Hepatoblastoma: Analysis of treatment outcome from a tertiary care center

Abstract

Aim:This study was designed to retrospectively review our experience with the multimodality management of hepatoblastomas (HB).Materials and Methods:Thirteen patients were treated for HB between 2000 and 2007. The clinical presentations, chemotherapy tolerance and response, surgical procedure undertaken, and complications were analysed.Results:Median age of the population was 12 months (3-60 months), with a male-to-female ratio of 3.3:1. Nine patients were treated with neoadjuvant chemotherapy incorporating cisplatin and adriamycin. Primary surgery was done in four patients. Extent of hepatic resection in the operated patients varied. Mixed type was the predominant histopathological diagnosis. Adjuvant chemotherapy was well tolerated with no morbidity or mortality. Five-year event-free survival (EFS) and overall survival (OS) of all the 13 patients is 76.9%. All the nine patients who could complete multimodality treatment are alive with no evidence of disease or complications with median follow-up of 63 months (46-122 months).Conclusions:Treatment of HB with multidisciplinary approach was well tolerated. OS and EFS of patients were comparable with published studies.

Multidisciplinary management of hepatoblastoma in children: Experience from a developing country

“…A complete surgical resection is the cornerstone of treatment; however, less than two‐fifths of patients have resectable disease at diagnosis due to local invasion, caval infiltration, or distant metastases . The prognosis for children with HB has improved over the last few decades; survival in the 1970s with surgical resection alone was about 10–20% . Extensive surgical resections of earlier days have given way to the current standard of care of neoadjuvant chemotherapy followed by surgery .…”

“…Extensive surgical resections of earlier days have given way to the current standard of care of neoadjuvant chemotherapy followed by surgery . After the routine use of preoperative PLADO (PLADO regimen), surgical resection was soon achieved in 87% of cases, whereas historically only 30% of the cases was operable upfront …”

“…24 The prognosis for children with HB has improved over the last few decades; survival in the 1970s with surgical resection alone was about 10-20%. 26 Extensive surgical resections of earlier days have given way to the current standard of care of neoadjuvant chemotherapy followed by surgery. 25 After the routine use of preoperative PLADO (PLADO regimen), surgical resection was soon achieved in 87% of cases, whereas historically only 30% of the cases was operable upfront.…”

“…25 After the routine use of preoperative PLADO (PLADO regimen), surgical resection was soon achieved in 87% of cases, whereas historically only 30% of the cases was operable upfront. 26 For surgically unresectable, nonmetastatic disease, liver transplantation has to be considered. 27 The presence of lung metastases at the time of diagnosis is not a bad prognostic sign per se, as approxi- respectively, for patients with metastasis.…”

Multidisciplinary Management of Pediatric Hepatoblastoma: A 20-Year Single-Center Experience

“… 6 With neoadjuvant chemotherapy, the tumor shrinks and becomes hard and fibrotic, resulting in 87% of patients being eligible for surgery. 7 , 8 …”