A large proportion of these patients have a primary liver disease, for example viral hepatitis, alcohol-related cirrosis, non-alcoholic steatohepatitis or chronic autoimmune disease, which is critical for the choice of treatment.
In some cases, the cancer can be treated surgically. The prerequisite for this is that the tumor is not too large to be surgically resectable. The operation may be extensive.
- During a liver resection, the part of the liver involving the primary tumor or metastasis is removed.
- A liver transplantation is assessed according to special criteria.
- Radiofrequency ablation of smaller tumors is a new treatment option. The method represents an advance in treatment of multicentric liver cancer. Up until now, multicentric liver cancer has been very difficult to treat.
The hepatic cells have a high sensitivity to radiation. Radiation therapy therefore plays a modest role in treatment of multiple large liver lesions as the liver parenchyma is easily damaged by radiotherapy. However, large doses of radiation may be delivered to small liver volumes with curative intent (stereotaxtic body radiation therapy, SBRT).