Does early-stage liver cancer metastasize?

Written by Yan Chun
Oncology
Updated on February 11, 2025
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Patients with early-stage liver cancer generally do not experience metastasis. This is because for patients with early-stage liver cancer, the lesions are localized and have not spread, thus being classified as early-stage. Moreover, the general treatment for patients with early-stage liver cancer involves curative surgery. Since the lesions are localized, in most cases, there will be no recurrence or metastasis after the surgery. Therefore, for early-stage patients, there is no need to administer adjuvant radiotherapy or adjuvant chemotherapy and other anti-tumor treatments after the surgery. However, once the liver cancer lesions invade surrounding tissues and metastasize to distant sites, it indicates that the lesions have spread, and the clinical stage has progressed to mid or late stages, losing the opportunity for curative surgery. Most patients undergo comprehensive treatments such as radiotherapy, chemotherapy, and targeted therapy which generally results in a reduction in survival time.

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Written by Yan Chun
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Should the gallbladder be removed in the early stage of liver cancer?

Whether early-stage liver cancer patients need to have their gallbladder removed depends on the location of the tumor. For liver cancers located close to the gallbladder, gallbladder removal is generally necessary. For liver cancer lesions that are farther from the gallbladder, it is usually sufficient to only remove the liver tumor, or to perform a resection of the local liver segment or sub-segment. Additionally, for early-stage liver cancer patients to undergo surgery, certain conditions must be met: the tumor must be five centimeters or smaller, there should be no cancerous thrombus in the main trunk of the portal vein, the liver cancer tumor should not involve the semi-dry or full-dry circumstances, and the liver function should be compensatory. Under these conditions, an effort should be made to perform liver tumor resection. Generally, cancers located in the left lobe of the liver require local resection, either of a liver segment or sub-segment, and sometimes resection of the liver lobe may be performed. Tumors located in the right lobe of the liver or the hepatic portal area require local tumor resection.

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Written by Liu Liang
Oncology
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What are the early symptoms of liver cancer?

The early symptoms of liver cancer lack specificity, so in clinical practice, early-stage liver cancer is generally detected only during routine screenings or physical examinations. By the time patients present with noticeable symptoms and seek medical attention, the cancer is often in the intermediate or advanced stages, making surgical removal unlikely for most patients. The early symptoms might include non-specific signs such as fatigue. It is usually only in the intermediate or advanced stages that patients experience obvious symptoms like pain in the liver area, palpable abdominal masses, abdominal distension, weight loss, and jaundice. By the time these symptoms appear, it is typically quite late, corresponding to the intermediate or advanced stages of the disease. Early stages typically do not show specific symptoms, though some patients might experience mild abdominal pain, bloating, or fatigue, which are not very specific signs.

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Does primary liver cancer have a genetic basis?

Primary liver cancer is generally not certain to be hereditary, but it may be somewhat related to genetics. For example, there are often phenomena of family and regional clustering of liver cancer. Current research believes that primary liver cancer, commonly referred to as liver cancer, is the result of a combination of factors, closely associated with hepatitis virus infection, aflatoxin infection, and contaminated drinking water. Common scenarios include hepatitis B virus infection leading to hepatitis B followed by cirrhosis, which can further develop into primary liver cancer. Also, long-term alcohol abuse leading to alcoholic cirrhosis can also result in liver cancer.

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Oncology
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Primary liver cancer causes

The causes and specific mechanisms of primary liver cancer are not yet very clear; its development is a complex process involving multiple factors and steps, influenced by various aspects such as environment and diet. Primary liver cancer is associated with chronic hepatitis B and C virus infections, aflatoxin, contaminated drinking water, and alcoholic cirrhosis, among other factors. Particularly, hepatocellular carcinoma has a significant association with hepatitis B, and most patients may also have a history of chronic hepatitis B.

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Liver cancer B-ultrasound manifestations

Generally speaking, for diseases of the hepatobiliary system, most of us conduct examinations using ultrasound because it is very convenient, safe, involves no radiation, and the results are relatively quick. Generally, liver cancer can appear as hypoechoic, hyperechoic, or mixed echogenicity on ultrasound. Most such liver cancer nodules may have a complete capsule, but some may not have a complete capsule. Overall, this type of liver cancer tends to grow expansively and invasively, compressing the surrounding normal liver tissue, and possibly showing some halo signs around it. The vast majority of liver cancers do not occur independently; they usually develop gradually from cirrhosis. Therefore, there is often an enlargement of the portal vein, and in some cases of liver cancer with metastasis, thrombosis in the portal vein can be seen.