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

Shanmugam, Naresh; Scott, Julius Xavier; Kumar, Vimal; Vij, Mukul; Ramachandran, Priya; Narasimhan, Gomathy; Reddy, Mettu Srinivas; Venugopal, K.; Munirathnam, Deenadayalan; Kelgeri, Chayarani; Sundaram, Karthick; Rela, Mohamed

doi:10.1002/pbc.26249

Cited by 26 publications

(28 citation statements)

References 28 publications

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“…Arora et al [18] found that the age ranged of 157 patients was from 12 to 24 months. In this study, median age at diagnosis was 22.3 months, the number of patients age were lower than 2 years old was 62 (63.27%), which are similar to previous literature [1,19]. The lung is the most common site of metastasis, 20% of children with HB present with lung metastases at the time of diagnosis [20,21].…”

Section: Discussionsupporting

confidence: 87%

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Prognostic analysis for children with hepatoblastoma with lung metastasis: A single‐center analysis of 98 cases

Zhang

Wang

et al. 2020

Asia-Pac J Clncl Oncology

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Background To analyze the factors affecting prognosis of hepatoblastoma (HB) with lung metastasis in children. Patients and Methods: 98 HB patients with lung metastases admitted to Beijing Tongren Hospital, Capital Medical University were collected and analysed. Results 64 patients had lung metastases at diagnosis (median age, 22.3 months). 34 patients developed lung metastases whilst on treatment (median time, 6.5 months). The time of diagnosis of lung metastasis in patients with HB did not signi cantly affect survival time or 3-year survival rate (P = 0.37). The survival time and 5-year survival rate of patients with standard treatment was signi cantly longer than that of without standard treatment (P < 0.001). The survival time and 3-year survival rate of patients with lung metastasis alone or underwent lung metastasectomy was signi cantly longer than that of patients with extrapulmonary involvement or without lung metastasectomy (P = 0.007, P = 0.099). Lung metastasis accompanied with extrapulmonary involvement was risk factors affecting prognosis (HR = 0.460, 95% CI 0.239-0.888). Conclusions The overall prognosis of HB with lung metastasis in children was poor, and the prognosis of patients with lung metastasis alone was better than those with extrapulmonary involvement. Standardized treatment and resection of lung tumor may prolong the survival of HB patients with lung metastasis.

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Section: Discussionsupporting

confidence: 87%

“…Hepatoblastoma (HB) is a rare malignant tumor and justly accounts for about 1% of all pediatric tumors, although it is the most common pediatric liver tumor among children [1]. It usually occur in the rst 2 years of life [2].…”

Section: Introductionmentioning

confidence: 99%

Prognostic analysis for children with hepatoblastoma with lung metastasis: A single‐center analysis of 98 cases

Zhang

Wang

et al. 2020

Asia-Pac J Clncl Oncology

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“…Another explanation could be the chemosensitive nature of the disease. Chemotherapy not only shrinks the size of tumors to achieve downstaging and abolish small pulmonary metastases, but also potentially controls tumor residuals . In our study, 80% (4/5) of pulmonary metastases resolved after NACT, 17.4% (4/23) achieved POST‐TEXT downstaging, and 22.2% (2/9) patients achieved MVI resolution.…”

Section: Discussionmentioning

confidence: 48%

Results of surgical resections with positive margins for children with hepatoblastoma: Case series from a single Asian center

Ren

Diao

et al. 2018

Pediatric Blood & Cancer

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The influence of margin status on the survival of patients with hepatoblastoma (HB) remains controversial. Here, we report long-term follow-up outcomes of 26 patients with HB who underwent hepatectomy with positive microscopic margins. Although these patients had microscopic residuals, the 5-year overall survival and event-free survival rates of those who had no metastases or macrovascular involvement (MVI) were 86.7% and 80.8%, respectively. This may support the hypothesis that patients with HB who undergo hepatectomy with positive microscopic residuals but without MVI or metastases can also achieve satisfactory survival rate. Further studies in this field are required. K E Y W O R D Shepatoblastoma, positive margins, prognosis, survival

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“…A review of previously reported cases, including the current study, showed that only seven (14.6%) of 48 reported patients with HB with post-LT relapse were alive and free from disease. 3,5,6,9,[23][24][25][26][27][28][29] There appears to be heterogeneity among the clinical characteristics of the reported post-LT relapse cases; some were rescued by resection of metastases alone, 6 whereas a considerable portion of patients progressed despite aggressive multimodal treatment. Thus, identification of novel prognostic factors is required prior to the establishment of standard therapeutic approaches.…”

Section: Discussionmentioning

confidence: 99%

Prognostic and therapeutic factors influencing the clinical outcome of hepatoblastoma after liver transplantation: A single‐institute experience

Umeda

Okajima

Kawaguchi

et al. 2018

Pediatric Transplantation

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LT has contributed to an elevation in cure rates for patients with unresectable HB; however, patients with recurrent HB after LT have poor prognosis. To analyze the prognostic and therapeutic factors that influence the clinical outcome of patients with HB receiving LT, we retrospectively analyzed 24 patients with HB who underwent LT between 1997 and 2015. The 5-year OS rate of all patients was 69.6±9.7%. The 5-year OS rate of 11 patients receiving salvage LT for recurrent tumor after a primary resection was comparable to that of 13 patients receiving primary LT. Among 12 evaluable patients receiving primary LT, six of 10 patients with a decline of serum AFP >95% at LT are currently alive and in remission, whereas two patients with a decline of AFP ≤95% experienced post-LT relapse. Among 9 evaluable patients receiving salvage LT, all three patients with any decline of AFP at LT are currently alive in remission, and three of six patients with no response to pre-LT salvage chemotherapy are also alive and in remission. Response to chemotherapy may be a reliable marker for prediction of post-LT relapse, even for patients receiving salvage LT.

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

Abstract: Improved outcomes can be achieved in children with HB even in countries with limited resources when they are managed by MDTs with expertise in pediatric oncology, liver resection, and liver transplantation.

Cited by 26 publications

References 28 publications

Prognostic analysis for children with hepatoblastoma with lung metastasis: A single‐center analysis of 98 cases

Prognostic analysis for children with hepatoblastoma with lung metastasis: A single‐center analysis of 98 cases

Results of surgical resections with positive margins for children with hepatoblastoma: Case series from a single Asian center

Prognostic and therapeutic factors influencing the clinical outcome of hepatoblastoma after liver transplantation: A single‐institute experience

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