Overview

Overview

Cleveland Clinic’s Liver Cancer Program includes hepatologists, radiologists, oncologists, liver and transplant surgeons, and specialized nurse coordinators – working together as a team. One call puts you in touch with our multidisciplinary team that works with patients who have benign liver tumors, cancerous liver tumors, cirrhosis of the liver and more in order to develop the appropriate treatment plan, aimed at preserving liver function and quality of life.

This new, “one-stop” clinic improves your treatment by eliminating multiple appointments with different physicians at various locations. Now, all of the doctors you need are assembled here under one roof for you. Not only is this model of care more convenient, but it also allows our physicians to create an individualized treatment plan that’s best for you in less than 30 days.

Mission

The mission of the Liver Cancer Program is to offer state of the art medical care to patients with hepatic tumors through a multidisciplinary team of experienced health care professional leaders in the field of hepatic oncology.

Contact us

To make an appointment, call 216.445.8389 or 800.223.2273, ext. 58389.

What We Treat

What We Treat

Tumors treated

Primary malignant tumors

Secondary malignant tumors

Treatment options

At Cleveland Clinic, advanced and diverse surgical techniques and medical oncological therapies are applied to treat complex tumors affecting the liver including:

Extended hepatectomy

Up to 70% of the liver volume can be removed if needed. Occasionally, future liver remnant (FLR) volume calculated via computed tomography (CT) or magnetic resonance imaging (MRI) is insufficient. Portal vein embolization is then indicated to achieve growth of the FLR volume. Typically, liver growth after portal vein embolization takes about 4 to 6 weeks. Before proceeding with extended hepatectomy a repeat CT or MRI is obtained for reassessment of liver volume.

ALPPS procedure (Associating liver partition and portal vein ligation for staged hepatectomy)

ALPPS procedure is a two stage hepatectomy in which during the first stage the portal vein branch to the liver lobe less affected by tumor is ligated and the liver parenchyma is divided so volume growth of the FLR is enhanced and achieved faster compared to traditional two stage hepatectomy.

Two-stage hepatectomy

When multiple tumors affect both lobes of the liver a two stage hepatectomy is often needed. During the first stage hepatectomy the lobe of the liver less affected by tumor is treated. Portal vein embolization follows this first operation to achieve enough volume of the cleared liver lobe. The second stage hepatectomy is performed after an interval of 4 to 6 weeks to remove the liver lobe most affected by tumor burden.

Ex-vivo hepatectomy

When tumors compromise large vascular structures of the liver, occasionally ex-vivo hepatectomy is needed. Through this approach the liver is explanted from the patient and the tumor is removed and vascular reconstructions needed performed. This technique allows easier and faster removal of the tumor and causing less blood loss. Once the liver is cleared from tumor, is re-implanted back into the patient.

Hepatic artery chemo-infusion (HAI) through a surgically implantable pump

  • Mostly implemented for advanced colorectal cancer liver metastasis (CRLM), HAI is a liver directed therapy through which chemotherapy is infused through a titanium implantable pump that has a catheter that is inserted in the hepatic artery.
  • Advantage of this form of chemotherapy is that it can be more effective and with less side effects compared to systemic chemotherapy.
  • Studies have shown that use of HAI prolonged patient survival when compared to patients in whom HAI was not implemented.

Advanced laparoscopic liver surgery

  • Minimally invasive liver surgery has evolved significantly. Its advantage is that post-operative recovery is faster and with less pain. Studies have shown that in selected patients no difference in oncologic outcome has been noticed when compared with traditional open surgery.
  • At Cleveland Clinic, state of the art laparoscopic liver surgery is offered to selected patients with various liver tumors.

Liver transplantation

  • Liver transplant is the surgery of choice for patients with cirrhosis and liver tumors. Selected patients with hepatocellular carcinoma, cholangiocarcinoma and liver metastasis from colorectal cancer can be considered for liver transplantation.
  • Liver transplantation using living donors offered at Cleveland Clinic is also an advanced and unique alternative treatment for patients with liver tumors.

Locoregional therapies (LRT)

LRT are non-surgical interventions performed by the interventional radiologist, to achieve total tumor destruction or to downsize the tumor

  • Chemoembolization.
  • Radioembolization.
  • Stereotactic beam radiation therapy (SBRT).
  • Microwave ablation.

Medical oncology treatments

  • Diverse systemic chemotherapies and molecular targeted therapies.

Liver tumor embolization

  • Embolization is the process of injecting microscopic particles into a branch of the hepatic artery (vessel that provides blood flow to the liver) to block or reduce the blood flow to a tumor in the liver.
  • A small cut is made into the skin and a catheter (a thin, flexible tube) is introduced into the artery in front of the hip. Using image guided technology, a catheter is advanced into the hepatic artery in the liver. X-ray dye is injected into the bloodstream to assure proper position. The small particles are then injected into the artery to plug it up, which blocks oxygen and nutrients from getting to the tumor, causing the tumor to die and shrink.
  • The catheter is then removed and then either a small device is used to plug up the artery in your groin or pressure is applied to that area to prevent bleeding.

Which treatment is best for you?

Your case will be reviewed by a multidisciplinary team to decide which treatment option will provide the most benefit to you. Treatment decision is based on a number of factors:

  • Liver function.
  • Location of the tumor/s.
  • Size of tumor.
  • Tumor spread to other sites other than the liver (metastasis).
  • Functional capacity.

Treatment follow up

You will have routine imaging done to monitor the status of your liver cancer. If there is recurrent liver cancer, development of more liver tumors or a suboptimal response to the treatment we may decide that further treatment is needed. Decision is made based on the factors mentioned previously. 

For additional information

Our Doctors

Our Doctors

Appointments & Locations

Appointments & Locations

Appointments

To schedule an appointment with a Cleveland Clinic liver cancer specialist, please call 216.445.8389.

Locations

Resources

Resources

Videos

Videos show graphic content. Please watch at your own disgression.

Treatment Guides

Podcasts

Listen to episodes of Cleveland Clinic's podcast Butts & Guts about liver cancer topics:

Patient Stories

Hear the inspiring stories of real Cleveland Clinic patients fighting liver cancer:

Consult QD

Find helpful posts from Cleveland Clinic's site for physicians and healthcare professionals. Discover the latest liver cancer research insights, innovations, treatment trends and more:

Support & Services

Support & Services

In addition to offering state of the art diagnostic techniques and liver cancer treatment methods, our specialists also offer an array of resources that can help patients cope with the demands of cancer. Patients are encouraged to take advantage of these resources to ease the burden of managing cancer.

Clinical Trials & Research

Clinical Trials & Research

The goal of our research program is to advance the knowledge on biology of liver, biliary and pancreas malignancy towards personalized medicine, best utilization of current therapies, and therapy discovery.

Through the Cleveland Clinic Cancer Program, patients’ bio-specimens including blood, breath exudate and liver tumor tissue are collected and bio-banked for research purposes. This process is initiated after informed consent is obtained from the patient at the liver tumor clinic.

Innovation and treatment discoveries are pivotal within the mission of the Cleveland Clinic Liver Cancer Program. Some of these endeavors include:

  • 3-D printing of liver models and computer software to aid surgical treatments of complex liver malignancies.
  • Tissue, serum and breath bio-repository for translational research.
  • Liver malignancy mice xenograft research platform—to study liver tumors from individual patients fostering personalized medicine in the field of liver oncology.

Cleveland Clinic Cancer Center clinical trials offer patients important treatment options and access to the latest treatments and procedures resulting from cancer research.

Clinical trials (or research studies) help us create the medicine of tomorrow. They provide hope through offering testing of new drugs, new surgical techniques or other treatments before they are widely available.

We can help you access hundreds of clinical trials across all specialty areas. Our new searchable online trials tool makes identifying treatment opportunities easier than ever.

Medical Professionals

Medical Professionals

Cleveland Clinic Cancer Center is committed to working with you to provide the best care for your patients. Our team is also dedicated to the training and education of medical professionals to advance cancer care and research.

Make an online referral

To make a direct online referral to our Cleveland Clinic Cancer Center, complete our Online Cancer Patient Referral Form or visit clevelandclinic.org/cancerpatientreferrals.

You will receive confirmation once the appointment is scheduled.