The quotation should follow multidisciplinary resectability review
Charité's metastasis program bases treatment on the primary cancer, while Heidelberg describes liver resection as an individualized decision based on the underlying disease and liver findings. A quote prepared before the primary pathology, systemic-treatment history, extrahepatic disease and liver anatomy are reviewed can price the wrong episode.
Liver resection can vary from limited surgery to complex staged treatment
The surgical cost depends on lesion number and location, future liver remnant, previous liver surgery and whether one operation or a staged strategy is planned. The estimate should name the planned extent of resection and assumed inpatient course rather than simply say 'metastasis surgery'.
- Liver-surgery consultation and multidisciplinary imaging review
- Planned liver resection or combined procedures
- Anesthesia and operating-room services
- Pathology of resected tissue
- Postoperative laboratory and imaging monitoring
- Ward, ICU or intermediate-care treatment when required
- Potential staged or repeat surgery when explicitly planned
Ablation is a separate interventional-radiology episode
Freiburg documents radiofrequency and microwave ablation for selected liver metastases. Ask whether the quote includes CT or ultrasound guidance, anesthesia or sedation, ablation equipment, overnight monitoring and follow-up imaging, and whether more than one lesion or session is expected.
SIRT/TARE requires planning, angiography and nuclear-medicine resources
Freiburg describes SIRT as a multidisciplinary inpatient procedure involving angiography, radioactive microspheres and post-treatment SPECT/CT. If SIRT/TARE is proposed, request a dedicated quotation that includes mapping/planning procedures, the treatment admission and required imaging rather than assuming it is included in a generic oncology estimate.
SBRT or CyberKnife has its own planning and fraction costs
Selected liver metastases can be assessed for stereotactic radiation. The estimate should specify simulation imaging, treatment planning, number of fractions, image guidance and specialist reviews. Radiation should be costed as a distinct local-treatment pathway rather than bundled with surgery or systemic therapy unless the hospital explicitly says so.
Systemic treatment costs follow the primary cancer
The systemic-treatment budget for colorectal liver metastases is different from metastatic breast cancer, melanoma or renal-cell carcinoma. Ask which regimen, number of cycles or treatment period is included and whether medication, laboratory monitoring, molecular testing, imaging and toxicity management are part of the estimate.
Restaging between treatment phases can add cost
Multimodal pathways can involve systemic therapy followed by repeat CT/MRI and another liver-team review before surgery or local treatment. The quotation should state whether restaging and repeat tumor-board assessment are included or billed separately.
Questions to ask before advance payment
Make sure the estimate reflects the primary tumor and the complete metastatic pattern, not only the presence of liver lesions.
- Which primary cancer and disease extent were assumed?
- Is the quote for surgery, ablation, SBRT, SIRT/TARE or systemic treatment?
- If surgery is planned, what extent of liver resection is assumed?
- Are multiple or staged procedures expected?
- Which CT, MRI or PET/restaging studies are included?
- Are pathology and relevant biomarker tests included?
- If systemic therapy is planned, how many cycles or months are covered?
- What inpatient stay is assumed?
- How are complications, ICU care or extra hospital days billed?
- How are unused advance payments or additional charges reconciled after treatment?
Official sources
Last source-reviewed 2026-08-30. Cost procedures and published service fees can change, so confirm current terms directly with the provider before transferring money or booking travel.
- European Metastasis Center – multidisciplinary metastatic-cancer care — Charité – Universitätsmedizin Berlin ↗
- Liver metastases – individualized liver resection — Heidelberg University Hospital ↗
- Liver metastases – surgery and multimodal care — University Medical Center Freiburg ↗
- SIRT for liver tumors and metastases — University Medical Center Freiburg ↗
- Finance – international self-pay estimates and final billing — Heidelberg University Hospital ↗