J Korean Surg Soc.  2011 Aug;81(2):134-140. 10.4174/jkss.2011.81.2.134.

Hepatoblastoma: 15-year experience and role of surgical treatment

• Moon SB
• Shin HB
• Seo JM
• Lee SK

• KMID: 2096668
• DOI: http://doi.org/10.4174/jkss.2011.81.2.134

Abstract

PURPOSE
Hepatoblastoma is the most common malignant liver tumor in children. The aim of this study was to review our results of hepatoblastoma treatment and to determine the role of surgical treatment in hepatoblastoma.
METHODS
This is a retrospective clinical study. The medical records of patients with hepatoblastoma, treated between October 1994 and October 2009, were reviewed. The patients were classified according to the pretreatment extent of disease (PRETEXT) grouping system. The main outcome variable was survival. Secondary outcome variables were complete, partial and no response to chemotherapy and surgery, when indicated.
RESULTS
Twenty-seven patients were treated during the observation period. Eighteen were males. Five were PRETEXT group I, 8 group II, 13 group III and 1 group IV. Complete excision was achieved in all patients except in one case that underwent liver transplantation (group IV). Median follow-up and survival rate were 2.3 years and 100%, 6.6 years and 75%, 5.8 years and 92%, 7.7 years and 100%, for groups I to IV, respectively. Twenty patients are currently considered to be in complete response status and three patients are receiving postoperative chemotherapy. Four patients died; the causes of death were cytomegalovirus hepatitis, bone marrow suppression during adjuvant chemotherapy, primarynonfunction after the transplantation for recurrent tumor and metachronous rectal cancer, respectively.
CONCLUSION
Favorable long-term outcome could be expected for hepatoblastoma with complete tumor excision and adjuvant chemotherapy.

Keyword

Hepatoblastoma; Surgery; Drug therapy; Transplantation

MeSH Terms

Bone Marrow
Cause of Death
Chemotherapy, Adjuvant
Child
Cytomegalovirus
Follow-Up Studies
Hepatitis
Hepatoblastoma
Humans
Liver
Liver Transplantation
Male
Medical Records
Rectal Neoplasms
Retrospective Studies
Survival Rate
Transplants

Figure

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  Fig. 1 (A) Tumor involved three adjacent sections (arrow) and complete resection with safe margins seems unlikely. (B) After 6 courses of neoadjuvant chemotherapy, extent of tumor decreased markedly (arrowhead) and was treated successfully with right hemihepatectomy.

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  Fig. 2 The event-free survival according to the PRETEXT classification.

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