J Korean Pediatr Soc.
2000 Aug;43(8):1098-1105.
Effectiveness of Preoperative Transcatheter Arterial Chemoembolization in
Hepatoblastoma
- Affiliations
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- 1Department of Pediatrics, Medical School, Chonbuk National University, Chonju, Korea.
Abstract
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PURPOSE: To evaluate the effectiveness of transcatheter arterial chemoembolization(TACE)
as a preoperative treatment for initially unresectable hepatoblastomas.
METHODS
From January 1995 to July 1999, we identified two boys and three
girls(age range: 5- 27 months; mean age: 12 months) with pathologically-confirmed
hepatoblastoma. To assess response to treatment, we utilized an identical TACE procedure
for all the patients. A second TACE procedure was performed 3 weeks after the first TACE
procedure and patients underwent tumor resection approximately 1 month following the second
TACE procedure. The therapeutic responses to TACE were assessed by measuring of tumor size,
shape, observation of tumor properties using abdominal computed tomography(CT), gross and
microscopic pathologic findings, levels of alpha- feto protein(AFP) and clinical adverse
events to TACE.
RESULTS
In these patients, hepatoblastomas showed marked reductions in tumor size. Massive
tumor necrosis and homogeneous distribution of lipiodol created a clear margin bordered by
surrounding normal liver tissue. At initial diagnosis, the mean AFP leve1=867Ang/mL,
47.4ng/mL after second TACE, and 8.6ng/mL at 6 months after surgical resection. Transient
fever was ob- served following TACE and elevations of levels of AST and ALT were observed
but these normalized 2 weeks following TACE. No major complications were associated with TACE.
CONCLUSION
We suggest that preoperative TACE is an effective, safe, and useful method for
patients with initially unresectable hepatoblastoma.