When developing a plan for liver cancer treatments, your cancer team will take into consideration the type of cancer, the size and growth rate of the tumor(s), your age, and the overall state of your health.

Our aim is to treat the whole body, not just the cancer. We will recommend parallel treatments that could provide relief from cancer treatment side effects.

Liver cancer treatments can include a combination of surgery (including a liver transplant), needle ablation, embolization, radiation therapy, targeted medical therapy, immunotherapy, advanced interventional endoscopy, and clinical trials.

Liver Transplant

Most people with primary liver cancer who live in the US have underlying liver disease. Liver transplantation gives people the best chance for a cure.

We use minimally invasive surgical approaches whenever possible. This type of surgery usually results in faster recovery, less pain, and smaller scars.

We are New York’s largest living donor liver transplant program, which means our patients are 10 times more likely to receive a liver transplant than other programs.

For more information about liver transplants at Columbia, visit the Center for Liver Disease and Transplantation.

Liver Resection

If you don’t have significant underlying liver damage, our surgeons can often remove the tumor surgically without a transplant. This is called resection. We often use robotic assisted minimally invasive techniques. In this way, the surgery is caried out with instruments and camera inserted via small holes in the abdomen. We also specialize in advanced liver surgery techniques that enable surgeons to remove tumors which are unresectable in standard techniques. Of those most extreme technique called  “ex vivo” technology, pioneered by Columbia’s Tomoaki Kato, MD. This technology lets tumors that are unresectable by most other facilities to be removed, offering a chance for a cure.

Local Therapies

We offer local therapies, which target liver tumors without removing them surgically. Some of these techniques use ablation, or heat, to destroy the tumor. Others use targeted radiation therapy.

Radiofrequency and Microwave Ablation

Radiofrequency and microwave ablation use highly targeted energy waves to destroy the tumor while sparing surrounding tissue. These treatments can sometimes cure patients with very small tumors.


Chemo-embolization puts small medication beads into an artery that supplies the tumor. The beads block off the blood supply and deliver chemotherapy directly into the tumor.

Radio Embolization

Radio arterial embolization delivers tiny spheres of a radioactive substance to the tumor using the liver artery system. The substance kills cancer cells at the tumor site. We often use radioactive isotype yttrium 90 (Y90) in radioembolization, so it is also called Y90 therapy.

Stereotactic Body Radiation

Stereotactic body radiation is cutting-edge radiation therapy used to treat locally aggressive tumors. We have seen exciting results in treating hepatocellular carcinomas that have started to invade the portal vein.

Management of Bile Duct Obstruction

Management of bile duct obstruction uses an endoscope—a long flexible tube with a camera, a light, and room to insert surgical tools—to unblock bile ducts and insert a stent. The procedure is called ERCP. Blocked bile ducts are a potential complication of liver tumors, liver surgery, and bile duct cancer. The stent opens up the duct and allows bile to drain into the intestine to improve your quality of life and relieve symptoms associated with jaundice.


Chemotherapy and Immunotherapy

Chemotherapy uses medications (chemicals) to stop cancer growth and spread and to prevent cancer from recurring, by causing rapidly dividing cancer cells to become damaged and die.

Chemotherapy is “systemic” medicine—it interferes with all fast-dividing cells in your body. Immunotherapy is to use medication to activate your own immune system to fight against cancer. It does not cause typical chemotherapy side effects, but it has its own side effects such as to trigger sutoimmune disease.   

Both chemotherapy and immunotherapy are given through an IV in our infusion center, but it can sometimes be given through a pill. It’s given in cycles across a few weeks, with each treatment followed by a rest period.

People with primary liver cancer may be offered chemotherapy or immunotherapy. Chemotherapy is effective for cholangiocarcinoma and immunotherapy is effective for hepatocellular carcinoma (HCC). If you have bile duct cancer, chemotherapy is the primary treatment if the cancer cannot be removed surgically.

Columbia medical oncologists are at the forefront of developing new liver cancer treatments. We have led multiple international clinical trials investigating new and better therapies for liver cancer and we have a wide range of clinical trials available for our patients.

Targeted Therapies

Hepatocellar carcinoma (HCC) is vascular: They grow lots of blood vessels to supply nutrients. We use a pill-based targeted therapy called sorafenib or levantinib, which blocks the signaling pathways that cause blood vessels to grow. It’s the most effective targeted treatment option in use for HCC today. We participated in the clinical trial leading to the drug’s approval.

For certain types of genetic profiles of the bile duct cancer, targeted therapies are also available. The medications are available for IFH1 mutation and FGFR fusion mutation. You can talk to your doctor about the genetic profile of your bile duct cancer and availability of the medications.  

Clinical Trials

You may qualify to participate in a clinical trial, which is a research study to learn more about promising new treatments or supportive care therapies. The hope is to improve the quality of life and survivorship of liver and bile duct cancer patients. Columbia Cancer offers dozens of liver cancer clinical trials. You can talk to your care team about whether a clinical trial is an option for you.

Learn More About Clinical Trials

Radiation Therapy

Radiation therapy causes cancer cells to break or die by targeting the DNA with high-energy particles, such as X-rays, gamma rays, electron beams, or protons. Radiation oncology specialists direct these particles to the tumor site from outside of your body to precisely target cancer cells, often sparing nearby tissue. This is sometimes called external beam radiation therapy.

If radiation therapy is recommended to you, your radiation oncologist, who is part of your personal care team, will design a treatment plan just for you to get the best possible results. Your treatment may be daily, weekly, every other day, or a single treatment.

With advanced radiation therapy techniques, doctors can better target tumors while reducing the radiation to nearby healthy tissues. Here at Columbia Cancer, our radiation oncology experts have the ability to provide state-of-the-art treatments for liver cancer.