A minimally invasive first stage of ALPPS for hepatoblastoma in a child

Ахаладзе, Д. Г.; Ускова, Н. Г.; Rabaev, G.S.; Kachanov, D. Yu.; Grachev, N.S.

doi:10.14701/ahbps.2020.24.3.352

Cited by 10 publications

(10 citation statements)

References 19 publications

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“…During the second stage, hepatectomy is performed after achieving adequate FLR (at least 50% of the total liver volume). 27 25 reported the first case of pure laparoscopic first-stage ALPPS in a child and showed the feasibility of a laparoscopic approach. In summary, ALPPS provides a better opportunity for CR in patients with primarily unresectable liver tumors, but may also be related to complications such as multifocal recurrence, 30 pleural effusion and pneumonia.…”

Section: Clinical Treatment Stagingmentioning

confidence: 99%

“… 24 The greatest advantage of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is the rapid increase in the FLR volume compared with portal vein ligation or embolization. 25 26 ALPPS is a two-stage hepatectomy procedure, including portal vein ligation and staged liver resection. 10 27 During the first stage, the liver is completely divided from the FLR with concomitant portal vein ligation of the lobe that will be removed, and the biliary tract system and the blood vessels are well preserved.…”

Section: Clinical Treatmentmentioning

confidence: 99%

“…Chan et al 29 in 2014, Wiederkehr et al 27 in 2015 and Hong et al 24 in 2017 successively performed ALPPS or monosegmental ALPPS in pediatric patients with HB with PRETEXT stage III/IV, and most of them showed a rapid increase in FLR and a decrease in AFP serum levels. In August 2020, Akhaladze et al 25 reported the first case of pure laparoscopic first-stage ALPPS in a child and showed the feasibility of a laparoscopic approach. In summary, ALPPS provides a better opportunity for CR in patients with primarily unresectable liver tumors, but may also be related to complications such as multifocal recurrence, 30 pleural effusion and pneumonia.…”

Section: Clinical Treatmentmentioning

confidence: 99%

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Advances in the conventional clinical treatment for hepatoblastoma and therapeutic innovation

Chen

Dong

2021

World Jnl Ped Surgery

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BackgroundHepatoblastoma (HB) is a rare malignancy usually occurring in children under 3 years old. With advancements in surgical techniques and molecular biology, new treatments have been developed.Data resourcesThe recent literatures on new treatments, molecular mechanisms and clinical trials for HB were searched and reviewed.ResultsSurgical resection remains the main option for treatment of HB. Although complete resection is recommended, a resection with microscopical positive margins (R1) may have similar 5-year overall survival and 5-year event-free survival (EFS) rates after cisplatin chemotherapy and the control of metastasis, as only once described so far. Indocyanine green-guided surgery can help achieve precise resection. Additionally, associating liver partition and portal vein ligation for staged hepatectomy can rapidly increase future liver remnant volume compared with portal vein ligation or embolization. Cisplatin-containing chemotherapies slightly differ among the guidelines from the International Childhood Liver Tumors Strategy Group (SIOPEL), Children’s Oncology Group (COG) and Chinese Anti-Cancer Association Pediatric Committee (CCCG), and the 3-year EFS rate of patients in SIOPEL and CCCG studies was recently shown to be higher than that in COG studies. Liver transplantation is an option for patients with unresectable HB, and successful cases of autologous liver transplantation have been reported. In addition, effective inhibitors of important targets, such as the mTOR (mammalian target of rapamycin) inhibitor rapamycin, β-catenin inhibitor celecoxib and EpCAM (epithelial cell adhesion molecule) inhibitor catumaxomab, have been demonstrated to reduce the activity of HB cells and to control metastasis in experimental research and clinical trials.ConclusionThese advances in surgical and medical treatment provide better outcomes for children with HB, and identifying novel targets may lead to the development of future targeted therapies and immunotherapies.

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Section: Clinical Treatment Stagingmentioning

confidence: 99%

Section: Clinical Treatmentmentioning

confidence: 99%

Section: Clinical Treatmentmentioning

confidence: 99%

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Advances in the conventional clinical treatment for hepatoblastoma and therapeutic innovation

Chen

Dong

2021

World Jnl Ped Surgery

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“…На сегодняшний день существует 7 англоязычных источников и 2 публикации, изданные в отечественных журналах, которые посвящены выполнению ALPPS у детей, суммарно насчитывающие 13 случаев выполнения данной операции [13-15, 19, 20, 37, 39-41], в том числе с проведением первого этапа из лапароскопического доступа [39]. Объем будущего остатка печени в приведенных публикациях ранжировался от 14,7 до 39,3% с медианой 22,2%, а срок выполнения второго этапа операции -от 6 до 16 сут (медиана 9 дней).…”

Section: обсуждение результатов исследованияunclassified

Extensive liver resection in a child with an extremely low future liver remnant volume

Ахаладзе

Rabaev

Меркулов

et al. 2021

Voprosy gematologii/onkologii i immunopatologii v pediatrii

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The incidence of posthepatectomy liver failure in adult patients and a large number of complications of two-stage liver resections require a search for criteria that allow highly accurate assessment of the risk of liver failure. For this purpose, the study of the future liver remnant volume and function have been widely introduced among adult patients, and the future liver remnant function measurement reflects the greater sensitivity. The absence of references to posthepatectomy liver failure, as well as the experience of determining the functional reserve of the future liver remnant in children, let us to suggest the possibility of a wider using one-stage liver resections when the future liver remnant volume is below the generally accepted threshold (25% of the healthy liver parenchyma volume) in the case of the functional reserve sufficient value. This clinical case describes the successful extended right hemihepatectomy and segmentectomy 1 in a 3-year patient with a future liver remnant volume of 16.5% without clinical signs of postresection hepatic failure, which confirms the thesis of the need to assess the functional liver reserve in pediatric oncology to reduce the frequency of two-stage resections and liver transplants. The patient’s parents gave consent to the use of their child’s data, including photographs, for research purposes and in publications.

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“…We read with great interest the article “A minimally invasive first stage of ALPPS for hepatoblastoma in a child” by Akhaladze et al, 1 reporting on a pediatric case where the authors successfully performed a laparoscopic ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) procedure to avoid post-hepatectomy liver failure after extended right hepatectomy for hepatoblastoma. Before ALPPS the future remnant liver (FRL) volume was 110.6 cm 3 in a child of 11.5 kg (1.0 % of body weight).…”

mentioning

confidence: 99%