Liver Metastases treatment | Best Hospitals, Doctors, Prices | Booking Health

Treatment of Liver Metastases

Treatment of Liver metastases | Information about European hospitals and doctors | Rankings | Clinics | Prices | Send request to the hospital and go for treatment of liver cancer stage 4

Best hospitals and doctors for liver metastases treatment abroad

Leading hospitals

Cost for treatment

Liver metastases diagnosis
Liver metastases treatment with alcohol or radiofrequency ablation of tumor nodes
Liver metastases treatment with surgical resection of tumor nodes
Treatment of liver metastases with percutaneous embolization (coiling) or chemoembolization
Cancer rehabilitation
According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
According to the authoritative Focus magazine, the University Hospital Duesseldorf ranks among the top Germany hospitals! The hospital is an excellent example of a combination of high-quality health care, research and teaching activities. With more than 50,000 inpatients and about 300,000 outpatients every year, the hospital is
University Hospital Ulm

University Hospital Ulm

Overall rating8.7 / 10
The University Hospital Ulm is an advanced medical complex that provides patients with high-class medical care using the very latest scientific achievements. The medical facility has been performing successful clinical activities for more than 40 years and has long earned an excellent reputation throughout Europe. The hospital r
University Hospital Bonn

University Hospital Bonn

Overall rating9.2 / 10
According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
According to the reputable Focus magazine, the University Hospital Carl Gustav Carus Dresden ranks among the top five German hospitals! The hospital is the benchmark for modern high-quality medicine. Positioning itself as a maximum care medical facility, the hospital represents all medical fields. There are 26 specialized depart
According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all fields of
University Hospital Jena

University Hospital Jena

Overall rating8.9 / 10
According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
The University Hospital Rechts der Isar Munich was founded in 1834. It combines long traditions with the very latest advances in modern medicine. The medical facility includes 33 specialized departments and 20 interdisciplinary centers, where patients can receive top-class medical care in all medical fields. The hospital annuall
According to the prestigious medical publication Focus, the University Hospital Tuebingen ranks among the top five German hospitals! The hospital was founded in 1805, therefore it is proud of its long history, unique experience, and outstanding achievements in the field of medical care, as well as research and teaching activitie
University Hospital Essen

University Hospital Essen

Overall rating9.6 / 10
According to the authoritative Focus magazine the University Hospital Essen ranks among the top German hospitals! With 27 specialized departments and 24 institutes, the hospital in Germany is a maximum care medical facility. The hospital has 1,300 beds for inpatient treatment. A highly qualified medical team of more than 6,000 e
The University Hospital Saarland Homburg is the largest hospital in the city of Homburg and the most important medical facility in the region. The hospital, which currently has 30 specialized departments and 20 institutes, was founded in 1947 and operates on the basis of Saarland University. The hospital plays a leading role in
According to the prestigious Focus magazine, the HELIOS University Hospital Wuppertal ranks among the top medical facilities in Germany! The hospital rightfully enjoys the status of the maximum care medical facility and provides its high-quality services in all modern fields of medicine. The hospital operates on the basis of the
The Memorial Sisli Hospital Istanbul is the largest and leading medical complex in Turkey, which meets the highest standards of medical care when providing the advanced diagnostics and treatment using the very latest methods. The hospital is part of the Memorial Health Group – it was the first project of this provider of m
The Primus Super Speciality Hospital New Delhi is a modern medical facility, which is distinguished by extremely high quality and standards of medical service. The hospital is located in the heart of New Delhi, in the capital of India. During its design and construction, the most advanced medical technologies from around the wor
The Memorial Bahçelievler Hospital Istanbul is an advanced multidisciplinary medical center that began its clinical practice in 2018. It is part of the world famous Memorial Healthcare Group. The hospital was designed in accordance with the very latest standards of modern architecture with the aim of providing top-class m
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Liver metastases, or secondary cancer of the liver, develop in spreading of the oncological process to the liver from other organs and body regions. Typically, liver metastases are indicative of stage IV cancer. Primary cancers of pancreas and stomach, kidneys, ovaries and uterus, colon and rectum, esophagus, lungs and breast are the most likely to spread to the liver. Considering the diversity of types of primary tumors, treatment of liver metastases is a challenging medical task. Nevertheless, clinicians in specialized hospitals use variety of modern therapeutic methods, so remission or even cure may be possible for some patients. Patients with stage IV liver cancer may benefit from targeted treatments and immunotherapy. Chemoembolization may be an additional option for patients with advanced cancer or first-line treatment for patients with small primary neoplasms or few liver metastases.


  1. Diagnostics of liver metastases
  2. Surgical resection
  3. Alcohol ablation
  4. Radiofrequency ablation
  5. Percutaneous embolization
  6. Radiation therapy
  7. Systemic treatments
  8. Leading hospitals and cost of treatment of liver metastases
  9. Treatment of liver metastases in the best hospitals with Booking Health

Diagnostics of liver metastases


Making the precise diagnosis of liver metastasis is the essential part of planning the therapeutic regimen. As a matter of fact, all organs need to be examined in order to detect the primary tumor and all possible secondary lesions. Laboratory tests that are aimed at assessing the general health state are also performed.

Diagnosis making starts from the anamnesis collection, i.e. discussing history of gastroenterological and oncological pathologies in the patient or his relatives. A doctor may also ask questions regarding working conditions, exposure to chemicals or radiation, etc. Anamnesis collection is followed by physical examination, laboratory tests and instrumental procedures.

Laboratory and instrumental diagnostics of liver cancer includes the following procedures:

  • Liver function tests
  • Ultrasound scan of the abdomen
  • MRI and / or CT scan of the abdomen
  • Angiogram (if necessary)
  • Laparoscopy with biopsy

Laparoscopy allows harvesting tissue sample for the subsequent histological and immunohistochemical laboratory examination, so that the tumor type, its sensitivity to medications and other important factors can be determined.

Depending on the diagnostic data, surgery, alcohol or radiofrequency ablation, as well as different types of embolization and systemic cancer treatment are used.

Surgical resection


Possibility of surgical treatment in patients with liver metastases depends on the following factors:

  1. Localization of the primary tumor. For instance, liver metastases in patients with bowel cancer are often treated by means of surgery.
  2. Control of the primary oncological process. Surgery for metastatic lesions is indicated in the remission of the primary tumor, not in case of its active progression.
  3. Number and size of liver metastases.
  4. Spread of the metastatic process beyond the liver, presence of the secondary neoplasms in other organs.

Surgery for liver cancer treatment is called liver resection. Liver resection includes removing the part of a liver. Sometimes doctors need to remove the whole organ, which is called total hepatectomy. After the liver resection, the remaining part of the organ regenerates over time and manages to maintain normal function.

In order to facilitate regeneration, doctors may temporarily block the branch of the portal vein a few weeks before the intervention. When the whole organ is removed and no healthy tissue for the regeneration is left, liver transplantation is required in order to avoid liver failure.

Alcohol ablation


Alcohol ablation of liver metastases is the image-guided interventional therapy. It is efficient in patients with liver lesions that are less than 3-5 cm in size, which includes both liver metastases and primary liver cancer. These are mainly patients with spread of colorectal cancer, breast cancer or endocrine tumors to the liver. Candidates for alcohol ablation therapy should meet the following requirements:

  1. The patient has less than three malignant loci in the liver
  2. Each locus has distinct margins and fibrous encapsulation
  3. Each locus should be located inside the liver, away from its surface

Alcohol ablation is performed under the ultrasound guidance. After performing anesthesia, a surgeon inserts a long thin needle inside the malignant locus. When the needle is in the correct position, a surgeon injects a concentrated alcohol solution through it. Concentrated alcohol causes necrosis of the malignant tissues. To destroy liver cancer completely, a patient may need few therapeutic sessions.

The procedure can also be performed in patients with concomitant liver cirrhosis. If benign liver cells have cirrhosis, they are less likely to suffer from the injection of concentrated alcohol.

This type of therapy should not be used in liver cancer patients who have chronic or acute liver failure, as they will not be able to tolerate it well.

Radiofrequency ablation


Radiofrequency ablation of liver metastases is aimed at direct destruction of the malignant loci without their surgical removal. Compared to surgery, this type of cancer therapy is less likely to cure the malignancy completely. Nevertheless, it improves survival and quality of life.

Actually, there are few types of non-chemical ablation of liver metastases. These are:

  1. Radiofrequency ablation. Radiofrequency ablation destroys the target area with high-energy radio waves.
  2. Microwave ablation. Microwave ablation includes targeted heating of the metastatic locus with the help of energy from electromagnetic waves.
  3. Cryoablation (cryotherapy). Cryoablation, on the contrary, destructs liver cancer with the help of low temperatures.

Regardless of the type of ablation, the procedure includes insertion of a thin needle or a needle-like probe directly into the tumor. To make the process more comfortable for the patient, anesthesia is used. High precision of the procedure is due to the visual guidance of ultrasound or CT scan.

When a needle or a needle-like probe is in the target region, radio waves, electromagnetic waves, or cold gasses are passed through it. Once the therapy is completed, the patient is transferred to the general ward and discharged from the hospital the same day.

Percutaneous embolization


The general term "embolization" means manipulating on the hepatic artery that feeds healthy liver tissue and liver cancer. Reducing blood supply and depriving liver metastases from oxygen and nutrients leads to their shrinkage or even total destruction. Combination medical therapies with additional administration of chemotherapeutic drugs or radioactive substances are also used:

  1. Trans-arterial chemoembolization (TACE).
  2. Drug-eluting bead chemoembolization (DEB-TACE).
  3. Radioembolization (selective internal radiation therapy, SIRT).

Trans-arterial embolization (TAE) starts from making a small incision in the groin and inserting a catheter into the femoral artery. Step by step, a catheter is guided towards the liver and reaches the artery that feeds a tumor. Once a catheter is inside the target blood vessel, a doctor injects an oily liquid or foam through it. Injected substances exclude the artery from the systemic circulation, which reduces viability of liver cancer and leads to its destruction.

In TACE and DEB-TACE, the procedure is complemented by the local introduction of a chemotherapeutic drug. High local drug concentration may be achieved without affection of healthy tissues. Due to the slow Nevertheless, in some patients with liver metastases from neuroendocrine tumors TAE is even preferred to TACE, as it has comparable anti-tumor effect alone with somewhat better tolerability.

Radiation therapy


Radiation therapy is not a common therapeutic option for liver malignancies, as healthy hepatocytes are extremely sensitive to the irradiation. Patients with hepatitis or cirrhosis are also not the best candidates for this procedure. So, risks and benefits of the radiation therapy performing are always assessed before the treatment start. In most patients, radiotherapy is a part of the combination liver cancer treatment scheme.

There are three main types of radiation therapy:

  1. External beam radiation therapy (EBRT) uses sources of radiation that are located outside a patient’s body. The procedure is somewhat similar to the X-ray examination, but it uses higher doses of irradiation. EBRT usually takes several weeks, as small irradiation doses are given to a patient daily.
  2. Stereotactic body radiation therapy (SBRT) allows reducing radiation damage to the healthy hepatocytes. In SBRT high-dose radiation beams are focused on the tumor precisely. Compared to the EBRT, a course of SBRT is shorter, as higher doses of radiation are given daily.
  3. Selective internal radiation therapy (SIRT), or radioembolization, is performed like a conventional embolization procedure. The difference is, SIRT includes additional introduction of microspheres with radioactive substance prior to the hepatic artery blockage. In SIRT, healthy liver cells are not affected.

Systemic treatments


Systemic treatments are given intravenously or orally, so that the drug enters the systemic circulation and reaches not only liver metastases, but also all organs. Depending on the drug type, systemic treatments are divided into:

  • Chemotherapy. The most efficient option is administering combinations of chemotherapeutic drugs. Unfortunately, the clinical response to chemotherapy usually does not last long in patients with liver metastases.
  • Hormone therapy. If the primary tumor is sensitive to hormones (e.g. in case of prostate cancer or breast cancer), hormone therapy is indicated in the secondary liver tumors as well.
  • Immunotherapy. This group of drugs influences proteins that are responsible for recognizing and attacking the tumor by a patient's own immune cells.
  • Targeted cancer drugs. These are monoclonal antibodies, PARP inhibitors, cancer growth blockers, angiogenesis blockers. Targeted cancer drugs interfere with specific tumor’s molecules or conditions that are essential for tumor growth and survival.

Leading hospitals and cost of treatment of liver metastases


Hospitals that admit patients for liver cancer treatment should have the most advanced equipment for the precise diagnosis making, access to the innovative medicines and treatment techniques, as well as highly trained healthcare professionals. The following hospitals are among TOP healthcare institutions that offer liver cancer treatment:

  1. University Hospital of Ludwig Maximilian University of Munich, Germany
  2. University Hospital Duesseldorf, Germany
  3. University Hospital Heidelberg, Germany
  4. Memorial Sisli Hospital Istanbul, Turkey
  5. University Hospital Ulm, Germany

Prices for liver cancer treatment depend on the chosen procedure. Prices for the surgery, radiation therapy, image-guided interventional procedures and systemic therapies are as follows:

  1. Diagnosis of liver metastases – from 1,686 EUR
  2. Treatment of liver metastases with alcohol or radiofrequency ablation – from 4,727 EUR
  3. Treatment of liver metastases with surgical resection – from 20,865 EUR
  4. Treatment of liver metastases with percutaneous embolization or chemoembolization – from 4,756 EUR

After the completion of the main treatment course, a patient may stay under the distant supervision of the foreign physician or repeatedly come to the foreign hospital for control examinations and recurrent liver cancer prevention.

Treatment of liver metastases in the best hospitals with Booking Health


Patients with liver metastases are free to undergo advanced treatment in any hospital in the world due to the work of international medical tourism provider Booking Health. Booking Health specialists consider all the peculiarities of treating people with liver metastases and offer help in:

  • Choosing the most relevant hospitals based on their specialization and success rates
  • Making appointment with the chosen doctor
  • Avoiding long waiting for the medical program start
  • Elaborating the preliminary medical program in advance, considering the available medical records
  • Providing favorable cost of treatment for liver metastases, without extra fees for foreign patients (saving up to 50%)
  • Help in buying and forwarding drugs and the required medical products
  • Communication with hospitals after cancer treatment completion
  • Cost of treatment control, return of unspent funds
  • Organization of additional procedures and rehabilitation (if necessary)
  • Offering non-medical service of the highest level: transfer, booking hotels and plane tickets, interpreting services

To start planning liver cancer treatment, please leave the request on the website of Booking Health. A medical advisor or patient case manager will contact you the same day and explain your further steps.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko