may not have had access to the latest treatments.

Hepatocellular carcinoma survival rates can give you an idea of the prognosis for people in your situation. But survival rates can't say whether you will be cured. For the clearest and most complete picture of your outlook, talk about it with your healthcare team. Your care team understands your overall health and can give a more personalized prognosis.

There are many factors that a healthcare team thinks about when deciding on a prognosis, including:

• The size of the cancer. A small cancer or a few small areas of cancer have a better prognosis, as they may be easier to remove with surgery.
• How much of the liver is affected. If cancer affects a lot of the liver, this gives a worse prognosis.
• How well the liver is working. Having good liver function gives a better prognosis.

A small hepatocellular carcinoma that can be completely removed with surgery has a good chance for a cure, especially if the remaining liver is healthy. In this situation, the five-year survival rate can be as high as 90%. For those who also have liver disease, liver transplant also can cure the cancer. Studies have found five-year survival rates after transplant of 75% or higher.

Liver cancer tends to grow quickly. Many people may not be healthy enough for surgery or may have cancer that can't be removed with surgery. In those situations, the chance of surviving at least five years is lower.

The Barcelona Clinic Liver Cancer Staging System, which is a common system for staging hepatocellular carcinoma, includes general estimates of life expectancy for people with this cancer. These life expectancy numbers give the healthcare team an idea of how long a person may be expected to live after treatment based on the stage of the cancer.

• Stage 0 has a life expectancy of more than five years.
• Stage A has a life expectancy of more than five years.
• Stage B has a life expectancy of more than five years when liver transplant is used. When transplant isn't an option, localized therapies have a life expectancy of more than 2.5 years. Treatment with medicines has a life expectancy of more than two years.
• Stage C has a life expectancy of more than two years.
• Stage D has a life expectancy of 3 months.