Stage I and II Childhood Liver Cancer
Stage III Childhood Liver Cancer
Stage IV Childhood Liver Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment for stages I and II and PRETEXT stages 1, 2, and 3 hepatoblastoma may include the following:

• Surgery to remove the tumor, followed by chemotherapy or watchful waiting (closely monitoring a patient’s condition without giving any treatment until symptoms appear or change).
• Chemotherapy to shrink the tumor, followed by surgery to remove the tumor.

Treatment for stage I and II hepatocellular carcinoma is usually surgery to remove the tumor, followed by combination chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I childhood liver cancer ¹ and stage II childhood liver cancer ². For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ³.

Treatment of stage III and PRETEXT stage 4 hepatoblastoma may include the following:

• Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible.
• If the tumor cannot be removed by surgery after chemotherapy, further treatment may include the following:
  • High-dose chemotherapy.
  • Radiation therapy.
  • Chemoembolization of the hepatic artery.
  • Liver transplant.
• A clinical trial of combination chemotherapy.

Treatment of stage III hepatocellular carcinoma is usually combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the tumor as possible.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III childhood liver cancer ⁴. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ³.

Treatment of stage IV hepatoblastoma may include the following:

• Combination chemotherapy to shrink the tumor, followed by surgery to remove as much of the cancer as possible, including cancer that has spread to the lungs. If the cancer is completely removed, additional chemotherapy is given to kill any cancer cells that may remain.
• If the tumor cannot be removed by surgery after chemotherapy, further treatment may include the following:
  • High-dose chemotherapy.
  • Radiation therapy followed by surgery to remove as much of the tumor as possible.
  • Chemoembolization of the hepatic artery.
  • Liver transplant.
• A clinical trial of chemotherapy.

Treatment of stage IV hepatocellular carcinoma may be combination chemotherapy to reduce the size of the tumor, followed by surgery to remove as much of the tumor as possible.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV childhood liver cancer ⁵. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ³.

Glossary Terms

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

A procedure in which the blood supply to the tumor is blocked surgically or mechanically and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

Treatment using more than one anticancer drug.

The major blood vessel that carries blood to the liver.

A type of liver tumor that occurs in infants and children.

A type of adenocarcinoma, the most common type of liver tumor.

An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

All of the cancer was removed by surgery.

All of the cancer was removed by surgery, except for a small amount of cancer that can be seen only with a microscope, or tumor cells that may have spilled into the abdomen during surgery.

Either (1) the tumor cannot be removed by surgery; or (2) cancer that can be seen without a microscope remains after surgery; or (3) the cancer has spread to nearby lymph nodes.

The cancer has spread to other parts of the body.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A surgical procedure in which tissue or an organ is transferred from one area of a person’s body to another area, or from one person (the donor) to another person (the recipient).

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.

Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called active surveillance, expectant management, and observation.