Liver Tumor Treatment Options: Surgery, Biopsy, and More

Treatment of liver tumors?

Hello Dr.
Chen,
I would like to ask about my aunt.
She is experiencing swelling and pain under her right rib cage, along with noticeable jaundice.
After undergoing an abdominal ultrasound at the hospital, the results showed tumors in both lobes of her liver, with the right lobe being completely filled with a tumor.
The AFP data is normal.
Is surgical treatment an option? Currently, she does not have any signs of ascites or liver cirrhosis, but her GOT, GPT, and rGT levels are elevated.
Is a liver biopsy necessary to determine whether the tumors are benign or malignant? Generally speaking, if the tumors are benign, is it common for them to be present throughout the entire liver? I understand that if the tumors are too extensive for embolization treatment, would the only options left be chemotherapy, radiation therapy, or a liver transplant? Thank you.

Xiao Pei, 20~29 year old female. Ask Date: 2007/06/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

Dear Ms.
Hsiao-Pei,
1.
If imaging studies and blood tests cannot confirm the tumor classification, a liver biopsy is necessary (but should be performed with caution).
2.
After understanding the tumor classification and staging, treatment options will be recommended based on medical consensus principles, while also respecting the choices made by the patient and their family after thorough understanding.
(Please do not trust unverified remedies or consume herbal medicines.)
Changhua Hospital cares about your health.
Chen Shih-Tien

Reply Date: 2007/06/06

More Info

When it comes to liver tumors, understanding the treatment options is crucial for making informed decisions. Your aunt's situation, characterized by significant pain, jaundice, and the presence of tumors in both lobes of the liver, raises several important considerations regarding her treatment options.

Firstly, the presence of tumors in the liver, especially when they fill the right lobe, suggests a potentially serious condition. The fact that her alpha-fetoprotein (AFP) levels are normal is somewhat reassuring, as elevated AFP levels are often associated with hepatocellular carcinoma (HCC), a common type of liver cancer. However, normal AFP does not rule out malignancy, especially in the context of other symptoms and imaging findings.

Regarding surgical options, the ability to perform surgery largely depends on the tumor's size, location, and whether it has invaded surrounding structures. If the tumors are localized and the liver function is adequate, surgical resection could be a viable option. However, if the tumors are extensive and involve significant portions of the liver, as indicated by your aunt's condition, surgery may not be feasible. In such cases, a biopsy may be necessary to determine the nature of the tumors—whether they are benign or malignant. A biopsy can provide critical information that guides treatment decisions.

In terms of treatment options, if the tumors are determined to be malignant and surgery is not an option due to their size or location, other treatments such as chemotherapy, targeted therapy, or radiation therapy may be considered. Chemotherapy is often used for advanced liver cancer, but its effectiveness can vary. Radiation therapy, including techniques like radiofrequency ablation (RFA) or stereotactic body radiation therapy (SBRT), can also be employed, particularly for smaller tumors or when surgery is not possible.

Liver transplantation is another potential treatment for patients with liver cancer, especially if the tumors meet specific criteria (such as the Milan criteria). This option is typically considered for patients with cirrhosis and small tumors, as it addresses both the cancer and the underlying liver disease.

It's essential to have a multidisciplinary team involved in your aunt's care, including hepatologists, oncologists, and surgeons, to evaluate her condition comprehensively and recommend the best course of action. They will consider her overall health, liver function tests (like GOT, GPT, and rGT), and the extent of the disease.

In summary, the treatment of liver tumors is complex and requires careful evaluation of multiple factors. A biopsy may be necessary to confirm the diagnosis, and treatment options will depend on the tumor's characteristics and the patient's overall health. If surgery is not an option, other therapies such as chemotherapy, radiation, or even liver transplantation may be considered. It is vital to discuss all these options with her healthcare team to ensure the best possible outcome.

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