Clin Pediatr Hematol Oncol.  2011 Apr;18(1):45-49.

Excellent Outcomes of Preoperative Chemotherapy and Surgery for Initially Unresectable Hepatoblastoma in Children

Affiliations
  • 1Department of Pediatrics, College of Medicine, Yeungnam University, Daegu, Korea. johah@med.yu.ac.kr

Abstract

BACKGROUND
Hepatoblastoma is the most common primary malignant tumor of the liver in children. Complete surgical resection is the treatment of choice for cure. However, only 50% are eligible for resection at diagnosis. Recently combination of preoperative chemotherapy and surgery had led improved resectability and survival rate.
METHODS
Between May, 2001 and November, 2010, 9 patients were diagnosed with initially unresectable hepatoblastoma at the department of pediatrics, Yeungnam University Hospital. Medical records were reviewed retrospectively. Initial evaluation included complete blood counts, liver function, serum AFP, cholesterol level and abdominal-CT scan. Preoperative chemotherapy was consisted of cisplatin and doxorubicin every 3-4 weeks. Second-line chemotherapy was cisplatin, vincristine and fluorouracil. The treatment response was analyzed by the Response Evaluation Criteria In Solid Tumors (RECIST) criteria.
RESULTS
Among 9 patients, male:female was 4:5. Median age at diagnosis was 12 months (4-59 months). The most common presenting symptom was the abdominal mass. Laboratory findings revealed: median AFP 216,841 ng/dL (3,535-1,036,404 ng/dL), anemia: 4, thrombocytosis: 5, elevated AST/ALT: 8, hyperbilirubinemia: 1 and hypercholesterolemia: 5. The median tumor size was 11 cm (8-15 cm). No patient had metastasis. After median 4 (3-5) cycles of preoperative chemotherapy, all patients(100%) showed a partial response and underwent complete surgical resection. Postoperative chemotherapy was given for median 4 (3-5) cycles. The median follow up was 34 months (6-117 months) and all patients are surviving without events.
CONCLUSION
Although this study includes limited number of cases, preoperative intensive chemotherapy and surgery for initially unresectable hepatoblastoma in children resulted in excellent outcomes.

Keyword

Hepatoblastoma; Preoperative chemotherapy; Outcomes; Unresectable

MeSH Terms

Blood Cell Count
Child
Cholesterol
Cisplatin
Doxorubicin
Fluorouracil
Follow-Up Studies
Hepatoblastoma
Humans
Liver
Medical Records
Neoplasm Metastasis
Pediatrics
Retrospective Studies
Vincristine
Cholesterol
Cisplatin
Doxorubicin
Fluorouracil
Vincristine
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