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Patrick Maguire, MD, Oncology, answeredThe American Joint Commission on Cancer (AJCC) Tumor Node Metastasis (TNM) system is used for liver cancer staging. The staging of hepatocellular carcinomas (HCC) depends upon whether there are single or multiple lesions, as well as their size and location. Of particular importance is whether the tumor(s) invade or encase major blood vessels. In addition, the serum alpha-fetoprotein (AFP) and underlying severity of the patient's liver disease are important factors for their prognosis. Those with severe cirrhosis tend to do relatively poorly.