•Malignant mesenchymoma of the liver

•Mesenchymal hematoma of the liver

•Liver metastases of other tumors

17.8 Staging

• Stages I–IV similar to other solid tumors

• The PRETEXT (PRETreatmentEXTent of disease) staging was developed for primary liver tumor (see special literature), which predicts the possibility of liver resection and is of prognostic value

17.9 Therapy

17.9.1 Surgical Management

• Initially more than 50% of liver tumors are not totally resectable

• Presurgical chemotherapy often leads to making large tumors resectable, particularly for hepatoblastoma

• Complete resection is required for cure, lobectomy often necessary

17.9.2 Liver Transplantation

• In patients with incomplete surgical resection of tumor or with unsatisfactory response to chemotherapy (see below), liver transplantation may be indicated

• Five-year survival rate is more than 60% by partial liver-lobe donation or liver donation postmortem

17.9.3 Radiotherapy

• Only rarely useful or curative

17.9.4 Chemotherapy

•Initial tumor reduction before surgery

•Active drugs: Cisplatin, vincristine, actinomycin D, doxorubicin, 5-fluorouracil, etoposide