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Childhood Liver Cancer Treatment (PDQ®)

Patient Version
Last Modified: 04/12/2012

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.

Hepatoblastoma

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

Treatment of stage III hepatoblastoma may include the following:

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:
  • A clinical trial of new combinations of chemotherapy, surgery to remove the tumor, and liver transplant.
Hepatocellular Carcinoma

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

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

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.

Undifferentiated Embryonal Sarcoma of the Liver

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

Infantile Choriocarcinoma of the Liver

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

Recurrent Childhood Liver Cancer

Treatment of recurrent hepatoblastoma may include the following:

Treatment of recurrent hepatocellular carcinoma may include the following:

Treatment Options in Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood liver cancer 1. 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 2.



Glossary Terms

biopsy (BY-op-see)
The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
chemoembolization (KEE-moh-EM-boh-lih-ZAY-shun)
A procedure in which the blood supply to a tumor is blocked after anticancer drugs are given in blood vessels near the tumor. Sometimes, the anticancer drugs are attached to small beads that are injected into an artery that feeds the tumor. The beads block blood flow to the tumor as they release the drug. This allows a higher amount of drug to reach the tumor for a longer period of time, which may kill more cancer cells. It also causes fewer side effects because very little of the drug reaches other parts of the body. Chemoembolization is used to treat liver cancer. Also called TACE and transarterial chemoembolization.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
choriocarcinoma (KOR-ee-oh-KAR-sih-NOH-muh)
A malignant, fast-growing tumor that develops from trophoblastic cells (cells that help an embryo attach to the uterus and help form the placenta). Almost all choriocarcinomas form in the uterus after fertilization of an egg by a sperm, but a small number form in a testis or an ovary. Choriocarcinomas spread through the blood to other organs, especially the lungs. They are a type of gestational trophoblastic disease. Also called chorioblastoma, chorioepithelioma, and chorionic carcinoma.
clinical trial (KLIH-nih-kul TRY-ul)
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
combination chemotherapy (KOM-bih-NAY-shun KEE-moh-THAYR-uh-pee)
Treatment using more than one anticancer drug.
condition (kun-DIH-shun)
In medicine, a health problem with certain characteristics or symptoms.
cryosurgery (KRY-oh-SER-juh-ree)
A procedure in which tissue is frozen to destroy abnormal cells. Liquid nitrogen or liquid carbon dioxide is used to freeze the tissue. Also called cryoablation and cryosurgical ablation.
drug (drug)
Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
embryonal tumor (em-BRY-uh-nul TOO-mer)
A mass of rapidly growing cells that begins in embryonic (fetal) tissue. Embryonal tumors may be benign or malignant, and include neuroblastomas and Wilms tumors. Also called embryoma.
hepatic artery (heh-PA-tik AR-tuh-ree)
The major blood vessel that carries blood to the liver.
hepatoblastoma (HEH-puh-toh-bla-STOH-muh)
A type of liver tumor that occurs in infants and children.
hepatocellular carcinoma (heh-PA-toh-SEL-yoo-ler KAR-sih-NOH-muh)
A type of adenocarcinoma and the most common type of liver tumor.
high-dose chemotherapy (hy-dose kee-moh-THAYR-uh-pee)
An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.
liver (LIH-ver)
A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
lung (lung)
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
metastatic (meh-tuh-STA-tik)
Having to do with metastasis, which is the spread of cancer from the primary site (place where it started) to other places in the body.
monitor (MAH-nih-ter)
In medicine, to regularly watch and check a person or condition to see if there is any change. Also refers to a device that records and/or displays patient data, such as for an electrocardiogram (EKG).
percutaneous ethanol injection (per-kyoo-TAY-nee-us EH-thuh-nol in-JEK-shun)
An injection of ethanol (alcohol) through the skin directly into a tumor to kill cancer cells. Ultrasound or a CT scan is used to guide the needle into the tumor. Also called alcohol ablation, ethanol ablation, and PEI.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
recurrent cancer (ree-KER-ent KAN-ser)
Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.
sarcoma (sar-KOH-muh)
A cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stem cell transplant (stem sel TRANZ-plant)
A method of replacing immature blood-forming cells in the bone marrow that have been destroyed by drugs, radiation, or disease. Stem cells are injected into the patient and make healthy blood cells. A stem cell transplant may be autologous (using a patient’s own stem cells that were saved before treatment), allogeneic (using stem cells donated by someone who is not an identical twin), or syngeneic (using stem cells donated by an identical twin).
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
targeted therapy (TAR-geh-ted THAYR-uh-pee)
A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells. Targeted therapy may have fewer side effects than other types of cancer treatments.
transplantation (tranz-plan-TAY-shun)
A surgical procedure in which tissue or an organ is transferred from one area of a person’s body to another area, or from one person (the donor) to another person (the recipient).
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
undifferentiated (un-DIH-feh-REN-shee-AY-ted)
A term used to describe cells or tissues that do not have specialized ("mature") structures or functions. Undifferentiated cancer cells often grow and spread quickly.
watchful waiting (WACH-ful WAY-ting)
Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. Watchful waiting is sometimes used in conditions that progress slowly. It is also used when the risks of treatment are greater than the possible benefits. During watchful waiting, patients may be given certain tests and exams. Watchful waiting is sometimes used in prostate cancer. It is a type of expectant management.

Table of Links

1http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=43714&tt=1&a
mp;format=1&cn=1
2http://www.cancer.gov/clinicaltrials