• Liver Tumor Program

    Dana-Farber/Boston Children's treats all primary liver tumors occurring in children and young adults. The two most common types of liver tumors are hepatoblastoma and hepatocellular carcinoma. We care for both newly diagnosed liver cancer and for children with relapsed disease.

    We have some of the most experienced pediatric liver cancer oncologists and surgeons in the world, as well as internationally recognized pediatric subspecialists who use sophisticated technology and therapies to maximize outcomes for our patients.

    How We Diagnose Liver Tumors

    In addition to a complete physical examination and medical history, our doctors use a variety of tests to diagnose liver cancer in children. These tests range from blood laboratories (to assess organ function and measure proteins excreted by the tumors) to advanced imaging studies (ultrasound, computerized tomography, and magnetic resonance imaging). Ultimately, the diagnosis is confirmed by tumor biopsy.

    Obtaining a correct diagnosis is a crucial first step in making sure your child receives the most appropriate treatment. Because liver pathology is complicated, liver tumors are sometimes misdiagnosed. For instance, hepatocellular carcinoma may be misdiagnosed as hepatoblastoma. Dana-Farber/Boston Children's has one of the largest, most sophisticated pathology services of its kind in the country. Our board-certified pediatric pathologists have further specialization in a variety of forms of cancer, with particular expertise in rare pediatric tumors.

    How We Treat Liver Cancer

    Children with hepatoblastoma or hepatocellular carcinoma will require surgery to remove the tumor. This may involve partial removal of the liver or, in rare cases, a total hepatectomy (removal of the liver) and liver transplant (in which your child's liver is replaced with a liver from a donor). If surgery is deemed too risky or is likely to leave part of the tumor behind, the child may be treated initially with chemotherapy to shrink the tumor to make it easier to remove. Hepatoblastoma is remarkably responsive to chemotherapy, and the majority of patients receive it in addition to surgery (usually both before and after surgery). Hepatocellular carcinoma is less responsive to chemotherapy, therefore surgery is key.

    Surgery may be more difficult for patients with hepatocellular carcinoma as this type of cancer often metastasizes, can involve multiple parts of the liver, and can occur in patients with underlying liver disease. Doctors may also perform a procedure called chemoembolization or radioembolization of the hepatic artery, which can allow direct delivery of therapy via the main blood vessel in the liver to the sites of disease.

    Any tumor in the upper gastrointestinal tract, including the liver, is a very complicated surgery and requires very specialized expertise. However, because liver tumors in children are so rare, very few pediatric surgeons have extensive experience in treating these tumors.

    At Dana-Farber/Boston Children’s, we have surgeons who specialize in pediatric liver surgery and have successfully performed some of the most complicated liver and upper gastrointestinal surgeries in children. Our surgeons utilize the full range of surgical options for liver tumors, including total hepatectomy with “back table” resection of the tumor and autotransplantation of the remnant liver, resections requiring reconstruction of the blood vessels or bile ducts or resections requiring heart-lung bypass to remove a tumor that has grown into the heart. When none of these options are sufficient, liver transplantation is an option and in the most extreme cases, a full multivisceral transplant may be needed to replace multiple organs that are involved by the tumor.

    Our Liver Cancer Treatment Specialists

    Dana-Farber/Boston Children's patients have access to the broadest set of pediatric and oncologic expertise available. The breadth of our expertise allows us to assemble a team of specialists to meet the specific needs of each patient.

    At the core of the treatment team are medical oncologists who specialize in treating liver cancer. Many of our physicians are also active researchers, so our patients have access to the very best and up-to-date treatments available.

    From there, we build a team that is best suited to carry out the patient’s treatment plan, including surgeons, hepatologists (liver specialists), radiation oncologists, interventional radiologists, pathologists, and transplant physicians. One of our surgeons, Heung Bae Kim, MD, is one of only a few surgeons in the nation who are dual-trained in pediatric general surgery and in liver transplantation – which means he brings to your child a virtually unparalleled expertise in pediatric liver tumor surgery.

    We round out our treatment team with experts who help your child prepare for life during and after treatment, including psychiatrists and psychologists, child life specialists, social workers, nutritionists, and school specialists.

    Liver Cancer Research and Clinical Trials

    Our clinical research program offers unique access to clinical trials in which children can receive the newest liver cancer treatments. A major focus of our research program is the rapid translation of scientific discoveries from the laboratory to the bedside to benefit patients. Through this research, our physicians work to improve therapeutic approaches and outcomes for hard-to-treat tumors. We are also investigating biologic therapies that use the body’s own immune system to fight cancer, new ways to deliver chemotherapy, and new interventional radiology techniques to enhance care.

    Precision Medicine for Liver Tumors: One or our surgeon-scientists, Khashayar Vakili, MD, is looking for a mechanism to decrease the growth of hepatocellular carcinoma. Transplant and surgery alone are usually ineffective for hepatocellular carcinoma because of the aggressive nature of the disease and the fact that there is no chemotherapy that actually works against the tumor. By studying individual patient tumors, he hopes to gain a greater understanding of the tumor’s biology with the goal of finding new therapeutic targets that can directly impact the specific tumor mutation – a type of treatment often referred to as precision medicine.

  • Top Ranked for Cancer Care

    U.S. News Best Children's Hospitals logoWorld class cancer care at the #1 Children's Hospital

  • Family Travels from Mexico to Treat Liver Tumor

    Manuel's family journeyed to Boston to find the best treatment for Manuel's liver tumor.

    Manuel with oncologist

  • Solid Tumor Clinical Trials

    Through research and clinical trials, we are developing innovative therapies and helping to improve treatment for solid tumors.callout bg