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Primary Liver Cancer

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Last Updated: 02 July 2021

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General | Latest Info

Liver Cancer is a type of cancer that starts in the liver. Cancer starts when cells in the body begin to grow out of control. To learn more about how cancers start and spread, see What Is Cancer? To understand Liver Cancer, it helps to know about the normal structure and function of the liver. The liver liver is the largest internal organ. It lies under your right rib just beneath your right lung. It has two lobes. To understand Liver Cancer, it helps to know about the normal structure and function of the liver. The liver is made up mainly of cells called hepatocytes. It also has other types of cells, including cells that line its blood vessels and cells that line small tubes in the liver call Bile ducts. Bile ducts carry bile from the liver to the gallbladder or directly to the intestines. You cannot live without your liver. It has many important functions: It breaks down and stores many of the nutrients absorbed from the intestine that your body needs to function. Some nutrients must be changed in the liver before they can be used for energy or to build and repair body tissues. It makes most of the clotting factors that keep you from bleeding too much when you are cut or injure. It delivers bile into the intestines to help absorb nutrients. It breaks down alcohol, drugs, and toxic waste in the blood, which then passes from the body through urine and stools different types of cells in the liver can form several types of malignant and benign tumors. These tumors have different causes, are treated differently, and have different prognosis. Primary Liver Cancer Cancer that starts in the liver is called Primary Liver Cancer. There is more than one kind of primary Liver Cancer. Hepatocellular carcinoma is the most common form of Liver Cancer in adults. Hepatocellular cancers can have different growth patterns: Some begin as a single tumor that grows larger. Only late in disease do it spread to other parts of the liver. The second type seems to start as many small cancer nodules throughout the liver, not just a single tumor. This is seen most often in people with cirrhosis and is the most common pattern seen in the United States. Doctors can classify several subtypes of HCC. Most often, these subtypes do not affect treatment or prognosis. But one of these subtypes, fibrolamellar, is important to recognize. It is rare, making up less than 1 % of HCCs and is most often seen in women younger than age 35. Often the rest of the liver is not diseased. This subtype tends to have a better outlook than other forms of HCC. Most of the rest of Is content refers only to hepatocellular carcinoma and is called Liver Cancer. Intrahepatic cholangiocarcinoma About 10 % to 20 % of cancers that start in the liver are intrahepatic cholangiocarcinomas. These cancers start in cells that line small Bile ducts within the liver.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Causes

Various cancer-causing substances are associated with primary liver cancer, including certain herbicides and chemicals such as vinyl chloride and arsenic. Smoking, especially if you abuse alcohol as well, also increases risk. Aflatoxins, cancer-causing substances made by type of plant mold, have also been implicate. Aflatoxins can contaminate wheat, peanuts, rice, corn, and soybeans. These are rare problems in most developed countries like the US. Other causes include hormones androgen and estrogen and dye formerly used in medical tests call thorotrast. Your sex. Men are more likely to get Hepatocellular carcinoma than women. Your weight. Obesity can increase the risk for Hepatocellular carcinoma. Your race. In the US, liver cancer is most common in Asian Americans and Pacific Islanders. Anabolic steroid use. Male hormones abuse by athletes to increase muscle can slightly increase liver cancer risk with long-term use. History of diabetes. Studies have suggested a link between diabetes and liver cancer. This is likely due to the link between diabetes and fatty liver disease. Inherit metabolic Diseases. Diseases that disrupt normal metabolism of the body have been shown to increase your risk of liver cancer. Rare Diseases. Studies have found a link between liver cancer and some rare diseases like alpha-1 antitrypsin deficiency, Tyrosinemia, and Wilson's disease.


What Is Liver Cancer?

The liver continuously filters blood that circulates through the body, converting nutrients and drugs absorbed from the digestive tract into ready-to-use chemicals. Liver performs many other important functions, such as removing toxins and other chemical waste products from blood and readying them for excretion. Because all blood in the body must pass through it, liver is unusually accessible to cancer cells traveling in the bloodstream. The liver can be affected by primary liver cancer, which arises in the liver, or by cancer which forms in other parts of the body and then spreads to the liver. Most liver cancer is secondary or metastatic, meaning it starts elsewhere in the body. Primary liver cancer, which starts in the liver, accounts for about 2 % of cancers in the US, but up to half of all cancers in some undeveloped countries. This is mainly due to the prevalence of hepatitis, caused by contagious viruses, that predispose people to liver cancer. In the US, primary liver cancer strikes twice as many men as women, at an average age of 67. Because the liver is made up of several different types of cells, several types of tumors can form there. Some of these are benign, and some are cancerous and can spread to other parts of the body. These tumors have different causes and are treated differently. The outlook for health or recovery depends on what type of tumor you have. Hemangioma Hepatic adenoma Focal nodular hyperplasia Cysts Lipoma Fibroma Leiomyoma None of these tumors are treated like liver cancer. They may need to be removed surgically if they cause pain or bleeding. Hepatocellular carcinoma cholangiocarcinoma This article discusses hepatocellular carcinoma. It's important to know what type of liver tumor you have. Be sure to get that information from your healthcare provider.


General

Race and ethnicity: in the United States, liver cancer rates are highest in Asian Americans and Pacific Islanders. White Americans have the lowest risk of liver cancer. Chronic infection with hepatitis B virus or hepatitis C virus is the most common liver cancer risk factor. These infections lead to cirrhosis of the liver. Both hepatitis B and C viruses may spread from person to person through sharing of contaminated needles, unprotected sex or childbirth. Viruses may also be passed on through blood transfusion, though this risk has been greatly reduced in the United States since the start of blood testing for these viruses.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Treatments

These depend on your age, overall health, how Advanced cancer is, and what you prefer. Different treatments can have different side effects, and you may need more than one. If you have liver disease though, thatas not an option. You may get a liver transplant instead, but these arenat too common. Tumor ablation: number of treatments kill tumors without removing them from your body. This is called tumor ablation and can be done with: alcohol. In ethanol ablation, also called percutaneous ethanol injection, your doctor injects pure alcohol into the tumor to kill cancer cells. Freezing. In cryoablation, also called cryosurgery or cryotherapy, your doctor uses liquid nitrogen to freeze and destroy the tumor. Heat. Your doctor uses probes with either electricity or microwaves to heat and kill tumor. Embolization therapy: your liver gets blood from two blood vessels. Most normal liver cells get it from one blood vessel and cancer cells get it from other. With embolization therapy, your doctor cuts off blood flow to cancer cells to kill the tumor. Radiation therapy: This Treatment uses high-power Radiation from X-rays and other sources to kill cancer cells. You can either get radiation from outside your body or have it place inside. Beads filled with radiation are sometimes used in radioembolization therapy. Target drug therapy: These medications work differently than Chemotherapy medicines. They go after very specific changes in cancer cells to try and destroy them. Since Chemotherapy often isnat helpful for primary Liver Cancer, doctors have been trying more Targeted medications.


Clinical trials

Clinical trials are critical testing ground for determining the safety and effectiveness of new treatments and drugs for cancer and many other diseases. As part of our commitment to providing innovative treatments, our doctors may recommend that you enroll in carefully selected clinical trials for liver cancer to offer you access to treatment options that may otherwise be unavailable to you. Patients who meet specific criteria may be considered for clinical trial on an individual basis and may qualify at any stage of disease or treatment. Talk to your doctor about whether liver cancer clinical trial is a good option for you and ask about risks and various requirements involve.


Surgery for liver cancer

Surgery is one of the primary treatment options for hepatocellular carcinoma and other types of liver cancer. Liver cancers are classified based on whether they can be remove. For example: localized resectable cancers may be removed by surgery. Only a small number of patients with liver cancer have such tumors. Localize unresectable cancers have not spread to lymph nodes or distant organs but cannot be removed by surgery. This may be because the non-cancerous part of the liver is not healthy, cancer has spread throughout the liver, or the tumor is close to main arteries, veins and bile ducts. Advanced cancers have spread to lymph nodes or other organs beyond liver and cannot be treated with surgery.


Radiation therapy

This treatment uses high-power energy from sources such as X-rays and protons to destroy cancer cells and shrink tumors. Doctors carefully direct energy to the liver, while sparing surrounding healthy tissue. Radiation therapy might be an option if other treatments aren't possible or if they haven't help. For advanced liver cancer, radiation therapy might help control symptoms. During external beam radiation therapy treatment, you lie on a table and a machine directs energy beams at precise point on your body. A specialized type of radiation therapy, called stereotactic body radiotherapy, involves focusing many beams of radiation simultaneously at one point in your body.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Overview

Liver Cancer is a cancer that begins in cells of your liver. Your liver is a football-size organ that sits in the upper right portion of your abdomen, beneath your diaphragm and above your stomach. Several types of cancer can form in the liver. The most common type of Liver Cancer is hepatocellular carcinoma, which begins in the main type of liver cell. Other types of Liver Cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common. Cancer that spreads to the liver is more common than cancer that begins in liver cells. Cancer that begins in another area of the body such as the colon, lung or breast and then spreads to the liver is called metastatic Cancer rather than Liver Cancer. This type of cancer is named after the organ in which it begins, such as metastatic colon Cancer to describe cancer that begins in the colon and spreads to the liver.


Liver Cancer

In contrast to benign liver tumors, liver cancer has the capacity to spread to other parts of the body. There are several different types of liver cancer: hepatocellular carcinoma is the most common type of primary liver cancer in adults. It begins in liver cells known as hepatocytes. Cholangiocarcinoma is cancer that develops in cells that line bile ducts within the liver. Hepatoblastoma is a rare type of liver cancer that develops in children. Angiosarcoma and Hemangiosarcoma are rare cancers that start in blood vessels of the liver. Each year in the United States, there are more than 25 000 individuals diagnosed with primary liver cancer and more than 18 000 deaths from the disease. Liver cancer is the fifth leading cause of cancer death among US men, and the ninth leading cause of cancer death among US women. Worldwide, more than 1 million individuals are diagnosed with liver cancer each year. Because hepatocellular carcinoma accounts for 80-90 % of all primary liver cancers, liver cancer information that follows focuses primarily on this type of cancer.

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* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Symptoms

Having one or more of the symptoms below does not mean you have Liver Cancer. In fact, many of these symptoms are more likely to be caused by other conditions. Still, if you have any of these symptoms, it is important to have them checked by a doctor so that the cause can be found and treat, if needed. Signs and symptoms of Liver Cancer often do not show up until later stages of the disease, but sometimes they may show up sooner. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed earlier, when treatment is most likely to be helpful. Some of the most common symptoms of Liver Cancer are: weight loss, loss of appetite Feeling very full after small meal Nausea or vomiting enlarge liver, felt fullness under ribs on right side enlarge spleen, felt fullness under ribs on left side Pain in abdomen or near right shoulder blade Swelling or fluid build-up in abdomen itching Yellowing of skin and eyes other symptoms can include fever, enlarge veins on belly that can be see through skin, and abnormal bruising or bleeding. People who have chronic hepatitis or cirrhosis might feel worse than usual or might just have changes in lab test results, such as liver function tests or alpha-fetoprotein levels. Some liver tumors make hormones that act on organs other than the liver. These hormones may cause: High blood calcium levels, which can cause nausea, confusion, constipation, weakness, or muscle problems. Low blood sugar levels, which can cause fatigue or fainting Breast enlargement and / or shrinkage of testicles in men. High counts of red blood cells, which can cause someone to look red and flushed High cholesterol levels Weight loss loss of appetite Feeling very full after small meal Nausea or vomiting enlarge Liver, felt as fullness under ribs on right side enlarge spleen, felt as fullness under ribs on left side Pain in abdomen or near right shoulder blade Swelling or fluid build-up in abdomen itching Yellowing of skin and eyes other symptoms can include fever, enlarge veins on belly that can be see through skin, and abnormal bruising or bleeding. People who have chronic hepatitis or cirrhosis might feel worse than usual or might just have changes in lab test results, such as liver function tests or alpha-fetoprotein levels. Some liver tumors make hormones that act on organs other than the liver. These hormones may cause: High blood calcium levels, which can cause nausea, confusion, constipation, weakness, or muscle problems. Low blood sugar levels, which can cause fatigue or fainting Breast enlargement and / or shrinkage of testicles in men. High counts of red blood cells, which can cause someone to look red and flushed High cholesterol levels


Early warning signs of liver cancer

Symptoms of liver cancer may differ for each person, and any one of these symptoms may be caused by other conditions. Some common early warning signs of liver cancer include: common symptoms of cancer that develop in the liver include: pain in the upper abdomen on the right side or near right shoulder blade enlarge liver felt as mass under ribs on the right side Abdominal swelling or bloating in the abdomen that develops as mass Jaundice, which appear as yellowing of skin and eyes and occurs when liver is not functioning properly weight loss not associate with changes in diet Decrease in appetite or feeling of fullness after small meal Nausea and vomiting not associate with other know conditions General weakness and / or fatigue that is persistent, ongoing weakness or fatigue Fever that is unrelated to other conditions enlarge spleen felt as mass under ribs on left side many symptoms of liver tumors may be similar to signs of other types of benign liver infections or diseases. In the case of liver cancer, symptoms will continue to evolve and worsen as the tumor grows and the disease advances. It is important to see a doctor for accurate diagnosis if you have any of the above signs of liver cancer. In rare cases, other disorders may develop as a result of liver cancer, especially in the early stages of disease. Paraneoplastic syndromes cause symptoms in other parts of the body. Awareness of these symptoms may help with diagnosing liver cancer. Some paraneoplastic syndromes related to liver cancer include: hypercalcemia: High blood calcium levels Hypoglycemia: Low blood sugar levels Erythrocytosis: High red blood cell count Hypercholesterolemia: High cholesterol levels Gynecomastia: Breast enlargement Shrinking of testicles in men

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* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Risk factors

Factors that increase the risk of primary Liver Cancer include: chronic infection with HBV or HCV. A chronic infection with the Hepatitis B virus or Hepatitis C virus increases your risk of Liver Cancer. Cirrhosis. This progressive and irreversible condition causes scar tissue to form in your liver and increases your chances of developing Liver Cancer. Certain inherited Liver Diseases. Liver Diseases that can increase the risk of Liver Cancer include hemochromatosis and Wilson's disease. Diabetes. People with this blood sugar disorder have a greater risk of Liver Cancer than those who don't have Diabetes. Nonalcoholic fatty Liver disease. Accumulation of fat in the liver increases the risk of Liver Cancer. Exposure to Aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops, such as grains and nuts, can become contaminated with Aflatoxins, which can end up in foods made of these products. Excessive alcohol consumption. Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase your risk of Liver Cancer.


General

Race and ethnicity: in the United States, liver cancer rates are highest in Asian Americans and Pacific Islanders. White Americans have the lowest risk of liver cancer. Chronic infection with hepatitis B virus or hepatitis C virus is the most common liver cancer risk factor. These infections lead to cirrhosis of the liver. Both hepatitis B and C viruses may spread from person to person through sharing of contaminated needles, unprotected sex or childbirth. Viruses may also be passed on through blood transfusion, though this risk has been greatly reduced in the United States since the start of blood testing for these viruses.


What Is Liver Cancer?

Liver cancer has a low survival rate compared to other cancers. However, you can reduce your risk of getting disease through early detection and healthy lifestyle habits. There is no way to prevent liver cancer completely, but you may be able to lower your risk by: Getting hepatitis B vaccine if you have drug dependency and share needles, have unprotected sex with multiple partners or are nurse, doctor, dentist or other medical professional Getting treatment for viral hepatitis Moderating alcohol intake Stopping Tobacco use-Banner MD Andersons Tobacco Recovery Program has resources to help you quit Tobacco. Using condom to reduce risk of contracting hepatitis C maintaining healthy body weight Treating underlying conditions such as diabetes and hemochromatosis talk to your doctor if youre at higher risk for liver cancer or if youre experiencing any signs or symptoms. Regular screenings for at-risk individuals are vital to early diagnosis.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Prevention

Many liver cancers could be prevented by reducing exposure to known risk factors for this disease. Avoid and treat Hepatitis B and C infections Worldwide, most significant risk factor for Liver Cancer is chronic infection with Hepatitis B virus and Hepatitis C virus. These viruses can spread from person to person through sharing contaminated needles, through unprotected sex, and through childbirth, so some liver cancers may be avoided by not sharing needles and by using safer sex practices. The US Centers for Disease Control and Prevention recommends that all children, as well as adults at risk get HBV Vaccine to reduce the risk of Hepatitis and Liver Cancer. There is no Vaccine for HCV. Preventing HCV infection, as well as HBV infection in people who have not been immunize, is based on understanding how these infections occur. Blood transfusions were once a major source of Hepatitis infection as well. But because blood banks in the United States test donate blood to look for these viruses, risk of getting Hepatitis infection from blood transfusion is extremely low. People at high risk for HBV or HCV should be tested for these infections so they can be watched for Liver Disease and treated if needed. The CDC recommends that you get test for HCV if any of the following is true: You were born from 1945 through 1965. You ever injected drugs. You needed medicine for blood clotting problem before 1987. You received blood transfusion or organ transplant before July 1992. You were or are on long-term hemodialysis You are infect with HIV You might have been expose to Hepatitis C in last 6 months through sex or sharing needles during drug use Treatment of Chronic HCV infection can eliminate virus in many people and may lower risk of Liver Cancer. A number of drugs are used to treat Chronic HBV. These drugs reduce the number of viruses in the blood and lessen liver damage. Although drugs don't cure disease, they lower the risk of cirrhosis and may lower the risk of Liver Cancer, as well. Limit Alcohol and tobacco use Drinking Alcohol can lead to cirrhosis, which in turn, can lead to Liver Cancer. Not drinking alcohol or drinking in moderation could help prevent Liver Cancer. Since smoking also increases the risk of Liver Cancer, not smoking will also prevent some of these cancers. If you smoke, quitting will help lower your risk of this cancer, as well as many other cancers and life-threatening diseases. Getting to and staying at a healthy weight. Avoiding obesity might be another way to help protect against Liver Cancer. People who are obese are more likely to have Fatty Liver Disease and diabetes, both of which have been linked to Liver Cancer. Limit exposure to Cancer-causing chemicals Changing the way certain grains are stored in tropical and subtropical countries could reduce exposure to Cancer-causing substances such as aflatoxins. Many developed countries already have regulations to prevent and monitor grain contamination.

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The liver

Diagnosis of Liver Cancer begins with medical history and physical examination. Make sure to tell your doctor if you have a history of long-term alcohol abuse or chronic hepatitis B or C infection. Diagnostic tests and procedures for Liver Cancer include the following: Liver function tests help your doctor determine the health of your liver by measuring levels of proteins, liver enzymes, and bilirubin in your blood. The presence of alpha-fetoprotein in blood can be a sign of Liver Cancer. This protein is usually only produced in the liver and yolk sac of babies before theyre are born. AFP production normally stops after birth. Abdominal CT or MRI scans produce detailed images of the liver and other organs in the abdomen. They can allow your doctor to pinpoint where the tumor is developing, determine its size, and assess whether it has spread to other organs.

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How We Care for You

Your liver is the largest organ in your abdomen. It weighs about the same as a half-gallon of milk youd buy at the supermarket. It is not only big in size, but also in importancethe Liver performs essential functions, like removing waste and filtering out toxins from blood. It also secretes bile and enzymes that allow the body to digest food and extract its nutrients, among other things. Liver cancers are the most common cancer types worldwide. Here in the United States, more than 40 000 Liver Cancer cases are diagnosed each year. People at highest risk for Liver Cancer are those with viral infections of the liver and Chronic Liver disease. Fatty Liver disease and alcohol-induce Liver cirrhosis are other potential causes. It is important to know that most liver diseases, which can lead to Liver Cancer, are treatable, say Yale Medicines Mario Strazzabosco, MD, director of the Liver Cancer Program at Yale Cancer Center. Also, many cases of hepatocellular carcinoma, most common type of primary Liver Cancer, can be diagnosed early if high-risk patients are closely monitored by their doctor. There is a lot that we can do for patients diagnosed at an early stage, and some patients can be cure. Cancer, in general, occurs at the cellular level. In a healthy body, new cells are generated to replace old, dying ones. But when theres disruptionnew, cells form unnecessarily or old cells do die as they shoulda, collection of extra cells can form tumor, or growth, that is either benign or malignant. To better understand and properly treat Liver Cancer, doctors will need to know whether cancer is primary or secondary. Cancer that originates in the liver is called primary Liver Cancer. This includes any malignant growth of liver cells that can eventually spread to other sites of the body. The most common type of primary Liver Cancer is called HCC, which is derived from hepatocytes, most likely as result of cirrhosis-related hepatitis B or C virus infections, steatohepatitis and alcoholic liver disease. HCC accounts for 90 percent of all primary Liver Cancer cases. Fibrolamellar carcinoma: variant of HCC with fibrous layers between tumor cells Angiosarcoma: Cancer of blood or lymph vessels in Liver Hepatoblastoma: rare type of childhood Liver Cancer Cholangiocarcinoma: bile duct Cancer secondary Liver Cancer is a cancer that has spread to the liver from somewhere else in the body, such as colon, breast or lung. When this occur, new growth contains the same type of cancer cells as the primary tumor. So, if colon cancer spreads to the liver, liver tumor will contain colon cancer cells, not liver cancer cells. Secondary Liver Cancer occurs more frequently than primary liver Cancer. Your doctor can test for Liver Cancer by performing a physical exam to check for jaundice, or by feeling your abdomen to detect changes in the size and shape of your liver or any nearby organs.

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Follow-up tests may be needed.

Some of the tests that were done to diagnose cancer or to find out the stage of cancer may be repeat. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop Treatment may be based on results of these Tests. Some tests will continue to be done from time to time after treatment has end. Results of these tests can show if your condition has changed or if cancer has recur. These tests are sometimes called follow-up Tests or check-ups.


Treatment Option Overview

Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of serious illness. Palliative care specialists work with you, your family and your other doctors to provide extra layer of support that complement your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy. When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer. Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.


Clinical trials

A clinical trial is a study to answer scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learnt in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of new treatment and how well it work. If clinical trial show that a new treatment is better than one currently being used, new treatment may become standard. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Clinical trials can be found online at NCI's website. For more information, call Cancer Information Service, NCI's contact center, at 1-800-4CANCER.

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About PDQ

Table 1. Definitions of TNM Stages IA and IB a

StageTNMDescription
IAT1a, N0, M0T1a = Solitary tumor 2 cm.
IBT1b, N0, M0T1b = Solitary tumor >2 cm without vascular invasion.

Physician Data Query is the National Cancer Institute's comprehensive Cancer information Database. The PDQ Database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. Health professional versions have detailed information written in technical language. Patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish. PDQ is a service of NCI. NCI is part of the National Institutes of Health. NIH is the federal government center of biomedical Research. PDQ summaries are based on an independent review of medical literature. They are not policy statements of NCI or NIH.


Treatment of Hepatoblastoma

For information about the treatments list below, see Treatment Option Overview section. Treatment options for newly diagnosed hepatoblastoma that can be removed by surgery at time of diagnosis may include the following: Treatment options for newly diagnosed hepatoblastoma that cannot be removed by surgery or is not removed at time of diagnosis may include the following: for newly diagnosed hepatoblastoma that has spread to other parts of body at time of diagnosis, combination chemotherapy is give to shrink tumors in liver and cancer that has spread to other parts of body. After chemotherapy, imaging tests are done to check whether tumors can be removed by surgery. Treatment options in clinical trials for newly diagnosed hepatoblastoma include:


Infantile Choriocarcinoma of the Liver

Treatment options for infantile choriocarcinoma of the liver include the following: initial surgical removal of tumor mass may be difficult because of its friability and hemorrhagic tendency. Often, surgical removal of the primary tumor is performed after neoadjuvant chemotherapy. Maternal gestational trophoblastic tumors are exquisitely sensitive to methotrexate, and many women, including those with distant metastases, are cured with single-agent chemotherapy. Maternal and infantile choriocarcinoma both come from the same placental malignancy. The Combination of cisplatin, etoposide, and bleomycin, as used in other pediatric germ cell tumors, has been effective in some patients and is followed by resection of residual mass. Use of neoadjuvant methotrexate in infantile choriocarcinoma, although often resulting in response, has not been uniformly successful.

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Table 2. Definitions of TNM Stage II a

StageTNMDescription
IIT2, N0, M0T2 = Solitary tumor >2 cm with vascular invasion, or multiple tumors, none >5 cm.

Table 3. Definitions of TNM Stages IIIA and IIIB a

StageTNMDescription
IIIAT3, N0, M0T3 = Multiple tumors, at least one of which is >5 cm.
IIIBT4, N0, M0T4 = Single tumor or multiple tumors of any size involving a major branch of the portal vein or hepatic vein, or tumor(s) with direct invasion of adjacent organs other than the gallbladder or with perforation of visceral peritoneum.

Table 4. Definitions of TNM Stages IVA and IVB a

StageTNMDescription
IVAAny T, N1, M0TX = Primary tumor cannot be assessed.
IVBAny T, Any N, M1Any T = See descriptions above in this table, stage IVA, Any T, N1, M0.

Table 5. Standard Treatment Options for HCC

StageStandard Treatment Options
Stages 0, A, and BSurgical resection
Stages C and DTransarterial embolization and transcatheter arterial chemoembolization
Recurrent StageLiver transplantation

Table 3. Definition of Evans Surgical Staging

Evans Surgical StageDefinition
Stage IThe tumor is completely resected.
Stage IIMicroscopic residual tumor remains after resection.
Stage IIIThere are no distant metastases and at least one of the following is true: (1) the tumor is either unresectable or the tumor is resected with gross residual tumor; (2) there are positive extrahepatic lymph nodes.
Stage IVThere is distant metastasis, regardless of the extent of liver involvement.

Table 1. Definitions of PRETEXT and POSTTEXT Groups a

PRETEXT and POSTTEXT GroupsDefinitionImage
IOne section involved; three adjoining sections are tumor free.Enlarge
IIOne or two sections involved; two adjoining sections are tumor free.Enlarge
IIITwo or three sections involved; one adjoining section is tumor free.Enlarge
IVFour sections involved.Enlarge
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Cholangiocarcinoma (bile duct cancer)

Table 1. Definitions of PRETEXT and POSTTEXT Groups a

PRETEXT and POSTTEXT GroupsDefinitionImage
IOne section involved; three adjoining sections are tumor free.Enlarge
IIOne or two sections involved; two adjoining sections are tumor free.Enlarge
IIITwo or three sections involved; one adjoining section is tumor free.Enlarge
IVFour sections involved.Enlarge

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Staging

Table 1. Definitions of PRETEXT and POSTTEXT Groups a

PRETEXT and POSTTEXT GroupsDefinitionImage
IOne section involved; three adjoining sections are tumor free.Enlarge
IIOne or two sections involved; two adjoining sections are tumor free.Enlarge
IIITwo or three sections involved; one adjoining section is tumor free.Enlarge
IVFour sections involved.Enlarge

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

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