J Korean Assoc Pediatr Surg.  1997 Dec;3(2):133-142. 10.13029/jkaps.1997.3.2.133.

Clinical Characteristics and Prognosis of Hepatoblastoma in Children

Affiliations
  • 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Hepatoblastoma is a rare pediatric malignancy which frequently presents at an advanced unresectable stage. With the neoajuvant chemotherapy, improved resectability and survival have been reported. Twenty children with biopsy proven hepatoblastoma were treated during the period between January 1987 and June 1995. Median age at diagnosis was 13 months(2 months to 7 year and 10 months), and 13 were male. Histologic profile was 13 epithelia1(5 fetal, 4 mixed, 1 embryonal, 3 undetermined), and 5 mixed mesenchymal and epithelial and 2 of undetermined type. Chemotherapy effectively reduced the tumor volume(p=0.008), and' was able to convert 7 out of 9 initially unresectable cases(78%) to resectable ones. Twelve radical and 2 palliative operations were done with or without adjuvant chemotherapy. The Median follow up period was 33 months and the median survival was 26 months. The group with curative resection had a 61.1 % 5 year survival rate, but none of palliative resection grpup survived more than 13 months(p=0.000l). In univariate analysis for prognostic factors revealed, large tumor size at diagnosis and abscence of thrombocytopenia were associated with poor survival, but these differences were not statistically significant. Histological pure fetal type did not mean a better prognosis. Even with a recent neoadjuvant chemotherapy, the strategy should be focused on the radical resection as early as possible.

Keyword

Hepatoblastoma; Curative Resection; Neoadjuvant Chemotherapy; Prognosis; Thrombocytopenia

MeSH Terms

Biopsy
Chemotherapy, Adjuvant
Child*
Diagnosis
Drug Therapy
Follow-Up Studies
Hepatoblastoma*
Humans
Male
Prognosis*
Survival Rate
Thrombocytopenia
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