Metastatic Sarcoma & Other Liver Cancers

There are several less common liver cancer such as metastatic soft tissue sarcoma to the liver, liver carcinosarcoma, angiosarcoma, epithelioid hemangioendothelioma, fibrosarcoma, teratoma, ovarian cancer, and undifferentiated embryonal sarcoma. Liver biopsy is often necessary to confirm tissue diagnosis/ types.

Treatment options for these types of liver cancer depend on tumor location, size, proximity to major vascular/biliary structures, and the volume of future of remnant. The best and only curative option is complete tumor removal via liver resection with clean margins.

Liver resection in the context of cytoreductive surgery (debulking) is also performed for metastatic neuroendocrine tumor, metastatic ovarian cancer, and other metastatic cancer to the liver which have shown favorable biological behavior over an extended period of time. Liver transplant surgery is not offered for these types of liver cancer due to uncertain prognosis.

Because the liver is the only organ in human body that can regenerate, normal healthy liver can tolerate resection up to 70% of the volume. The remaining part of the liver regrows (hypertrophy) within 3-4 weeks. Even patients who have been treated with systemic chemotherapy extensively can tolerate liver resections very well.

Minimally invasive laparoscopic liver resection or robotic liver resection with/ without microwave/ radiofrequency liver ablation is often performed to achieve disease-free status. A surgical consultation with an experienced liver specialist or liver surgeon, such as Dr. Iswanto Sucandy initiates the most important step in multidisciplinary treatment approach to achieve best long-term survival /outcomes.