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		Home > Cancer and Treatments > Liver (hepatoma) Cancer Hepatoma (liver) Cancer Treatment Information Whether a cancer tumor has spread from another site, most commonly the colon, or has developed originally within the liver (HCC) or bile ducts (cholangiocarcinoma), many are very treatable with opportunities for a long disease-free survival. Surgical removal of the tumor along with part of the liver generally offers the best opportunities for a cure. Many of these surgeries can be performed laparoscopically or along with removal and reconstruction of structures adjoining the liver that may also be involved with the tumor (vascular structures, bile duct, diaphragm, etc.). The following is a list of the surgical procedures most commonly performed for liver tumors: Wedge resection removal of a small tumor along with some surrounding liver tissue Hepatic lobectomy removal of one half or one side of the liver for larger tumors or those involving the major blood supply to one side of the liver Segmentectomy removal of one or more segments of the liver (there are 8 anatomical segments to the liver) Bile duct resection removal of the gallbladder and the main bile duct draining the liver; reconstruction of bile drainage is performed using a portion of the small intestine Liver transplantation used for primary liver malignancies such as hepatocellular carcinoma or cholangiocarcinoma. This entails removing the entire liver along with the tumor and replacing it with a new one. (see also U-M Transplant Center, Liver Transplant) Intraoperative ultrasound used during an operation for its increased sensitivity to detect other tumors not identified on prior imaging which can allow treatment at the same setting. This also allows greater planning of the above resections with respect to the liver's internal anatomy. Radiofrequency ablation (RFA) an electrode is placed under ultrasound guidance into the tumor and the tumor is "heated" resulting in tumor destruction How much of the liver can be safely removed? Up to 75% of the liver can be removed in patients without any underlying liver disease. The remaining liver will "grow" over a period of 4-8 weeks to the same size of the original liver. As much as 60% of the liver can be removed in patients with underlying liver disease. What if there is too little liver reserve to allow resection? A procedure called Portal Vein Embolization (PVE) can be performed prior to the planned operation to allow early growth of the liver and thereby permit the ability to pursue a safe resection. PVE is performed by our Interventional Radiologists most commonly as an outpatient procedure. Are there other treatment options? Some patients are not candidates for surgical resection either due to overall disease burden, underlying liver disease, or medical fitness for operation. In these circumstances, there are many other treatment options that also allow for significant gains in quality of life and survival. Additionally, many of these treatments provide the opportunity for decreasing the stage of the disease and thereby provide a future attempt at a curative resection. The following is a list of other therapies for liver tumors: Radiofrequency ablation (RFA) performed as an outpatient procedure, most commonly by interventional radiology or during an operation; an electrode is placed under ultrasound guidance into the tumor and the tumor is "heated" resulting in tumor destruction Trans-arterial Chemoembolization (TACE) primarily used for hepatocellular carcinoma (HCC), TACE is performed by our Interventional Radiologists, usually as an outpatient procedure to interrupt the blood supply of the tumor itself Multi-Modality Chemotherapy various chemotherapy regimens exist that may be combined with other therapies to allow for overall improved combined success or to decrease the stage of disease to allow for eventual resection/removal of the tumor Stereotactic Focal Liver Irradiation performed by members of radiation oncology as an outpatient, detailed radiologic assessment allows planning of high dose liver irradiation to the site of the tumor while sparing the surrounding liver tissue Investigational Treatment Protocols patients who are eligible for therapies listed above as well as patients who are not may be eligible for ongoing and future investigational treatment protocols Return to the top of the page updated 11/2007		See Also: Gastrointestinal Clinical Trials on the Engage website Adjust text size University of Michigan Comprehensive Cancer Center 1500 East Medical Center Drive Ann Arbor, MI 48109 This site is part of the U-M Health System. The information presented is not a tool for self diagnosis or a substitute for professional care. © 2008 U-M Comprehensive Cancer Center

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