Liver Cancer

Liver cancer can be diagnosed using imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI). MRI provides high accuracy in distinguishing benign from malignant liver tumors and can detect cancers smaller than 1 cm.

If imaging results are inconclusive, a liver biopsy may be performed for confirmation. Because early detection is critical, interpretation by an experienced radiologist is essential.

Staging is determined by the number and size of tumors, the degree of vascular invasion, and whether the cancer has spread beyond the liver. Based on CT or MRI findings, liver cancer is commonly classified as follows:

Stage I

• A single tumor ≤ 2 cm with no vascular invasion

Stage II:

• A single tumor ≤ 2 cm with vascular invasion, OR
• A single tumor > 2 cm without vascular invasion, OR
• Multiple tumors ≤ 2 cm without vascular invasion

Stage III:

• A single tumor > 2 cm with vascular invasion, OR
• Multiple tumors ≤ 2 cm with vascular invasion, OR
• Multiple tumors with at least one > 2 cm without vascular invasion

Stage IV:

• Multiple tumors > 2 cm with vascular invasion, OR
• Regional lymph node metastasis, OR
• Distant metastasis to other organs

The prognosis of liver cancer depends not only on the tumor itself but also on the underlying liver function. In fact, liver failure due to chronic liver disease is often a greater cause of death than the tumor itself. Therefore, comprehensive treatment requires both effective cancer therapy and preservation of liver function.

Treatment options include:

Liver Resection (Hepatectomy)

Surgical resection is an effective treatment for early-stage liver cancer in patients with adequate liver function and no extrahepatic disease. Advances in laparoscopic and robot-assisted techniques reduce pain and shorten recovery compared to traditional open surgery.

Liver Transplantation

Transplantation can cure both liver cancer and the underlying chronic liver disease by replacing the diseased liver with a healthy donor liver. Safe transplantation can be performed even with ABO-incompatible donors, and donors benefit from minimal scarring and faster recovery through laparoscopic liver resection.

Radiofrequency Ablation (RFA)

A minimally invasive procedure in which a needle-shaped probe delivers radiofrequency energy to burn and destroy small tumors (< 3 cm).

Cryoablation Therapy

For tumors unsuitable for RFA (e.g., near large vessels), cryoablation uses freezing and thawing cycles under CT or ultrasound guidance to destroy cancer cells.

Transarterial Chemoembolization (TACE) / Transarterial Radioembolization (TARE)

Minimally invasive interventional radiology procedures. Embolic particles coated with chemotherapy drugs (TACE) or radioactive isotopes (TARE) are injected into arteries feeding the tumor. These block blood supply, deliver drugs or radiation, and may be combined with RFA or external radiation to improve outcomes.

Proton Therapy

A highly advanced form of radiation therapy using proton beams to precisely target and destroy cancer cells while sparing surrounding liver tissue.

Radiation Therapy

It is used primarily for palliation, to relieve symptoms and prevent complications when the tumor invades blood vessels, lymph nodes, or bone.

Systemic Therapy

For advanced cases, systemic therapies such as targeted agents and immune checkpoint inhibitors can prolong survival and improve quality of life.