Innovative treatment of the hepatocellular carcinoma

With rising prevalence of the hepatocellular carcinoma (HCC) in recent years it is meanwhile the fifth most common cancer entity and the second most frequent cause of cancer related death.

Diagnosis and therapy of HCC are complex and require specialists of various disciplines. In recognition of this growing importance of HCC and in order to optimize the treatment process, in 2012 the University Hospital Heidelberg launched the Liver Cancer Center Heidelberg (LCCH). Within the LCCH specialists of the abdominal and transplant surgery, gastroenterology and hepatology, pathology, radio oncology, nuclear medicine, diagnostic and interventional radiology, and medical oncology are working closely together.

Central interdisciplinary consultation hours

The interdisciplinary consultation hours for patients with supposed liver tumor, assured HCC or bile duct tumor findings as well as patients within the follow-up treatment take place at the National Center for Tumor Diseases (NCT, Im Neuenheimer Feld 460). These consultation hours are the central place to go for all patients with liver tumors. This is the starting point for coordination of the entire therapy and we form a team of constant medical contacts.

Broad therapeutic spectrum

Established and new therapy procedures for treatment of liver cancer are available at the site of the University Hospital Heidelberg: The liver surgery of the Surgical Hospital is one of the most experienced and largest of its kind in Europe, the liver transplantation center was the most capacious in Germany in 2013. The Department for interventional radiology offers various methods for local therapy of liver tumors (RFA, TACE, IRE). At the  HIT (Heidelberg Ion Radiation Therapy Center), liver tumors are treated with ultra-modern irradiation facilities; nuclear medical therapies (radioembolisation) are available. For patients in advanced stage of tumor where a local therapy is no longer possible the expertise of hepatologists and oncologists is available.

Interdisciplinary tumorboard

Twice a week (every Tuesday and Thursday) the LCCH-Team discusses liver tumor cases interdisciplinary within the hepatobiliary tumorboard. Internal guidelines (Standard Operating Procedures) are updated regularly and are the basis for the interdisciplinary discussion of patient cases. Several representatives of the LCCH participated in drafting the German S3-guideline for diagnosis and therapy of HCC published in 2013.

Innovative tumor characterization and integration of new therapies into the treatment

Essential strategy of the LCCH is the integration of innovative clinical trials into the treatment of HCC-patients. Thus, patients should timely benefit from newly developed therapy methods. The detailed molecular processing of HCC-tissues is offered by the Institute of Pathology. Thus, individual biomarkers are registered and the patients can be identified for and informed about clinical trials at an early stage.

For this immunohistochemical and molecular characterization of tumor tissue, Heidelberg offers a leading liver pathology center with more than 4000 cases handled per year.

Linking of patients’ treatment and fundamental knowledge

Besides the clinical care the LCCH follows the coordination of the expertise at one site. The LCCH is closely linked to the members of the former SFB/TRR 77 who, in close cooperation with Hannover Medical School, dealt with the molecular pathogenesis and the implementation of innovative targeted therapies for HCC. In recent years, the SFB released excellent scientific publications, among others in Science, Cell, and Nature and therefore enjoys an internationally excellent reputation.