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Liver Cancer

Liver cancer most commonly hepatocellular carcinoma (HCC) is a cancer that demands both oncological expertise and a deep understanding of liver function. Many patients with liver cancer also have underlying cirrhosis, which shapes every treatment decision. At Shree Hospitals, our hepatobiliary oncology team delivers tailored liver cancer treatment in Mumbai India, across the full range of treatment modalities from surgical resection to transplant candidacy assessment, ablation, and systemic immunotherapy.

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1800-268-4000

Our Approach to Managing Liver Cancer

Liver cancer treatment is complex because you are always treating two things simultaneously the tumour and the liver it lives in. Our liver cancer specialists in Mumbai use the Barcelona Clinic Liver Cancer (BCLC) staging system alongside Child-Pugh liver function scoring to ensure that every treatment decision is calibrated to the patient's residual liver capacity, not just the cancer stage. This is the precision that makes the difference between a treatment that helps and one that harms.

1. Diagnosis & Staging

AFP (Alpha-fetoprotein) and PIVKA-II tumour markers elevated in most HCC cases
Contrast-enhanced CT or MRI liver the arterial phase enhancement pattern is diagnostic for HCC
Liver biopsy reserved for cases where imaging is inconclusive
BCLC staging determines treatment allocation (resection, ablation, TACE, systemic therapy, or best supportive care)
Child-Pugh and MELD scoring to quantify liver functional reserve before any intervention
Surveillance ultrasound + AFP every 6 months in all cirrhotic patients

2. Surgical Resection

Surgery is the first-line curative option for patients with preserved liver function and localised disease:

Anatomical liver resection removal of the hepatic segment containing the tumour
Laparoscopic hepatectomy for peripheral tumours in selected patients
Adequate future liver remnant (FLR) assessment mandatory before major resection
Portal vein embolisation (PVE) used pre-operatively to grow the FLR when borderline
R0 resection (complete margin clearance) is the surgical goal in all liver tumour surgery

3. Ablation Therapies

For patients with small tumours not amenable to surgery:

Radiofrequency Ablation (RFA) heat-based destruction for tumours ≤3 cm
Microwave Ablation (MWA) faster, higher temperature effective for tumours up to 5 cm
Percutaneous ethanol injection (PEI) for Child-Pugh C patients with small tumours where thermal ablation is not feasible
Image-guided (ultrasound or CT) precision for all ablative procedures

4. Transarterial Chemoembolisation (TACE)

The standard treatment for intermediate-stage HCC:

Conventional TACE chemotherapy (doxorubicin) mixed with Lipiodol, followed by embolisation of the hepatic artery branch feeding the tumour
Drug-eluting bead TACE (DEB-TACE) microspheres loaded with chemotherapy for sustained local drug release
Repeated as needed typically every 6–8 weeks with imaging response assessment between sessions
Can serve as bridge to transplant in patients awaiting liver transplantation

5. Systemic Therapy

Advanced HCC beyond surgical and locoregional options now has multiple effective systemic agents a major advance in hepatobiliary oncology Mumbai:

Atezolizumab + bevacizumab (Atezo-Bev) first-line immunotherapy combination; now the international standard
Lenvatinib alternative first-line TKI for patients ineligible for Atezo-Bev
Sorafenib established first-line option, still used in specific contexts
Second-line options: regorafenib, ramucirumab, cabozantinib, nivolumab, pembrolizumab
Combination regimens continue to evolve with rapidly improving survival data

6. Liver Transplantation Assessment

In carefully selected patients, liver transplantation is the only treatment that addresses both the tumour and the underlying cirrhosis:

Milan criteria assessment tumours within these limits have excellent post-transplant outcomes
Downstaging with TACE or ablation to bring patients within transplant criteria
Transplant evaluation at Shree Hospitals in coordination with liver transplantation programme
TACE used as bridge therapy to prevent tumour progression while awaiting a donor

How To Identify Liver Cancer?

Liver cancer develops most commonly in patients with known liver disease cirrhosis, chronic hepatitis B or C, or fatty liver-related cirrhosis. In these patients, 6-monthly surveillance is the most effective early detection strategy. When symptoms occur, they indicate more advanced disease:

Right upper abdominal pain or fullness — the liver capsule stretching as the tumour enlarges
Unexplained weight loss — rapid, not attributable to diet
Jaundice — yellowing of the skin and eyes; indicates bile duct involvement or significant liver dysfunction
Abdominal swelling (ascites) — fluid accumulation; may be new or worsening in a known cirrhotic
Loss of appetite and nausea — persistent, without another cause
Fatigue out of proportion to activity level
Fever of unknown origin — occasionally seen with large or rapidly growing HCCs

All patients with cirrhosis regardless of cause should be on a HCC treatment surveillance programme. Speak to a liver cancer specialist in Mumbai at Shree Hospitals to establish or review your surveillance plan.

Important FAQs: Liver Cancer

What is the most common cause of liver cancer in India?

Hepatitis B infection is the leading cause India has a high prevalence of chronic HBV, and cirrhosis from HBV is a major driver of HCC. Hepatitis C, alcoholic liver disease, and NAFLD/NASH-related cirrhosis are other significant contributors.

Can liver cancer be cured?

Early-stage HCC (BCLC Stage 0 and A) treated with resection, ablation, or transplantation has 5-year survival rates of 50–70%. Outcomes drop sharply in intermediate and advanced stages. This is why surveillance in at-risk patients is so important.

What is the difference between TACE and ablation?

Ablation physically destroys the tumour using heat (RFA/MWA). TACE delivers chemotherapy to the tumour through its blood supply and then blocks that supply. Both are locoregional not systemic. The choice depends on tumour size, number, and location.

Is liver cancer the same as liver metastases?

No. Primary liver cancer (HCC or cholangiocarcinoma) originates in the liver itself. Liver metastases are cancers from elsewhere in the body (colon, breast, stomach) that have spread to the liver. They are managed very differently.

What are the side effects of sorafenib or immunotherapy for liver cancer?

Sorafenib commonly causes hand-foot skin reaction, diarrhoea, and fatigue. Immunotherapy can cause immune-related side effects including hepatitis, pneumonitis, and skin rash. Both are manageable with dose adjustments and supportive care at Shree Hospitals.

How often should I be screened for liver cancer if I have cirrhosis?

Every 6 months with an ultrasound and AFP. This is the international standard and the basis of all HCC surveillance guidelines. Patients with known cirrhosis should be on a formal surveillance programme regardless of symptoms.

Treatments For Liver Cancer at Shree Hospitals

We offer a complete range of liver cancer treatment services including advanced screening and diagnosis, personalised treatment plans, liver-sparing surgery, chemotherapy, targeted therapy, immunotherapy, radiation therapy, interventional procedures such as ablation and embolisation, rehabilitation, and long-term survivorship care designed to help patients achieve the best possible outcomes.

Liver Resection (Hepatectomy)

Surgical removal of the liver segment containing the liver tumour. Curative for early HCC in patients with adequate liver reserve. Laparoscopic approach available for peripheral lesions. Performed by experienced hepatobiliary surgeons with intra-operative ultrasound guidance.

Radiofrequency / Microwave Ablation

Minimally invasive destruction of small liver tumours using heat. Performed under imaging guidance no surgical incision required. Highly effective for tumours ≤3–5 cm in patients who are not surgical candidates. Part of all curative-intent liver cancer treatment in Mumbai India pathways.

TACE (Transarterial Chemoembolisation)

Selective delivery of chemotherapy directly to the tumour via its feeding artery, combined with embolisation to cut off blood supply. Standard treatment for intermediate-stage HCC repeated as needed based on imaging response.

Atezolizumab + Bevacizumab

The current international standard first-line systemic treatment for advanced HCC. Combines PD-L1 immune checkpoint inhibition with anti-VEGF therapy. Delivers meaningfully longer survival than sorafenib in eligible patients. Cornerstone of hepatobiliary oncology Mumbai systemic care.