See the Treatment Options Overview section for information on the treatments listed below.
Hepatoblastoma
Treatment options for hepatoblastoma that is surgically resectable at diagnosis may include the following:
For fetal histologically incomplete hepatoblastoma, surgical resection of the tumor followed by combination chemotherapy. For small cell undifferentiated hepatoblastoma, aggressive chemotherapy should be administered.
For hepatoblastoma with well-differentiated fetal histology, surgical resection of the tumor followed by watchful waiting or chemotherapy.
Treatment options for hepatoblastoma that cannot be removed surgically or that cannot be removed at diagnosis include:
Tumor shrinkage by combination chemotherapy followed by surgical removal of the tumor.
Combined chemotherapy followed by liver transplantation.
Treatment with hepatic artery chemoembolization to shrink the tumor, followed by surgical removal of the tumor.
If the tumor in the liver cannot be removed surgically and there is no sign of cancer elsewhere in the body, treatment may be liver transplantation.
For hepatoblastoma that has spread to other parts of the body at the time of diagnosis, combination chemotherapy is given to shrink the liver tumor and the cancer that has spread to other parts of the body. After chemotherapy, imaging is performed to see if the tumor can be removed by surgery.
Treatment options may include the following:
If the tumor in the liver and elsewhere in the body (usually a nodule in the lung) can be removed, surgery to remove the tumor, followed by chemotherapy to kill any cancer cells that may remain.
If tumors elsewhere in the body cannot be removed or a liver transplant cannot be performed, chemotherapy, hepatic artery chemoembolization, or radiation therapy may be performed.
Radiofrequency ablation may be performed if the tumor cannot be removed elsewhere in the body or if the patient does not want to undergo surgery.
Treatment options in clinical trials for newly diagnosed hepatoblastoma include:
Chemical therapy and surgical clinical trials
Hepatocellular carcinoma
Treatment options for hepatocellular carcinoma that is surgically resectable at diagnosis include:
Surgical removal of tumor only
Surgical removal of the tumor followed by chemotherapy
Combination chemotherapy followed by surgical removal of the tumor.
Treatment options for hepatocellular carcinoma that cannot be removed surgically and has not spread to other parts of the body at the time of diagnosis may include:
Chemotherapy to shrink the tumor, followed by surgery to remove the tumor completely.
Perform chemotherapy to shrink the tumor. If complete removal of the tumor by surgery is not possible, further treatment options may include.
Liver transplantation.
Chemical embolization of the hepatic artery to shrink the tumor, followed by surgical removal of the tumor or liver transplantation.
Chemoembolization using only the hepatic artery
Chemical embolization followed by liver transplantation.
Hepatic artery embolization as palliative treatment to relieve symptoms and improve quality of life.
Treatment of hepatocellular carcinoma that has spread to other parts of the body at the time of diagnosis may include:
Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible from the liver and other areas where the cancer has spread. Studies have not shown that such treatment works well, but some patients may benefit.
Treatment options for hepatocellular carcinoma associated with hepatitis B virus (HBV) infection include:
Surgical removal of the tumor
Antiviral drugs for hepatitis B virus infection
Treatment options in clinical trials for newly diagnosed hepatocellular carcinoma include:
Chemical therapy and surgery in clinical trials
Undifferentiated embryonal sarcoma of the liver
Treatment options for undifferentiated embryonal sarcoma of the liver include:
Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible. Surgery may also be followed by chemotherapy to remove the tumor.
Surgery to remove the tumor, followed by chemotherapy. A second surgery may be performed to remove the remaining tumor, followed by more chemotherapy.
Liver transplantation if tumor cannot be surgically removed.
Clinical trials of new treatment options, which may include preoperative targeted therapy (pazopanib), chemotherapy, and/or radiation therapy.
Choriocarcinoma of the liver in infants
Treatment options for hepatic choriocarcinoma in infants include:
Tumor shrinkage with combination chemotherapy followed by surgical removal of the tumor.
Surgical removal of the tumor
Vascular hepatocellular carcinoma
For information on the treatment of vascular liver tumors, see the PDQ summary for the treatment of vascular tumors in children.
Recurrent pediatric hepatocellular carcinoma
Treatment of progressive or recurrent hepatoblastoma may include:
Surgical resection of isolated (single and separate) metastatic tumors with or without chemotherapy.
Radiofrequency ablation
Combined chemotherapy.
Liver transplantation.
Ablation therapy (radiofrequency ablation or percutaneous ethanol injection) as palliative therapy to relieve symptoms and improve quality of life.
Clinical trials examining certain genetic changes in patients’ tumor samples. The type of targeted therapy that will be given to the patient depends on the type of genetic alteration.
Treatment of progressive or recurrent hepatocellular carcinoma may include:
Tumor shrinkage with hepatic artery chemoembolization followed by liver transplantation.
Liver transplantation.
Clinical trials of targeted therapy (sorafenib).
Clinical trials examining certain genetic changes in patients’ tumor samples. The type of targeted therapy that will be given to the patient depends on the type of genetic alteration.
Treatment of recurrent undifferentiated embryonal sarcoma of the liver may include:
Clinical trials examining certain genetic changes in a patient’s tumor sample. The type of targeted therapy that will be given to the patient depends on the type of genetic alteration.
Treatment for recurrent hepatic choriocarcinoma in infants may include:
A clinical trial to examine certain genetic changes in a patient’s tumor sample. The type of targeted therapy that will be given to the patient depends on the type of genetic alteration.
Treatment options in clinical trials
Use our Clinical Trials Search to find NCI-supported (patients being accepted) clinical trials for cancer. You can search for trials by cancer type, patient age, and where the trial is being conducted. You can also get general information about clinical trials.