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Pre-operative diagnostic biopsy and surgery in paediatric liver tumours--the Amsterdam experience
J M Schnater1, C F Kuijper, J Zsiros
1Pediatric Surgical Centre, Emma Children's Hospital AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Aim:
To report 24 years of pre-treatment biopsy and surgical experience in primary liver tumours in children.
Methods:
Between 1979 and 2003, 53 children presented with a primary liver tumour of whom 48 who underwent surgical resection were evaluated (two died, two were unresectable, and one was transplanted). Biopsy data, per- and post-operative complications, mortality, and survival were retrospectively reviewed.
Results:
Benign tumours were diagnosed in eight patients. Surgical resection for a malignant tumour was performed in 40 patients (26 hepatoblastomas (HB), eight hepatocellular carcinomas (HCC) (four had fibrolamellar HCC), three rhabdomyosarcomas (RMS), one neuroblastoma, one non-hodgkin lymphoma (NHL), and one teratoma). Primary resection was performed in one HB, and four HCCs. The cumulative survival without evidence of disease was 73% for HB (median 7 years) and 88% for HCC (median 3.5 years).
Conclusion:
The treatment results are comparable with those of larger international series except for HCC. The existing diagnostic pitfalls in differentiating between the various liver malignancies justify the use of a diagnostic biopsy.
