Localized unresectable liver cancer cannot be removed by surgery even though it has not spread to the nearby lymph nodes or to distant parts of the body. Surgery to remove the tumor is not possible because of cirrhosis (or other conditions that cause poor liver function), the location of the tumor within the liver, or other health problems.

Patients with localized unresectable cancer may receive other treatments to control the disease and extend life:

• Radiofrequency ablation -- The doctor uses a special probe to kill the cancer cells with heat. The probe contains tiny electrodes that destroy the cancer cells. Sometimes the doctor can insert the probe directly through the skin. Only local anesthesia is needed. In other cases, the doctor may insert the probe through a small incision in the abdomen or may make a wider incision to open the abdomen. These procedures are done in the hospital with general anesthesia.

  Other therapies that use heat to destroy liver tumors include laser or microwave therapy.

• Percutaneous ethanol injection -- The doctor injects alcohol (ethanol) directly into the liver tumor to kill cancer cells. The doctor uses ultrasound to guide a small needle. The procedure may be performed once or twice a week. Usually local anesthesia is used, but if the patient has many tumors in the liver, general anesthesia may be needed.

• Cryosurgery -- The doctor makes an incision into the abdomen and inserts a metal probe to freeze and kill cancer cells. The doctor may use ultrasound to help guide the probe.

• Hepatic arterial infusion -- The doctor inserts a tube (catheter) into the hepatic artery, the major artery that supplies blood to the liver. The doctor then injects an anticancer drug into the catheter. The drug flows into the blood vessels that go to the tumor. Because only a small amount of the drug reaches other parts of the body, the drug mainly affects the cells in the liver.

  Hepatic arterial infusion also can be done with a small pump. The doctor implants the pump into the body during surgery. The pump continuously sends the drug to the liver.

• Chemoembolization -- The doctor inserts a tiny catheter into an artery in the leg. Using x-rays as a guide, the doctor moves the catheter into the hepatic artery. The doctor injects an anticancer drug into the artery and then uses tiny particles to block the flow of blood through the artery. Without blood flow, the drug stays in the liver longer. Depending on the type of particles used, the blockage may be temporary or permanent. Although the hepatic artery is blocked, healthy liver tissue continues to receive blood from the hepatic portal vein, which carries blood from the stomach and intestine. Chemoembolization requires a hospital stay.

• Total hepatectomy with liver transplantation -- If localized liver cancer is unresectable because of poor liver function, some patients may be able to have a liver transplant. While the patient waits for a donated liver to become available, the health care team monitors the patient's health and provides other treatments, as necessary.

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