Surgical management of locally-advanced and metastatic hepatoblastoma

Lake, Charissa; Tiao, Gregory M.; Bondoc, Alexander

doi:10.1016/j.sempedsurg.2019.150856

Cited by 44 publications

(46 citation statements)

References 54 publications

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“…If it is not clear, it is prone to tumor recurrence and distant dissemination. The results of this study showed that the prognoses of HB with distant metastases and multiple liver lesions were relatively poor, which were consistent with literature reports [21] .…”

Section: Discussionsupporting

confidence: 92%

Clinical characteristics and prognosis of 132 cases of infantile hepatoblastoma — A 14-year retrospective study from a single center

Zhi¹,

Zhang²,

Zhang³

et al. 2020

Preprint

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Background The study aimed to summarize the clinical data of hepatoblastoma (HB) in infants under 1 year of age, analyze their treatment effects and factors that affect the prognosis. Methods Clinical data of 132 pathologically confirmed children under the age of 1 year old with hepatoblastoma who were admitted to the pediatric single center of Beijing Tongren Hospital,Capital Medical University from May 2005 to May 2019 were collected. The clinical efficacy and prognosis of combined treatment were summarized through retrospective analysis. Results 1. Of the 132 children enrolled, 74 were male and 58 were female; median age was 8.40 months; the onset of disease was the most common (75.0%) of abdominal distension; infant HB had high AFP at the initial diagnosis, with an average level of (127406.5 ± 7232.5) ng/ml, the platelet value was (405 ± 166) × 109/L; the pathological type was mainly epithelial (57.6%), and most of the epithelial types were fetal (67.1%); the PRETEXT stage was mainly stage III (54.5%), followed by stage II (34.1%); 45 cases had distant metastases, most of which were lung metastases (86.7%); 24 patients (18.2%) had portal vein or hepatic vein or vena cava invasion, 5 (3.8%) had tumor rupture, and 26 (19.7%) had multiple intrahepatic lesions. 2. The patients were followed up to May 2020, with a median follow-up time of 58 months. Among them, 84 cases had complete remission and 18 cases had partial remission. According to Kaplan-Meier survival analysis, the 5-year overall survival rates (OS) were 80.1%; the event-free survival rates (EFS) were 77.5%. Log-rank test showed that HB patients with AFP> 1210ng/ml at first diagnosis had a good prognosis; the EFS of the patients at PRETEXT IV stage was only 28.6%;children with distant tumor metastasis and multiple primary tumor lesions had poor prognosis, which were risk factors affecting the prognosis of infant HB (P < 0.05). Conclusions Infant HB has its own characteristics. Through comprehensive treatment, the prognosis is relatively good, but it is still susceptible to multiple factors such as AFP level, PRETEXT stage, the presence of distant metastasis and multiple intrahepatic lesions.

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Section: Discussionsupporting

confidence: 92%

Clinical characteristics and prognosis of 132 cases of infantile hepatoblastoma — A 14-year retrospective study from a single center

Zhi¹,

Zhang²,

Zhang³

et al. 2020

Preprint

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“…Hepatoblastoma is the most common liver malignancy in children with an incidence of approximately 1.2-1.5 cases per million [8 , 9] . It accounts for 1% of the pediatric malignancies [9] and it is usually diagnosed before the age of 3 years [8] . These type of liver tumors arise from pluripotent stem cells derived from hepatoblast which can differentiate mainly into epithelial and mesenchymal elements [10] .…”

Section: Discussionmentioning

confidence: 99%

“…According to the component of the tumors, different subtypes are defined, each of them with different management and prognosis [10] . The overall survival is 70%-80%, with 30%-60% of patients having unresectable tumors at presentation and 10%-20% metastatic disease, being the lungs the most common site [8] . The best outcomes are associated with full surgical resection with negative margins, however, in extensive disease (with vascular invasion) the treatment remains controversial and patient specific [8] .…”

Section: Discussionmentioning

confidence: 99%

“…The overall survival is 70%-80%, with 30%-60% of patients having unresectable tumors at presentation and 10%-20% metastatic disease, being the lungs the most common site [8] . The best outcomes are associated with full surgical resection with negative margins, however, in extensive disease (with vascular invasion) the treatment remains controversial and patient specific [8] . Liver transplant is an alternative, however, the decision to proceed depends on the different institution's criteria of resectability, biologic aggressiveness of the tumor, metastatic disease, and response to chemotherapy [8 , 10] .…”

Section: Discussionmentioning

confidence: 99%

“…The best outcomes are associated with full surgical resection with negative margins, however, in extensive disease (with vascular invasion) the treatment remains controversial and patient specific [8] . Liver transplant is an alternative, however, the decision to proceed depends on the different institution's criteria of resectability, biologic aggressiveness of the tumor, metastatic disease, and response to chemotherapy [8 , 10] . In this case, the tumor was initially managed with chemotherapy, followed by resection.…”

Section: Discussionmentioning

confidence: 99%

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Use of drug-coated balloons in the management of a recalcitrant postsurgical hepatic vein stenosis in a pediatric patient

Parra

Brandão

2020

Radiology Case Reports

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Drug-coated balloons (DCB) are a treatment alternative to conventional angioplasty in arterial, hemodialysis fistulas, and venous stenoses. This case report describes a child with the diagnosis of hepatoblastoma treated with chemotherapy and a right extended hepatectomy with venous reconstruction. The patient presented with signs and symptoms of portal hypertension due to a hepatic venous outflow obstruction secondary to stenosis of the surgical anastomosis. The response to conventional angioplasty was limited with frequent recurrence of symptoms. DCBs were used as an alternative prior to stent consideration aiming to assess if these devices could provide improvement of the symptoms and as a long-term therapy. The use of DCBs increased the time interval of reinterventions in comparison with conventional angioplasty. The patient eventually required stents due to recurrence of the primary disease. While this report does not provide an in-depth evaluation in terms of the efficacy and safety of DCB, this case illustrates a potential novel treatment modality to be considered for children, when stenotic venous lesions not amenable for stenting are present.

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IL‐34 in hepatoblastoma cells potentially promote tumor progression via autocrine and paracrine mechanisms

et al. 2022

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Hepatoblastoma is the most common pediatric liver tumor, but little research has been done on the role of macrophages in hepatoblastoma. The purpose of this study was to gain insight into potential roles for macrophages in hepatoblastoma. Paraffin-embedded specimens from 56 patients who underwent surgical resection were examined with immunohistochemical staining for the macrophage-specific markers, Iba1 and CD163. Significant differences were seen among histological subtypes. Significantly increased numbers of macrophages were detected in embryonal components compared to fetal components in the mixed epithelial type. In vitro studies using human monocyte-derived macrophages and two hepatoblastoma cell lines (HepG2 and Huh6) were performed.Conditioned medium from these cell lines induced increased CD163 expression in macrophages. Direct co-culture with macrophages induced tumor cell proliferation via induction of protumor cytokine secretion from macrophages. Direct co-culture with macrophages also induced interleukin (IL)-34 overexpression by Huh6 cells via Brd4 signaling. IL-34 overexpression promoted tumor cell proliferation and chemoresistance. High IL-34 and Brd4 expression was detected in embryonal components, which have potentially higher proliferation activity than fetal components. In conclusion, IL-34 expression in embryonal components may induce macrophage chemotaxis in a paracrine manner, and tumor cell proliferation and chemoresistance in an autocrine manner. IL-34 is a potential therapeutic target for hepatoblastoma.

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Surgical management of locally-advanced and metastatic hepatoblastoma

Cited by 44 publications

References 54 publications

Clinical characteristics and prognosis of 132 cases of infantile hepatoblastoma — A 14-year retrospective study from a single center

Clinical characteristics and prognosis of 132 cases of infantile hepatoblastoma — A 14-year retrospective study from a single center

Use of drug-coated balloons in the management of a recalcitrant postsurgical hepatic vein stenosis in a pediatric patient

IL‐34 in hepatoblastoma cells potentially promote tumor progression via autocrine and paracrine mechanisms

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