Department of Medical Oncology
Atrayee Basu Mallick, MD
Avnish Bhatia, MD
Christina Brus, MD
Andrew E. Chapman, DO
Nancy L. Lewis, MD *
Edith P. Mitchell, MD, FACP *
Madhaven Pillai, MD *
Michael J. Ramirez, MD
Lewis J. Rose, MD, FACP
Allison Zibelli, MD, FACP
*Practice Focus: Gastrointestinal Oncology
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Thomas Jefferson University Hospital
Each year in the United States, about 15,000 men and 6,000 women are told they have primary liver cancer. Most are over 64 years old. Risk factors include infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), heavy alcohol use, aflatoxin (a harmful substance made by certain types of mold), iron storage disease, cirrhosis, obesity, or diabetes. Primary liver cancer may also be referred to as hepatocellular carcinoma or HCC. A significant percentage of chronic liver diseases eventually give rise to liver cancer. The number of Americans diagnosed with primary or secondary liver cancer has doubled in the last decade, and our volume reflects this trend: as many as 20 new patients with liver cancer are referred to the Liver Tumor Program every month.
Primary liver cancer is cancer that forms in the tissues of the liver. Secondary liver cancer is cancer that spreads to the liver from another part of the body. It's common for cancer to spread (metastasize) to the liver from the colon, lungs, breasts, or other parts of the body. When this happens, the disease is not liver cancer. Instead, the cancer in the liver is named for the organ or the tissue in which it began. For example, colon cancer that spreads to the liver is metastatic colon cancer. It is not liver cancer.
Stage I: In stage I, there is one tumor and it has not spread to nearby blood vessels.
Stage II: There is one tumor that has spread to nearby blood vessels; or there is more than one tumor (none of which is larger than 5 centimeters).
Stage III: Stage III is divided into stage IIIA, IIIB, and IIIC. In stage IIIA, there is more than one tumor larger than 5 centimeters; or one tumor that has spread to a major branch of blood vessels near the liver. In stage IIIB, there are one or more tumors of any size that have either spread to nearby organs other than the gallbladder; or broken through the lining of the peritoneal cavity. In stage IIIC, the cancer has spread to nearby lymph nodes.
Stage IV: In stage IV, cancer has spread beyond the liver to other places in the body, such as the bones or lungs. The tumors may be of any size and may also have spread to nearby blood vessels and/or lymph nodes..
The multidisciplinary team offers the most advanced surgical and nonsurgical treatments for virtually every type of liver tumor. We work closely with Jefferson’s Liver Transplant Program, the longest continuously operating liver transplant program in the Philadelphia area, with more than 700 transplants performed since 1984.
Our innovative treatment methods include “bloodless” liver resection, robotic liver resection, radiofrequency ablation (RFA), intrahepatic chemotherapy, or chemoembolization, Yttrium-90 microsphere radioembolization, which selectively targets tumors with a high dose of radiation, and selective internal radiation therapy (SIRT), which involves injecting localized radiation into the hepatic artery.
Stereotactic body radiation therapy (SBRT) treats surgically inoperable liver cancer as well as colon cancer. With the aid of image-guided radiation therapy (IGRT) with cone beam CT and the Active Breathing Coordinator (ABC) device, the linear accelerator (LINAC) precisely targets the cancer. Jefferson is one of the first centers in the nation to use this advanced, highly effective technology.
Reference: National Cancer Institute.