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Hepatoblastoma in low birth weight infants: an institutional review
Stephanie A Kapfer1, Mary Jane Petruzzi, Michael G Caty
1Division of Pediatric Surgery, Department of Surgery, State University of New York at Buffalo, The Women and Children's Hospital of Buffalo, Buffalo, NY 14222, USA.
Insights
Hepatoblastoma in low birth weight infants (<1,500g) shows high survival rates despite aggressive disease. Standard care for these infants and hepatoblastoma management requires no changes.
Area of Science:
- Pediatric Oncology
- Neonatology
Background:
- The association between hepatoblastoma and low birth weight is not well understood.
- There is a suggestion that hepatoblastoma in low birth weight infants may be more aggressive.
Observation:
- Four patients with hepatoblastoma and birth weights under 1,500g were treated between 1989 and 2003.
- All patients survived, with some experiencing bilateral or recurrent disease.
- Pulmonary complications requiring prolonged oxygen and ventilatory support were common.
Findings:
- Despite aggressive disease presentation, 100% patient survival was achieved in this cohort.
- The study did not identify specific etiological factors beyond speculation about oxygen free radical damage.
Implications:
- Current standard care for low birth weight infants does not need modification.
- Management protocols for hepatoblastoma in low birth weight infants remain unchanged based on this cohort.
Abstract:
The association between hepatoblastoma and low birth weight documented recently in the literature has yet to be well explained, in particular the suggestion that these patients may have a more aggressive form of the disease. From 1989 to 2003, our institution treated four patients for hepatoblastoma who had birth weights of less than 1,500 g. Notable was 100% patient survival despite bilateral and, in one case, recurrent disease. Speculation regarding the etiology of this subset of hepatoblastoma has included damage to developing hepatocytes induced by oxygen free radicals. Our patients universally had pulmonary disease requiring prolonged supplemental oxygen and ventilatory support. However, our review supports no changes in the standard care of low birth weight infants or in managing those who develop hepatoblastoma.
