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The PRETEXT preoperative typing system
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Stage I
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Tumor confined to 1 liver segment, no tumor invasion in 3 adjacent liver segments
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Stage II
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The tumor involved 2 liver segments and the other 2 adjacent liver segments were not invaded by the tumor.
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Stage III
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The tumor involves 2 liver segments and the other 2 non-contiguous liver segments are not involved; or the tumor involves 3 liver segments.
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Stage IV
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The tumor involved 4 liver segments.
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Annotation factors
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P (portal invasion)
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V (hepatic vein/vessel invasion)
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F (multifocality)
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E (extrahepatic tumor extension)
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R (tumor rupture)
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M (distant metastasis)
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The postoperative COG Evans staging system
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Stage I a
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Complete resection of the tumor, histopathologic type of simple fetal type
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Stage I b
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Complete resection of tumor, histopathological types other than simple fetal type
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Stage II
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Tumor largely resected, with microscopic remnants
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Stage III
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Tumor with visual remnants, or basic resection with positive lymph nodes, or tumor rupture or peritoneal hemorrhage
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Stage IV
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Occurrence of distant metastases at diagnosis, regardless of complete resection of the primary lesion
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