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[Surgical strategy in pediatric liver malignancies]
D von Schweinitz1, J Fuchs, H Mildenberger
1Abteilung für Kinderchirurgie, Medizinische Hochschule, Hannover.
Langenbecks Archiv Fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft Fur Chirurgie. Kongress
|January 1, 1996
Summary
Comparing liver tumor treatments in children, this study found that combined chemotherapy and surgery significantly improved outcomes for hepatoblastoma (HB). Hepatocellular carcinoma (HCC) survival remained poor, emphasizing the need for radical surgical resection.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Hepatobiliary Medicine
Background:
- Liver tumors in children, including hepatoblastoma (HB) and hepatocellular carcinoma (HCC), present significant therapeutic challenges.
- Treatment strategies have evolved, necessitating a comparison of outcomes between historical and modern approaches.
Purpose of the Study:
- To compare the therapeutic results of pediatric liver tumors treated before and after 1988, focusing on hepatoblastoma and hepatocellular carcinoma.
- To evaluate the impact of surgical advancements and updated treatment protocols on patient survival rates.
Main Methods:
- Retrospective analysis of two groups of children with liver tumors: Group 1 (pre-1987) and Group 2 (post-1988, treated under GPOH HB 89/94 protocols).
- Comparison of resection rates, tumor-free survival, and overall cure rates for HB and HCC.
- Assessment of the role of surgical resection, lung metastasis resection, and liver transplantation.
Main Results:
- Hepatoblastoma resection rates improved from 81% to 93%, with tumor-free survival increasing from 38% to 77% in Group 2.
- Anatomic liver resections were more effective than atypical resections for achieving radical tumor removal.
- Hepatocellular carcinoma treatment yielded consistently poor results, with a 25% cure rate across both groups.
Conclusions:
- Combined chemotherapy and surgical resection represent a highly effective strategy for treating pediatric hepatoblastoma.
- Radical surgical resection is critical for achieving cure in pediatric hepatocellular carcinoma.
- Liver transplantation and resection of lung metastases can improve tumor-free survival for liver tumors in children.