Pediatric Liver Tumor & Hepatoblastoma

Advanced genomic sequencing for liver tumors

Every child who comes to UCSF for cancer care benefits from the UCSF500 Cancer Gene Panel. This test analyzes a tumor's DNA to help identify what's driving the cancer. It may also reveal genetic predisposition syndromes or markers that help us select targeted therapies, predict treatment response and match patients to clinical trials.

Treatments for hepatoblastoma and other liver tumors

For many children with liver cancer, treatment involves a combination of therapies. Our goal is to cure cancer while protecting children's long-term health and quality of life.

Chemotherapy

Sometimes we give patients chemotherapy before surgery to shrink liver tumors so they're easier to remove. After surgery, chemotherapy can help destroy remaining cancer cells. For children who are waiting for a liver transplant, chemotherapy can help control tumor growth.

Cisplatin is the most common chemotherapy drug for liver cancer, but it can cause hearing loss. For some children with liver cancer that hasn't spread, we offer a medication called sodium thiosulfate (STS) alongside chemotherapy. This approach has been shown to reduce the risk of hearing loss by up to 50%.

Liver cancer surgery

Most children with liver cancer need surgery. We use minimally invasive techniques whenever possible to help them recover faster and with less pain.

We also use a breakthrough surgical technique that can detect cancer that has spread beyond the liver. During surgery, our surgeons inject a fluorescent dye into the bloodstream. When cancerous cells absorb the dye, they glow and can be seen in real time using a special camera. This helps surgeons locate and remove tumors that may not normally be visible on imaging scans.

Interventional radiology

Our interventional radiologists use catheter-based procedures to diagnose liver cancer. We perform minimally invasive, image-guided biopsies to collect tumor tissue for testing. This approach allows children to start treatment immediately after diagnosis, without having to wait to heal from a surgical biopsy.

We also use interventional procedures for children who aren't healthy enough for surgery or who need treatment to relieve symptoms. These procedures may include:

• Radiofrequency ablation (RFA). Uses extreme heat to destroy tumors

• Transarterial chemoembolization (TACE). Delivers a high dose of chemotherapy to the tumor while cutting off its blood supply

• Transarterial radioembolization (TARE). Delivers radioactive beads directly to the tumor

Liver transplantation

A liver transplant may be needed for liver cancer that's still confined to the liver but can't be safely removed with surgery. UCSF's Pediatric Liver Transplant Program is one of the leading programs in the country.

We're among only a few hospitals offering living donor transplants. This allows us to schedule surgery at the right time for the patient instead of having to wait for a deceased donor organ to become available.

Our hepatologists are also national leaders in developing protocols to safely reduce immunosuppressive medications as soon as possible after liver transplant. This can help minimize the long-term side effects of these medications.

Children who have liver transplantation may have an increased risk of developing certain cancers later in life. Our oncologists, hepatologists and transplant surgeons work together to provide comprehensive, lifelong follow-up care to help manage these risks.