Liver and Gallbladder Cancer

Malignancies confined to the liver are one of the most common forms of cancer. There are two basic types of the disease: primary liver cancer originates in the tissues of the liver itself, while metastatic liver cancer occurs when cancer cells spread from other parts of the body, most commonly from the stomach, pancreas, breast or lung. Ultimately, about a third of all cancers will spread to the liver.

Surgery usually provides the best chance for a cure, and our surgical specialists are among the best in the country. In some cases, however, tumors develop internally within the liver and complete surgical removal is not possible.

The University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC) offers a comprehensive Liver-Directed Therapies Program, providing the most advanced treatments available -- from complete or partial surgical removal to systemic, combination therapies to regional, targeted treatment options -- to provide the very best outcomes possible for patients with all forms of liver cancer.

Our multidisciplinary Liver-Directed Therapies Program team consists of experts in medical oncology, radiation oncology, surgical oncology, interventional radiology, nuclear medicine, gastroenterology, hepatology and pathology. These specialists meet and consult weekly to develop the best plan of treatment for each individual patient.

Liver Cancer Treatments

Experts within the University of Maryland Liver Center consider all possible options to help patients determine a treatment plan for liver cancer. The multidisciplinary team of physicians examine each patient's case at a weekly meeting and discuss treatment options, which can include surgery, chemotherapy or radiation.

The University of Maryland has been recognized for its treatment of liver cancer, including:

Selective Internal Radiation Therapy (SIRT) - the University of Maryland is the first and one of the most experienced radioembolization centers in the country
Intrabiliary brachytherapy - as a component of pre-liver transplant treatment of bile duct cancers that requires tremendous expertise
Complex cancer genetic testing for patients who require advanced therapy
Robot-assisted liver surgery allows for high rates of success in high-risk patients
Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Selective Internal Radiation Therapy (SIRT)

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Selective Internal Radiation Therapy (SIRT) is a type of internal radiation therapy that uses millions of microscopic beads injected into the liver, directly to the site of the tumor. UMGCCC is one of the select few state-of-the-art facilities that provide this treatment in the United States. Our team of experts has one of the largest experiences in the United States treating patients with Yttrium-90 microspheres (SIR-Spheres) for inoperable liver cancer. To date, we have treated more than 140 patients with SIRT, and our experts have presented the results of our SIRT research and treatment at both national and international meetings.

Radiofrequency Ablative Therapy

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Radiofrequency ablation (RFA) is a very localized treatment that kills the tumor with heat, while sparing the rest of the liver. RFA involves inserting a thin needle, guided by imaging techniques such as ultrasound or computed tomography, through the skin, (or in some cases, through a laparoscopic incision) and into the core of a tumor. Alternating current is then used to heat or "cook" the tumor to about 100 degrees Celsius, destroying the tumor and hopefully, any cancer cells in the tissue immediately surrounding it. The heat, while fatal to the tumor, does not travel far, eliminating the possibility of liver disease.

Chemoembolization/Embolization

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Chemoembolization is a method of delivering chemotherapy directly to the tumor while blocking blood flow to the liver. A thin tube is inserted in the hepatic artery, and chemotherapy drugs are injected into the tumor, along with an agent that blocks the artery. This allows the chemotherapy to attack the tumor at a higher concentration and for a longer period of time, while minimizing exposure in the rest of the body. It also cuts off the blood supply to the tumor, depriving it of the oxygen and nutrients it needs to grow.

Stereotactic Body Radiation Therapy (SBRT)

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Stereotactic Body Radiation Therapy, or SBRT, is a method of delivering external beam radiation to the site of a tumor using high-dose, precisely focused beams of radiation. Once only used for the brain, stereotactic radiation therapy can now be used to treat tumors in other regions of the body, including otherwise inoperable tumors of the liver, thanks to recent advances in imaging, dose delivery and patient positioning techniques. SBRT, also known as fractionated radiosurgery (because a fraction of the dose is delivered at each session), destroys tumors with high doses of radiation, while sparing healthy surrounding tissue. UMGCCC was the first medical center in the Mid-Atlantic region to offer the Trilogy System, the one of the most advanced forms of technology available for providing stereotactic body radiation therapy.

Liver Transplant

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The University of Maryland Medical Center (UMMC) is the state’s busiest liver transplant center. For over five years, we have performed among the highest number of liver transplants annually on the East Coast. Learn more about the Liver Transplant Center at UMMC.

Liver Resection

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A liver resection is the removal of the tumor from the liver, either open or minimally invasively.