Innovative Liver Tumor Clinic Unites Specialists, Patients In One Site

Cleveland Clinic’s Liver Tumor Clinic is designed to provide leading-edge management and treatment of diverse and complex liver malignancies. Patients have access to a multidisciplinary team of specialists — hepatobiliary and transplant surgeons, hepatologists, oncologists, radiation oncologists, interventional radiologists and specialized nurse coordinators — in a one-stop clinic, eliminating multiple appointments with different physicians at various locations.

An innovative model

Federico Aucejo, MD, heads the Liver Tumor Clinic, and says the innovative multidisciplinary model allows the elaboration of treatment strategies tailored to each individual patient. The model — based on comprehensive disease evaluations, liver malignancy care paths and Tumor Board consensus — allows delivery of cost/effective individualized therapies. Patients are evaluated and treatment is coordinated in a short timeframe: less than 30 days.

“Physicians review medical records, image studies and laboratory values of all patients who are evaluated through the clinic in one central location. The presence of diverse specialists allows interdisciplinary discussions maximizing the patients’ options,” Dr. Aucejo says. “The concept of articulating value-based multidisciplinary clinics, care paths and tumor boards is evolving, innovative and adapts to the changing physiognomy of healthcare.”

The number of patients diagnosed with liver cancer continues to rise due to a variety of reasons including inefficient cancer screening and surveillance programs and emerging uncontrolled risk factors, Dr. Aucejo says.

Program Highlights:

The Liver Tumor Clinic treats all types of liver cancers including:

• Hepatocellular carcinoma
• Cholangiocarcinoma
• Liver metastasis from colorectal cancer
• Liver metastasis from neuroendocrine tumors
• Gallbladder cancer
• Others

Treatment options include diverse surgical interventions, and locoregional and medical oncological therapies only offered by the most highly specialized centers in the nation:

• Surgical treatments – Extensive liver resections, two-stage hepatectomy, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) procedure, ex-vivo hepatectomy, liver transplantation, minimally invasive liver surgery via laparoscopic and robotic technology
• Locoregional treatments – Microwave ablation, cryoablation, electroporation (NanoKnife) and radiofrequency ablation
• Transcatheter therapies – Radioembolization, chemoembolization
• Medical oncology treatments – Diverse systemic chemotherapies, molecular targeted therapies, and clinical trials

An immeasurable value

Such a multidisciplinary approach is invaluable to patients with liver cancers, says Cleveland Clinic oncologist Bassam Estfan, MD.

“Having such a resource at our disposal is an extremely valuable tool for optimal care for the increasingly complex and challenging cases we see,” Dr. Estfan says. “Shared clinic visits allow the team to discuss care as viewed from different vantage points. The cumulative multispecialty expertise allows piecing together different aspects of treatment and management to form a comprehensive care plan that is unique to every patient.”

Innovative discoveries

Innovation and treatment discoveries are pivotal within the mission of Cleveland Clinic’s Liver Tumor Clinic. Some of these endeavors include:

• 3-D printing of liver models and computer software to aid surgical treatments of complex liver malignancies
• Tissue, serum and breath bio-repository for translational research
• Liver malignancy mice Xenograft research platform to study liver tumors from individual patients fostering personalized medicine in the field of liver oncology

For questions, contact Dr. Aucejo at aucejof@ccf.org. Refer a patient by calling 855.REFER.123.