Progress in the study of therapeutic strategies for hepatoblastoma in children
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Published on: September 12, 2019
Ran Tang1, Shi-Qin Qi1, Tao Zhang1
1Department of Pediatric Surgery, Anhui Provincial Children's Hospital, Hefei 231000, Anhui Province, China.
Insights
Hepatoblastoma (HB) is a rare pediatric liver cancer. Current treatments like surgery, chemotherapy, and liver transplant aim to improve outcomes, but challenges like drug resistance persist.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Malignancies
Background:
- Hepatoblastoma (HB) is the most common primary malignant liver tumor in children, accounting for 50-60% of pediatric liver cancers.
- It predominantly affects children under 3 years, with unclear etiology possibly linked to genetics.
Purpose of the Study:
- To synthesize current therapeutic strategies for Hepatoblastoma (HB).
- To establish an evidence-based foundation for enhancing HB management in children.
- To improve patient prognosis and quality of life.
Main Methods:
- Diagnosis relies on imaging (ultrasound, CT, MRI) and alpha-fetoprotein testing.
- Treatment modalities include surgical resection, chemotherapy, and liver transplantation.
- A multidisciplinary approach is encouraged, with research into novel agents.
Main Results:
- Surgical resection is the primary curative option for localized tumors.
- Chemotherapy aids tumor shrinkage and progression management.
- Liver transplantation is reserved for unresectable or recurrent cases.
Conclusions:
- Despite advancements, challenges include chemotherapy resistance and organ donor shortages.
- Individualized therapies and novel agents are crucial for better outcomes.
- Enhanced management strategies are vital for improving pediatric HB prognosis.
Abstract:
Hepatoblastoma (HB) is the most common primary malignant liver tumor in children, representing approximately 50% to 60% of pediatric liver cancers. It predominantly affects children under the age of 3 years, with a slightly higher incidence in boys compared to girls. The main pathological subtypes of HB are epithelial and mixed types. The etiology and pathogenesis are unclear and may be related to factors such as genetics and gene mutations. The diagnosis primarily relies on imaging examinations (including abdominal ultrasound, computed tomography, and magnetic resonance imaging) and serum alpha-fetoprotein testing. Treatment approaches include surgical resection, chemotherapy, and liver transplantation. Surgical resection is currently the only curative option, especially effective for early-stage localized tumors; chemotherapy can be used to shrink tumors before surgery or to manage their progression; liver transplantation is recommended for cases that cannot be surgically removed or for instances where the disease recurs after surgery. Recent advancements have encouraged a multidisciplinary approach to treatment, with ongoing research into new chemotherapeutic and targeted agents. Despite these developments, challenges remain, such as the need for more precise and individualized therapies, chemotherapy resistance that can lead to poor outcomes in some patients, and a shortage of organ donors, along with the risk of immune rejection after transplantation. A thorough synthesis of current therapeutic strategies will establish an evidence-based foundation to enhance the management of HB in children, ultimately improving prognosis and quality of life.
