Clinical heterogeneity of pediatric hepatocellular carcinoma

D’Souza, Amber M.; Towbin, Alexander J.; Gupta, Anita; Alonso, M. Henar; Nathan, Jaimie D.; Bondoc, Alex; Tiao, Greg; Geller, James I.

doi:10.1002/pbc.28307

Cited by 16 publications

(14 citation statements)

References 38 publications

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“…After screening titles and abstracts, 563 articles were retrieved for full-text evaluation. Ultimately, 67 non-overlapping studies [ 11 , 12 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ,…”

Section: Resultsmentioning

confidence: 99%

Liver Transplantation for Pediatric Hepatocellular Carcinoma: A Systematic Review

Kakos¹,

Ziogas

Demiri

et al. 2022

Cancers

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Liver transplantation (LT) is the only potentially curative option for children with unresectable hepatocellular carcinoma (HCC). We performed a systematic review of the MEDLINE, Scopus, Cochrane Library, and Web of Science databases (end-of-search date: 31 July 2020). Our outcomes were overall survival (OS) and disease-free survival (DFS). We evaluated the effect of clinically relevant variables on outcomes using the Kaplan–Meier method and log-rank test. Sixty-seven studies reporting on 245 children undergoing LT for HCC were included. DFS data were available for 150 patients and the 1-, 3-, and 5-year DFS rates were 92.3%, 89.1%, and 84.5%, respectively. Sixty of the two hundred and thirty-eight patients (25.2%) died over a mean follow up of 46.8 ± 47.4 months. OS data were available for 222 patients and the 1-, 3-, and 5-year OS rates were 87.9%, 78.8%, and 74.3%, respectively. Although no difference was observed between children transplanted within vs. beyond Milan criteria (p = 0.15), superior OS was observed in children transplanted within vs. beyond UCSF criteria (p = 0.02). LT can yield favorable outcomes for pediatric HCC beyond Milan but not beyond UCSF criteria. Further research is required to determine appropriate LT selection criteria for pediatric HCC.

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Section: Resultsmentioning

confidence: 99%

Liver Transplantation for Pediatric Hepatocellular Carcinoma: A Systematic Review

Kakos¹,

Ziogas

Demiri

et al. 2022

Cancers

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“…Data from the PHITT that administers neoadjuvant chemotherapy to patients with unresectable HCC at diagnosis will eventually answer this question [89] . Survival rates were higher for patients responding to preoperative chemotherapy [81] .…”

Section: Contraindicationsmentioning

confidence: 93%

“…The first study inquiring the role of LT as primary surgical treatment for HCC without extrahepatic involvement was from Czauderna et al [81] in the early 2000s. They highlighted that the results of the conventional resective approach in cases with resectable tumors were far less favorable than those who benefited from LT for unresectable masses.…”

Section: Indicationsmentioning

confidence: 99%

“…This opened a window of opportunity for proposing LT as a curative strategy for children with unresectable HCC. Although there is still no consensus about the criteria for proposing LT to manage HCC in children, the results of Czauderna et al [81] emphasize that HCC in children is different from that in adults. Hence, an opposite strategy to that of HCC in adults could be followed: while HCC are selected for LT in adults with smaller tumors, in term of mass and/or number (the Milan criteria) [82] , there are no well-defined pediatric criteria to contraindicate the HCC candidate for LT [82] as follows:…”

Section: Indicationsmentioning

confidence: 99%

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A practical approach to pediatric liver transplantation in hepatoblastoma and hepatocellular carcinoma

Calinescu¹,

Hery²,

Goyet³

et al. 2021

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Progressively, as chemotherapy has become more effective, more children with liver malignancies are amenable to liver transplantation, and indications have expanded from a limited range of cases (mostly hepatoblastoma) to a range of other unresectable malignant liver tumors; as a result, more children with hepatocellular carcinoma are also now proposed to transplantation, even and often outside the Milan criteria, for a cure. Recent series have highlighted that patient and graft survivals after transplantation for hepatoblastoma and hepatocellular carcinoma have improved in the last decade. Although consensus has not yet been reached about transplantation as a possible cure for other tumor types than hepatoblastoma and hepatocellular carcinoma, liver transplantation, generally speaking, has become an important pillar in the management of pediatric liver malignancies. Remaining limitations and inquiries relate to patient selection (in term of selection criteria considering the risk of recurrence), the role and usefulness of chemotherapy after transplantation, or the best immunosuppression strategy to both protect renal function and improve outcome. Although some prospective studies are on the way regarding these aspects, more studies are needed to explore this rapidly changing aspect of care.

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“…There does not appear to be a racial disparity between African American and Caucasian children with roughly equal incidence reported [123]. The five-year overall survival rate is poor, estimated to be between 13% and 28% [125]. HCC develops in one of two distinct clinical settings: de novo tumors with no evidence of preceding liver damage versus those that develop on a background of underlying liver disease or cirrhosis from metabolic, infectious, and/or vascular causes.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Pediatric Primary Hepatic Tumors: Diagnostic Considerations

2021

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The liver is the third most common site of abdominal tumors in children. This review article aims to summarize current evidence surrounding identification and diagnosis of primary hepatic tumors in the pediatric population based upon clinical presentation, epidemiology, and risk factors as well as classical imaging, histopathological, and molecular diagnostic findings. Readers will be able to recognize the features and distinguish between benign and malignant hepatic tumors within different age groups.

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Clinical heterogeneity of pediatric hepatocellular carcinoma

Cited by 16 publications

References 38 publications

Liver Transplantation for Pediatric Hepatocellular Carcinoma: A Systematic Review

Liver Transplantation for Pediatric Hepatocellular Carcinoma: A Systematic Review

A practical approach to pediatric liver transplantation in hepatoblastoma and hepatocellular carcinoma

Pediatric Primary Hepatic Tumors: Diagnostic Considerations

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