Treatment Options for Childhood Liver Cancer

Hepatoblastoma
Hepatocellular Carcinoma
Undifferentiated Embryonal Sarcoma of the Liver
Infantile Choriocarcinoma of the Liver
Recurrent Childhood Liver Cancer
Treatment Options in Clinical Trials

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of stages I and II hepatoblastoma may include the following:

• Surgery to remove the tumor, followed by chemotherapy with one or more drugs or watchful waiting (closely monitoring a patient’s condition without giving any treatment until symptoms appear or change).
• Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible.
• A clinical trial of a new combination of surgery or biopsy, watchful waiting, and chemotherapy.

Treatment of stage III hepatoblastoma may include the following:

• Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible.
• Combination chemotherapy followed by liver transplant if surgery to remove the tumor is not possible.
• Chemoembolization of the hepatic artery which may be followed by surgery to remove as much of the tumor as possible.
• A clinical trial of a new combination of surgery or biopsy, chemotherapy, and liver transplant.

Treatment of stage IV hepatoblastoma may include the following:

• Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the cancer as possible, including cancer that has spread to other parts of the body such as the lungs. If the cancer is completely removed, additional chemotherapy is given to kill any cancer cells that may remain.
• Chemotherapy followed by liver transplant if surgery to remove the tumor is not possible.
• If the tumor that has spread to other parts of the body cannot be completely removed by surgery after chemotherapy, further treatment may include the following:
  • High-dose chemotherapy with or without stem cell transplant or surgery to remove as much of the tumor as possible.
  • Chemoembolization of the hepatic artery to shrink the tumor, followed by surgery to remove as much of the tumor as possible.
  • Radiation therapy alone or before or after surgery to remove as much of the tumor as possible.
• A clinical trial of new combinations of chemotherapy, surgery to remove the tumor, and liver transplant.

Treatment of stages I and II hepatocellular carcinoma may include the following:

• Surgery to remove the tumor, followed by combination chemotherapy.
• Combination chemotherapy followed by surgery to remove as much of the tumor as possible.
• Chemoembolization of the hepatic artery to shrink the tumor, followed by surgery to remove as much of the tumor as possible.

Treatment of stage III hepatocellular carcinoma and PRETEXT stage 4 hepatocellular carcinoma may include the following:

• Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible.
• Combination chemotherapy followed by liver transplant if surgery to remove the tumor is not possible.
• If the tumor cannot be completely removed by surgery after chemotherapy, further treatment may include the following:
  • Cryosurgery.
  • Percutaneous ethanol injection.
  • Chemoembolization of the hepatic artery to shrink the tumor, followed by surgery to remove as much of the tumor as possible.
  • Radiation therapy.

Treatment of postsurgically-staged stage IV hepatocellular carcinoma may be combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible.

Treatment of undifferentiated embryonal sarcoma of the liver may include the following:

• Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible and then more chemotherapy.
• Surgery to remove the tumor followed by chemotherapy. A second surgery may be done to remove tumor that remains, followed by more chemotherapy.
• Liver transplant if surgery to remove the tumor is not possible.
• A clinical trial of chemotherapy before or after surgery, and radiation therapy may also be given.

Treatment of infantile choriocarcinoma may be combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible.

Treatment of recurrent hepatoblastoma may include the following:

• Surgery to remove isolated (single and separate) metastatic tumors.
• Liver transplant.
• A clinical trial of a new treatment.

Treatment of recurrent hepatocellular carcinoma may include the following:

• Chemoembolization of the hepatic artery to shrink the tumor, followed by surgery to remove the tumor.
• Liver transplant.
• A clinical trial of a new treatment.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood liver cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.