Treatment of Liver Tumors in Children

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MSK Kids’ doctors customize your child’s treatment to the type and stage of the tumor and the risk of it coming back later. Most patients have surgery, and some also have chemotherapy before and/or after surgery. Your team will explain every aspect of your child’s care, make sure you understand what is involved, and answer any questions you may have.

Surgery for Pediatric Liver Tumors

The liver is an organ that regenerates, which means it grows back its own tissue that has been removed. Because of this, we are often able to remove large amounts of unhealthy liver tissue in young people with advanced liver tumors so that the liver grows back to its original size. For some large tumors, such as hepatoblastoma, we shrink the tumor with chemotherapy before surgery to make it easier to remove. Some children are able to have surgery alone. In the case of small tumors, we may monitor a child with regular  imaging exams and give treatment only if the tumor grows. This is known as watchful waiting.

Are pediatric liver tumors treated with chemotherapy?

Chemotherapy is usually required before hepatoblastoma surgery to shrink the tumor and afterward to reduce the chance of the cancer coming back. Other liver tumors, including hepatocellular carcinoma and undifferentiated embryonal sarcoma of the liver, are usually treated with chemotherapy. We generally do not use chemotherapy to treat fibrolamellar hepatocellular carcinoma, except in unique circumstances.

Are there any targeted therapies for pediatric liver tumors?

Some children with liver cancers may receive anticancer drugs through clinical trials. The main drugs currently being tested either block the development of the blood vessels that tumors need to grow and spread or by helping the immune system to recognize the tumors.

Locoregional Therapies for Pediatric Liver Tumors

Treatments applied directly to cancer are called locoregional therapies. They include radiofrequency ablation, where tumor tissue is destroyed with very high heat, and chemoembolization, where anticancer drugs are sent into arteries that sustain a tumor and are sealed in place. At MSK Kids, we sometimes use these treatments to treat inoperable liver tumors, those that have come back or resist other therapies, and tumors that spread to the liver from cancers elsewhere in the body.

Is radiation therapy used to treat pediatric liver tumors?

Radiation therapy is rarely used to treat primary liver tumors in children but may be used to treat tumors that have spread to the liver from elsewhere.