Posted by: wockhardthospitals | August 7, 2009

Liver Tumors – can be treated? Symptoms, Diagnosis and Treatment.

The very diagnosis of a tumor in the liver instills fear in the mind of a patient, since the treatment for liver tumor is considered complex and likely to be associated with limited success. However, not all liver tumors are cancerous, further with the advancement in diagnostic and surgical and non-surgical techniques, it is now possible to treat these patients with some ray of hope.

What is a liver tumor ?

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Click on the image to know more about our services

Liver tumor can be Bening ( non-cancerous) e.g. Focal nodular hyperplasia, adenoma, hemangioma or Maligant (cancerous). Malignant tumors can be Primary Hepato cellular carcinoma (HCC) i.e. those arise within the liver or Metastatic tumor i.e. those spread to liver from a tumor somewhere else in the body.

Symptoms of Liver tumors :

Unfortunately majority of liver tumors do not produce any symptoms for a long, until they have either become big or undergo complications and hence are often diagnosed in advanced stage. The commonest symptoms is dull pain or vague discomfort in right upper half of tummy or under the right rib cage.

Other symptoms are Jaundice, fever, decreased appetite, and loss of weight. Patients with previous history of hepatitis caused by B or C virus and those suffering from Cirrhosis of the liver are at increasing risk of developing primary cancer (HCC) in their liver.

Diagnosing the liver tumors :

Abdominal Ultrasonography is the first imaging modality to suggest presence of tumor in the liver. However for better characterization of the tumor and planning of therapy ( Surgical or non-surgical), a good quality CT or MRI scan is essential. A contrast enhanced multi slice CT angio of liver not only shows the exact extent of the tumor but also helps to detect any other tumor in remaining liver and shows the condition of liver to be left behind after resection of the tumor. PET scan is indicated for detection of certain liver tumors at other sites in the body. Biopsy of the tumors to confirm the diagnosis is not indicated for cases, which are suitable for surgery as it can lead to implantation of tumor cells. Biopsy should be done only for cases who are considered for non-surgical therapies.

Treatment for liver tumors :

For majority of the tumors of the liver surgery i.e. “Liver resection” is the presently considered the best treatment.

Liver surgery has traditionally been considered to be hazardous being associated with high risk. However, during last two decades with better understanding of structure and function of liver, improvement in diagnostic imaging technologies, refinements in surgical techniques and availability of well trained liver surgeons, it is now possible to perform liver surgeries safely with less than 5% risk to life. Before advising liver resection to these patients surgeon evaluates the size and quality of remaining healthy liver which will remain inside the patients after removal of tumor bearing part of the liver.

This is to avoid risk of post surgery liver failure. Fortunately only 30% of functioning liver is god enough to sustain the body. Further liver  has unique capacity to regenerate within 4 to 6 weeks time. A large size of the tumor is not a contraindication for surgical resection. The long-term survival results after surgical resection of liver tumors have improved recently. A 5-year survival rate of 51% to 68% is reported from experienced centers for selected cases.

Liver Transplantation for liver tumors :

Patients with severely compromised liver function due to cirrhosis are not considered for resection surgery. Such patients can be offered Liver transplantation as therapy, provided the tumor in early stage.

Non-surgical therapies :

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Click image to know more

Those patients who are not suitable for surgery can be offered palliative therapy to keep the tumor under control. One such therapy is Chemo-embolisation, which involves giving anti cancer drug directly into liver tumor and then blocking its arterial supply. It is done under radiological guidance using DSA technique.

Other treatment option for such patients is local destruction of tumor by radio frequency delivered by introducing a specialized electrode in side the tumor. RF ablation can be done percutaneously under CT or USG guidance or via laproscope (minimally invasive technique) or at open surgery.

Follow -up of patients :

The patients following surgery for their liver tumor have to follow-up with their treating doctor at regular interval and under go CT scan every 3 monthly this is to detect any local recurrence or development of any new tumor in the disease. Such recurrence can be treated with either further liver surgery or buy RF ablation.

By Dr. S. K Mathur, GI Hepato Pancreato Billiary & Liver Transplant Surgeon, Wockhardt Hospitals


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