How we treat liver cancer and tumors at Nebraska Medicine:
Management of liver cancers and neuroendocrine tumors requires a multidisciplinary approach. For this reason, at Nebraska Medicine we have a specialized program that combines the expertise of medical oncologists, interventional radiologists, hepatobiliary and transplant surgeons to offer the most effective therapy for these unique tumors.
Combined modalities are often most effective in treating neuroendocrine tumors.
Our program holds weekly care conferences to discuss any patients with hepatobiliary carcinoma, pancreatic surgery or neuroendocrine tumors.
Surgery
We have taken the approach of being surgically aggressive towards these tumors, sometimes employing radical surgical procedures to treat metastatic neuroendocrine tumors. More specifically, we utilize staged hepatectomy, portal vein embolization and radiofrequency or microwave ablation.
Transplantation
Liver transplantation may be an option for some patients with slow-growing tumors confined to the liver, particularly patients who have debilitating symptoms due to hormone production.
Trans Arterial Chemoembolization (TACE)
This is a procedure where high doses of chemotherapy are delivered directly to tumors within the liver. The blood supply to that part of the liver is also blocked off so that the chemotherapy drug does not spread to the rest of the body.
Selective Internal Radiation
This procedure involves the delivery of small glass beads loaded with a radioactive compound being delivered to the liver. Because the blood vessels supplying the tumor are of a different size than those supplying the uninvolved liver, the radiation is delivered directly to the tumor without damaging the surrounding liver.
Treatment
Nebraska Medicine offers patients the full realm of treatment options to secure the best outcomes for patients with both primary and metastatic liver cancer. Resection and liver transplantation provide the most favorable outcomes for primary liver cancer patients. What makes liver cancer particularly difficult to treat is the fact that many patients don't discover they have the disease until they are in more advanced stages of the disease.
Resection
If the tumor has not spread outside the liver and it is localized, surgery may be recommended and is referred to as surgical resection. The liver can regenerate damaged or resected tissue as long as there is not cirrhosis or hepatitis present. In some cases, up to 75 percent of the affected part of the liver can be completely removed. Today, the five-year survival rate after resection often exceeds 50 percent. The strongest predictors of recurrence are the presence of involvement of the smallblood vessels and/or additional tumor sites besides the primary lesion. We also routinely utilize novel techniques to achieve complete removal of tumors that are often considered unresectable by conventional means.
Laparoscopic Surgery
Laparoscopic liver resection is a minimally invasive technique to remove diseased parts of the liver. When possible, laparoscopic surgery is the procedure of choice over open surgery which is easier on the patient. A traditional liver resection can be a complicated operation because there is so much blood flowing through the liver, and it requires a very large incision. Laparoscopic surgery is usually an outpatient procedure and compared to traditional surgery, results in less pain and discomfort following surgery, shorter recuperation time and a quicker return to normal activities.
Liver Transplant
Nebraska Medicine is home to one of the most active and prominent liver transplant centers in the world. Liver transplantation is sometimes an option for people with a small, early-stage liver tumor or for certain cases that involve bile duct tumors. In the past, individuals with cancer were not eligible for transplantation. However, new treatment options that can reduce the size of the tumor have helped increase the eligibility of patients. Eligibility is based on the number of tumor nodules, the size of the tumors, how much the tumor has spread, the age and overall health of the patient.