Treatment of Liver Cancer

Liver cancer treatment requires consideration of liver function and tumor location to determine the appropriate method. Surgical resection and liver transplantation are curative treatments. However, half of the patients diagnosed with liver cancer often have more than one tumor, making surgical resection less likely; furthermore, some patients may experience recurrence after surgery. Therefore, for patients who cannot undergo surgery, other localized liver cancer treatments or liver transplantation can be considered. For liver cancers involving three or fewer tumors smaller than 3 cm, or a single tumor smaller than 5 cm in a suitable location, localized treatments such as Radiofrequency Ablation (RFA) or Microwave Ablation (MWA) can also achieve curative effects. If surgical resection or localized ablation is not possible, radiation therapy is an option. For larger or multiple tumors and patients with poor liver function who are not suitable for surgery, Transarterial Chemoembolization (TACE) can be used.

For cases with vascular invasion, distant metastasis, or ineffective TACE, systemic drug therapy may be considered. Current oral targeted drugs include Sorafenib, Lenvatinib, Regorafenib, and Cabozantinib. Immunotherapies include combination treatments such as Atezolizumab plus Bevacizumab, Tremelimumab plus Durvalumab, and Ipilimumab plus Nivolumab.

Liver cancer tends to recur, so adherence to medical advice for treatment and follow-up is essential. Many anticancer drugs are now available, and combination therapy is the trend. A multidisciplinary team for liver cancer can evaluate and determine the best treatment strategy. Early detection and early treatment offer the best prognosis. Therefore, patients with chronic hepatitis, liver cirrhosis, or a family history of liver cancer should have regular blood tests and abdominal ultrasounds every 3-6 months.

Prevention

• Patients with chronic hepatitis B or C or a family history of liver cancer should undergo regular blood tests and abdominal ultrasound examinations to detect lesions early and receive early treatment.
• Avoid consuming foods prone to aflatoxins, such as peanuts, soybeans, and corn.
• Avoid alcohol consumption.
• Avoid unnecessary injections or blood transfusions.