Children with liver tumors have complex needs requiring highly
integrated care. Through a unique program, Children's Mercy
Hospital brings together the medical and surgical expertise within
the Division of Hematology and Oncology with that of the Liver Care
Center to offer patients the combined services of a
pediatric-centered, subspecialty team that includes their
oncologist, hepatologist and a transplant surgeon, as well as the
ancillary services offered by social work and nutrition.
"Our collaborative effort from the beginning allows us to plan a
multidisciplinary treatment approach that will maximize the cure
and minimize the side effects," said Michelle Manalang, MD,
Pediatric Hematologist/Oncologist, Clinical Director, in describing
the hospital's Liver Tumor Program as a way to improve care for
children with hepatoblastoma.
Hepatoblastoma is the most common malignant liver tumor in
children in the United States. Nearly 70 percent are considered
late stage (III or IV) when diagnosed. Although there are a number
of methods for approaching treatment, complete surgical resection
of the tumor is the most important component to a successful
Among the benefits of this uniquely organized model of care is
that patients are followed closely by each area from the moment
they enter the Children's Mercy system.
"I think this has sped up the care for families, because the
team has dynamically discussed a plan, based on a thorough case
review, prior to meeting with the family," Dr. Manalang says. The
result is that the family is able to move forward more quickly with
treatment. And, with a coordinated plan, the doctors can jointly
order follow-up diagnostic tests that will fulfill each of their
needs and result in less cost, less radiation, and less
back-and-forth travel time for the family, Dr. Manalang says.
Once patients complete treatment, the team continues to follow
their progress through a quarterly liver tumor clinic. In this
single appointment setting, the families can discuss all facets of
their child's care with each of the sub-specialists involved. The
approach continues the effort to provide a more positive experience
for the families, and a quicker means by which to act, if
necessary, based on the collective decision of their care team.
Through its affiliation with the Children's Oncology Group,
Children's Mercy is involved in current research investigating
different chemotherapy regimens to determine which may be more
effective in young patients with liver cancer; whether early
referral to a liver transplant surgeon increases survival rates;
and whether more intense chemotherapy will improve the treatment of
advanced hepatoblastoma. Results will help clinicians better
understand hepatoblastoma so they may improve cure rates while
reducing the potential life-long side effects of treatment.
Learn more about our active clinical trial investigating combination chemotherapy in treating newly diagnosed liver cancer.