Clinical Study of Hepatoblastoma in Children

Park, Jin Wan; Park, Jae Berm; Han, Sang Ah; Woo, Jong Gook; Seo, Jeong Meen; Lee, Suk Koo

Abstract

PURPOSE: By the help of neoadjuvant chemotherapy, resectability and survival rate of hepatoblastoma have improved. To evaluate recent treatment outcome of hepat-oblastoma, pediatric hepatoblastoma in our institute were reviewed.
METHODS
The medical records of 11 pediatric hepatoblastoma patients were analysed retrospectively.
RESULTS
All but one patient old were under 3 years old at diagnosis (range: 1~150 months). The male to female ratio was 6 : 5. Two patients were treated without neoadjuvant chemotherapy. One of them received right lobectomy for initially resectable tumor. Another one patient received a liver transplant for multiple unresectable tumors and liver cirrhosis. Nine patients received neoadjuvant chemotherapy based on the CCG-823F or CCG-8881A protocol. Two of them showed lung metastasis, but the metastatic nodules were reduced in size and number in one patient, disappeared in another patient after neoadjuvant chemotherapy. The mean tumor size at diagnosis in 9 patients was 10.5 cm (range: 6.4~14 cm). After neoadjuvant chemotherapy, the mean size reduction was 53% (range: 37~67%) in 9 patients. In 8 out of 9 patients (88%) a curative resection was performed after average 4 cycles of neoadjuvant chemotherapy. All the patients were followed for a median duration of 21 months (range: 5~88 months). Nine of all 11 patients are still alive without tumor recurrence.
CONCLUSION
Neoadjuvant chemotherapy was able to increase the resectability of an initially unresectable hepatoblastoma and should not be abandoned even with a distant metastasis such as the lung. Liver transplantation is a good back-up for an unresectable hepatoblastoma.