Tumors in the liver

Different types of abnormalities can develop in the liver. Such an abnormality is also called a growth or tumor. Benign and malignant abnormalities can be distinguished.

The most common benign liver abnormalities are:

  • Hemangiomas (blood vessel tumor in the liver).
  • Focal Nodular Hyperplasia (FNH).
  • Adenoma.
  • Cyst (fluid-filled cavity in the liver).

Benign abnormalities in the liver usually do not cause any symptoms and do not require treatment. If necessary, your treating doctor will discuss with you why a benign abnormality should be removed.

The most common malignant liver abnormalities are:

  • Hepatocellular carcinoma (HCC, this tumor originated primarily in the liver and originates from the liver cells).
  • Cholangio carcinoma (CCA, this tumor originated primarily in the liver and originates from the bile duct cells).
  • Liver metastases (metastases are metastases in the liver, originating from a malignant tumor elsewhere in the body, for example the large intestine, stomach, breast or ovary).

PUMP study: Treatment of liver tumors with chemotherapy via the chemo pump

Patients with liver tumors may be eligible for one of the studies in which local chemotherapy is given directly into the liver via the chemo pump. This treatment was developed at the Memorial Sloan Kettering Cancer Center in New York and was introduced to the Netherlands in 2018 by dr. Bas Groot Koerkamp.

The chemotherapy pump delivers chemotherapy directly into the liver through a tube. This tube and the chemo pump are placed with surgery. Chemotherapy is then given via the chemo pump for six months. The chemo pump can be filled through the skin so that treatment can be continued continuously and for a longer period of time. The advantage is that the chemotherapy is delivered to the liver in a high dose and is then also processed. There is hardly any chemotherapy in the rest of the body so there are no complaints such as nausea or sensory disturbances.

At the moment, the treatment is only available in a research context. Patients with operable colon cancer metastases in the liver are eligible for the PUMP I study. In this study, the chemo pump is placed during the operation, during which the metastases in the liver are also removed. Chemotherapy is then given for six months to treat remaining minuscule metastases in the liver. At the moment, there is no other treatment available after surgery in the Netherlands. This study compares whether surgery alone or surgery with additional treatment with chemo pump results in survival gain.

In a second study that has started in 2019, the chemo pump will be used in patients with inoperable bile duct cancer in the liver. In this study (the PUMP II study), the chemo pump is placed with surgery, the tumors are too large to remove with surgery. Chemotherapy is then given for six months to make the tumors smaller. Surgery may then be performed in a small number of patients to remove the tumors as a second step. In addition to the treatment with the chemo pump, the standard chemotherapy is also given via an IV. This study examines whether the additional treatment with chemo pump provides survival gain.

If you have any questions about the chemo pump or if you would like more information, please visit the website of the study, www.chemopomp.nl. You can also contact the study team via pump@erasmusmc.nl or 010-7042125.