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 child's doctor for clinical trials that are not listed here but may be right for your child.

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

• Surgery to remove the tumor, followed by chemotherapy with one drug or watchful waiting, for a certain type of hepatoblastoma.
• Combination chemotherapy to shrink the tumor, followed by surgery to remove the tumor.
• Surgery to remove the tumor, followed by chemotherapy.
• A clinical trial of a new combination of surgery or biopsy and watchful waiting or 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 treatments that may include surgery, biopsy, chemotherapy, or liver transplant.

The treatment of stage IV hepatoblastoma often includes chemotherapy and surgery. Combination chemotherapy is given to shrink the cancer in the liver and cancer that has spread to other parts of the body, such as the lungs or brain. After chemotherapy, imaging tests are done to check whether the cancer can be removed by surgery. Treatment may include one or more of the following:

• If the cancer in the liver and other parts of the body can be completely removed, the treatment is surgery to remove the tumor followed by chemotherapy to kill any cancer cells that may remain.
• If the cancer in the liver cannot be removed by surgery and there are no signs of cancer in other parts of the body, the treatment is a liver transplant. If a liver transplant is not possible, treatment may include one or more of the following:
  • Chemotherapy.
  • Radiation therapy.
  • Chemoembolization of the hepatic artery
  • A second 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 the tumor.
• Chemoembolization of the hepatic artery to shrink the tumor, followed by surgery to remove the tumor.

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

• Chemotherapy to shrink the tumor, followed by surgery to remove the tumor.
• Chemotherapy to shrink the tumor. If surgery to completely remove the tumor is not possible, further treatment may include the following:
  • Liver transplant.
  • 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 stage IV hepatocellular carcinoma that was staged after surgery may include the following:

• 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.
• A biopsy or 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.

Treatment of choriocarcinoma of the liver in infants may include the following:

• Combination chemotherapy to shrink the tumor, followed by surgery to remove the tumor.

Treatment of recurrent hepatoblastoma may include the following:

• Combination chemotherapy.
• 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.
• Liver transplant.
• A clinical trial of targeted therapy.
• 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.