Liver Cancer

There are two forms of liver cancer. Cancer that starts in the liver is called primary liver cancer, or hepatocellular carcinoma (HCC). Cancer that spreads to the liver from another organ is called metastatic liver cancer. HCC accounts for most liver cancers, and it occurs more often in men than women.

Screening

Certain people are at higher risk for developing HCC, including those who have hepatitis or cirrhosis. The most common causes of liver cancer are chronic infection with either hepatitis B or hepatitis C or cirrhosis. Cirrhosis is another word for the scar tissue that develops when the liver has been damaged by long-term infection with hepatitis or alcohol use. Cirrhosis is not cancer itself, but the presence of cirrhosis greatly increases the risk for developing liver cancer. In fact, any person with cirrhosis should undergo screening to check for liver cancer on a regular basis. Current guidelines recommend an ultrasound of the liver every six months in patients with cirrhosis.

If an ultrasound shows a suspicious area in the liver, either a CT scan or MRI is obtained next. These imaging tests can accurately diagnose liver cancer based on the way it looks and reacts to intravenous dye. Biopsies are rarely needed to diagnose liver cancer. Although there is no blood test that can be used to detect liver cancer, a blood test called AFP (alpha-fetoprotein) can help confirm the diagnosis if the level is high.

Treatments

Partial hepatectomy

In this procedure, the surgeon removes the part of the liver that contains the mass, as well as a margin of normal healthy tissue. Following surgery, the remaining liver grows in size to replace the lost volume, restoring normal function.

Laparoscopic hepatectomy

Many liver resections can be performed laparoscopically, depending on tumor size and location.

Liver transplantation

In cases where a liver transplantation is the best option, our surgeons collaborate closely with physicians at nearby transplant centers to facilitate treatment. All patients are cared for by a closely coordinated multidisciplinary treatment group.

Radiofrequency/microwave ablation

Ablation is performed using a special probe that burns the cancer in the liver to destroy it. This technique can be used to treat small tumors as an alternative to surgical removal or can be used to avoid surgery in patients who are not candidates.

Transarterial chemoembolization (TACE)

In this procedure, interventional radiologists gain access to the patient's arterial system via the groin and then advance a catheter into the artery supplying the liver. Medication and particles are injected directly into the blood vessel that supplies the tumor in order to destroy it and control its growth.