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[Clinical characteristics and survival of children with hepatoblastoma--single centre experience]
Insights
Hepatoblastoma treatment combining chemotherapy and surgery offers high cure rates in children. This approach significantly improves outcomes for this common childhood liver cancer.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Malignancies
- Clinical Cancer Research
Context:
- Hepatoblastoma is the most common primary liver cancer in children, accounting for 1% of all pediatric cancers.
- Current treatment involves intensive chemotherapy followed by surgical resection, with survival rates between 75-95%.
Purpose:
- To summarize the clinical characteristics and treatment outcomes of children diagnosed with hepatoblastoma.
- To evaluate the effectiveness of combined chemotherapy and surgical resection in treating pediatric hepatoblastoma.
Summary:
- A retrospective analysis of 11 hepatoblastoma patients (1995-2007) revealed common symptoms like abdominal distension and elevated alpha-fetoprotein (AFP).
- Diagnosis was confirmed via biopsy or post-resection, with epithelial and mixed types being most frequent. Initial lung metastasis occurred in 27% of patients.
- Combined preoperative chemotherapy and complete tumor resection, followed by postoperative chemotherapy, led to a high rate of definitive cures, with 6 patients in continuous remission.
Impact:
- The study highlights the efficacy of multimodal treatment strategies in achieving high cure rates for hepatoblastoma.
- Findings support the established treatment paradigm for pediatric hepatoblastoma, emphasizing the importance of complete tumor resection and adjuvant chemotherapy.
Introduction:
Hepatoblastoma is the most frequent malignant liver tumour of childhood and it accounts for 1% of all paediatric cancers. The outcome is significantly improved by introducing intensive chemotherapy regimens followed by complete surgical tumour resection. The long-term survival is 75-95% at present.
Objective:
To summarize clinical characteristics and treatment results in children with hepatoblastoma.
Method:
The patients diagnosed with hepatoblastoma and treated at the Department of Haematology of the University Children's Hospital in Belgrade, between January 1995 and December 2007 were retrospectively analysed. We analysed mode of therapy, surgical management and patients' survival according to Kaplan Mayer statistical test.
Results:
Eleven patients were treated (ten boys and one girl), aged from 6 months to 13 years, mean 32 months, median 12 months. The most frequent presenting sign was abdominal distension. Routine laboratory examination showed elevated alpha-fetoprotein (AFP), range 147 to 44880 ng/ml, mean 8667 ng/ml.Ten patients (91%) had elevated platelet count, range 450 to 909 x 10(9)/l. Initial lung metastasis developed in 3 patients (27%).The diagnosis was established by an open surgical biopsy in 6 patients and after complete tumour resection in 4 patients, namely 2 patients after preoperative chemotherapy and in 2 patients with no previous chemotherapy. Histopathology verified hepatoblastoma in 10 patients: in 7 patients with epithelial type and in 3 patients with mixed epithelial-mesenchyme type. Six patients were in continuous remission with mean follow up of 58 months. One patient was lost to follow up. Four patients died; three patients due to disease progression and one patient due to sepsis after the first cycle of chemotherapy.
Conclusion:
Combined preoperative chemotherapy with complete tumour resection followed by postoperative chemotherapy results in a high percentage of definitive cures.