TY - JOUR
T1 - Features predicting unresectability in hepatoblastoma
AU - D'Antiga, Lorenzo
AU - Vallortigara, Francesca
AU - Cillo, Umberto
AU - Talenti, Enrico
AU - Rugge, Massimo
AU - Zancan, Lucia
AU - Dall'Igna, Patrizia
AU - De Salvo, Gian Luca
AU - Perilongo, Giorgio
PY - 2007/9/1
Y1 - 2007/9/1
N2 - BACKGROUND. Approximately 20% of patients who have hepatoblastoma (HB) still have unresectable disease after preoperative chemotherapy (POC). In these circumstances, orthotopic liver transplantation (OLT) should be performed 1 month after POC. The authors sought to identify presenting features that would predict unresectability in patients with HB and to provide suggestions for early referral and listing for OLT. METHODS. Notes, radiology films, and histology from patients who were treated over the previous 20 years were reviewed. Unfeasible resection was defined by bilobar involvement, vascular extension, and metastatic disease after POC. Failed conservative treatment (FCT) was used to categorize patients who were not disease-free with their native liver ≥1 year after surgery. RESULTS. Of 28 patients who were studied, 14 patients underwent resection, and 10 patients required OLT. Four patients did not undergo any type of surgery because of tumor progression. Overall, the 5-year survival rate was 76% (95% confidence interval, 54.8-89%). Predictors of FCT were multifocality (P = .006), a high pretreatment extent of tumor (PRETEXT) score (III or IV; P = .006), portal vein involvement (P = .02), hepatic vein involvement (P = .02), or vena cava involvement (P = .05). Patients who achieved a curative resection presented at a younger age (median, 0.7 years vs 4.2 years, P = .02). Patients who had multifocal lesions and those who had an α-fetoprotein (αFP) level
AB - BACKGROUND. Approximately 20% of patients who have hepatoblastoma (HB) still have unresectable disease after preoperative chemotherapy (POC). In these circumstances, orthotopic liver transplantation (OLT) should be performed 1 month after POC. The authors sought to identify presenting features that would predict unresectability in patients with HB and to provide suggestions for early referral and listing for OLT. METHODS. Notes, radiology films, and histology from patients who were treated over the previous 20 years were reviewed. Unfeasible resection was defined by bilobar involvement, vascular extension, and metastatic disease after POC. Failed conservative treatment (FCT) was used to categorize patients who were not disease-free with their native liver ≥1 year after surgery. RESULTS. Of 28 patients who were studied, 14 patients underwent resection, and 10 patients required OLT. Four patients did not undergo any type of surgery because of tumor progression. Overall, the 5-year survival rate was 76% (95% confidence interval, 54.8-89%). Predictors of FCT were multifocality (P = .006), a high pretreatment extent of tumor (PRETEXT) score (III or IV; P = .006), portal vein involvement (P = .02), hepatic vein involvement (P = .02), or vena cava involvement (P = .05). Patients who achieved a curative resection presented at a younger age (median, 0.7 years vs 4.2 years, P = .02). Patients who had multifocal lesions and those who had an α-fetoprotein (αFP) level
KW - Children
KW - Hepatoblastoma
KW - Liver resection
KW - Liver transplantation
KW - Liver tumors
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U2 - 10.1002/cncr.22876
DO - 10.1002/cncr.22876
M3 - Article
C2 - 17661341
AN - SCOPUS:34548157474
VL - 110
SP - 1050
EP - 1058
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 5
ER -