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KMID : 0371320020630040337
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Journal of the Korean Surgical Society
2002 Volume.63 No. 4 p.337 ~ p.341
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Clinical Study of Hepatoblastoma in Children
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Park Jin-Wan
Park Jae-Berm
Han Sang-Ah
Woo Jong-Gook
Seo Jeong-Meen
Lee Suk-Koo
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Abstract
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Purpose: By the help of neoadjuvant chemotherapy, resectability and survival rate of hepatoblastoma have improved. To evaluate recent treatment outcome of hepat-oblastoma, pediatric hepatoblastoma in our institute were reviewed.
Methods: The medical records of 11 pediatric hepatoblastoma patients were analysed retrospectively.
Results: All but one patient old were under 3 years old at diagnosis (range: 1∼150 months). The male to female ratio was 6：5. Two patients were treated without neoadjuvant chemotherapy. One of them received right lobectomy for initially
resectable tumor. Another one patient received a liver transplant for multiple unresectable tumors and liver cirrhosis. Nine patients received neoadjuvant chemotherapy based on the CCG-823F or CCG-8881A protocol. Two of them showed lung metastasis,
but
the metastatic nodules were reduced in size and number in one patient, disappeared in another patient after neoadjuvant chemotherapy. The mean tumor size at diagnosis in 9 patients was 10.5 ㎝ (range: 6.4∼14 ㎝). After neoadjuvant chemotherapy,
the
mean size reduction was 53% (range: 37∼67%) in 9 patients. In 8 out of 9 patients (88%) a curative resection was performed after average 4 cycles of neoadjuvant chemotherapy. All the patients were followed for a median duration of 21 months
(range:
5∼88 months). Nine of all 11 patients are still alive without tumor recurrence.
Conclusion: Neoadjuvant chemotherapy was able to increase the resectability of an initially unresectable hepatoblastoma and should not be abandoned even with a distant metastasis such as the lung. Liver transplantation is a good back-up for
an
unresectable hepatoblastoma.
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