Other Liver Treatments

Beyond hitting the liver tumors with radiation (e.g. SIR Spheres) or doing a more targeted delivery of chemotherapy agent (e.g. PHP), doctors also target the liver with two primary methods:

Resection (surgical removal)

Resection is the surgical removal of the tumor and is used predominantly when only a single tumor is present in the liver. It is often reserved for patients who are several years out from a primary eye tumor diagnosis and repeated imaging studies show only one tumor. Since liver resection can sometimes remove some healthy tissue along with the tumor, it is reserved for select cases. Only a small percentage of patients have this option (~10% are typically eligible) and many doctors also advise against it if there are multiple tumors because the tumor has a high likelihood of recurrence. However, new research is showing better outcomes if tumors are caught early and are able to be resected. Therefore, if resection is deemed to be an option, it is something to consider seriously. It may also be a good idea for the surgeon to be prepared to do radio-frequency ablation (RFA or other ablative technique similar to this) on any small tumors they might find that the scan missed and that might make surgical resection impossible once the surgery is in process. Some surgeons will recommend a laparoscopic "look-see" prior to the surgery to ensure it can go forward without surprises.

This paper shows a promising result: liver resection is associated to prolonged survival over 24 months and should be considered only in selected patients with metastatic disease confined to the liver. 

Ablation (heating or freezing to kill tumor cells)

Ablation involves inserting small probes into tumors and heating (i.e., radio frequency ablation, microwave ablation) or freezing (cryoablation) the tumors to kill them. This can be done through the skin or surgically. Like resection, this is typically not recommended if multiple tumors are present. Ablation can be used in other areas of the body beyond the liver, such as the lung, kidney and soft tissue.