Liver Cancer Treatment

Surgery remains the most effective way to cure liver cancer—either by taking out part of the liver (partial hepatectomy) or removing the whole organ during a transplant operation.

Some tumors are not removable with surgery, and some people are too frail to undergo operations. We also offer the latest tumor ablation therapies for a minimally invasive approach. Learn more about tumor ablation therapies.

For more advanced disease, we can block tumor blood supply (embolization), target tumor blood vessel growth and protein use (targeted therapy), or deliver precision radiation therapy. We continue to research new options.

Learn more about our Gastrointestinal Cancer Program or find cancer clinical trials at Stanford.

Liver Transplant

A liver transplant replaces a diseased liver with a healthy liver from either a deceased or living donor.
Your doctor may recommend a transplant when:

• Removing just the tumor(s) is not possible because of its location or the liver being too diseased
• The tumor(s) is still small and has not invaded nearby blood vessels

Waiting for a deceased donor is challenging because of the limited number of livers available and the need to match blood type and approximate body size.

With living donation, just a section of the donated liver is removed. The donor’s organ continues to function, and the transplanted section can regenerate within weeks. Still, the operation carries risks for the donor.

Liver transplantation may give you better quality of life and help you live longer. However, it is important that you are aware of the complications related to major surgery and organ rejection, as well as possible side effects from the medications you will need to take after a liver transplant surgery.

Learn more about:

• Stanford's Liver Transplant Program and our commitment to the comprehensive and lifelong care of your liver illness
• Complications from liver transplant
• Transplants from living donors

Partial Hepatectomy

Removing just the part of the liver where the tumor is located is called partial hepatectomy.
When we can, we recommend this surgery. But it is only appropriate for a single tumor that has not grown into blood vessels. Patients also need good liver function and good overall health. Unfortunately, many patients are not good candidates.

Liver Ablation

Ablation is a minimally invasive procedure that destroys liver tumors, but does not remove them. Ablation is less likely than surgery to cure cancer, but it is a good option when an operation is not possible. Generally, it is limited to just a few small tumors.

We offer several types of tumor ablation therapies, using a special needle or probe:

• Cryotherapy: Freezes the tumor
• Ethanol ablation: Uses concentrated alcohol
• Microwave thermotherapy: Microwave energy heats and destroys the tumor
• Radiofrequency ablation: Uses high-energy radio waves

Learn more about tumor ablation therapies.

Liver Chemotherapy

Most liver tumors resist chemotherapy, so we use the treatment in limited circumstances. Three drugs can shrink some tumors, though usually only temporarily:

• Doxorubicin (Adriamycin)
• 5-fluorouracil
• Cisplatin

Learn more about chemotherapy at Stanford.

Liver Embolization

Liver embolization relies on the fact that the organ receives blood supply from two different veins (the hepatic and portal). That means doctors can safely close off whichever branch of the hepatic vein is feeding the tumor, blocking or reducing the blood flow it needs to survive.

Embolization provides an option when surgery or ablation is not possible. We sometimes combine it with ablation.

We offer three types of liver embolization:

• Arterial embolization: Small particles are injected to plug the branch (also called trans-arterial embolization, or TAE)
• Chemoembolization: Chemotherapy drugs create the block, while chemotherapy is also delivered locally to the tumor (also called trans-arterial chemoembolization, or TACE)
• Radioembolization: Small beads with radioactive isotopes close the branch (also called trans-arterial radioembolization, or TARE)

Liver Radiation

Radiation can provide a treatment option for more advanced liver cancer, and we continue to explore new ways to make its delivery more precise and effective.

Learn more about radiation therapy at Stanford and about our innovative techniques and delivery systems:

• CyberKnife: We invented, and continue to improve, this radiosurgery technology, which offers laser-like accuracy.
• Image-guided radiation therapy (IGRT): Built-in imaging compensates for tumor movement
• Intensity-modulated radiation therapy (IMRT): Beam and dose are instantly adjusted for the tumor, giving a tailored approach
• Stereotactic body radiation therapy (SBRT): Shorter treatment is safely delivered with powerful, precise doses — an approach we helped develop.

Liver Targeted Therapy

Sorafenib (Nexavar®) is a targeted therapy that blocks both the blood vessels and several of the proteins that liver cancers need to grow.

Your doctor's specific treatment recommendation depends on:

• Type of tumor
• Your age, overall health, and medical history
• Extent of the disease
• Your tolerance of specific medicines, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference