News and Features Expediting care for children with complex liver tumors

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 outcome.

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.

Clinical Trials

Learn more about our active clinical trial investigating combination chemotherapy in treating newly diagnosed liver cancer. 

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