Strategy for hepatoblastoma management: Transplant versus nontransplant surgery

A. P. Pimpalwar, K. Sharif, P. Ramani, M. Stevens, R. Grundy, B. Morland, C. Lloyd, D. A. Kelly, J. A C Buckles, J. De Ville De Goyet

Research output: Contribution to journalArticle

Abstract

Background: Liver transplantation now is proposed for managing selected hepatoblastoma cases. Indications are not yet well defined. Methods: The case records of 34 children with hepatoblastoma treated over a period of 10 years (1991 to 2000) were reviewed retrospectively. Results: All patients benefited from preoperative chemotherapy. Twenty patients underwent major hepatic resections. Twelve patients, in absence of residual metastasis, underwent liver transplant because the tumour remained unresectable after chemotherapy. Two patients who presented with recurrence after a right hepatectomy, benefited from transplant as a second option. Two other patients did not undergo surgery because of widespread disease or resistance to chemotherapy. Disease-free survival rates were 95% after surgical resection, 100% when primary transplant was performed in patients with good response to chemotherapy, 60% after transplantation in patients with poor response to chemotherapy, 50% in patients with transplant as second option, and 0% in patients not undergoing surgery. Conclusions: Transplantation is a potentially curative option for unresectable hepatoblastoma when chemosensitive (decrease in alpha-fetoprotein and decrease in tumour size). In this context, also favourable cases with good response but difficult resections with doubtful margins of resection may best be proposed for primary transplantation. Patients with recurrent or resistant disease are not good candidates.

Original languageEnglish
Pages (from-to)240-245
Number of pages6
JournalJournal of Pediatric Surgery
Volume37
Issue number2
DOIs
Publication statusPublished - 2002

Keywords

  • Chemotherapy
  • Hepatectomy
  • Hepatic resection
  • Hepatoblastoma
  • Liver transplant
  • Outcome

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Strategy for hepatoblastoma management: Transplant versus nontransplant surgery'. Together they form a unique fingerprint.

  • Cite this

    Pimpalwar, A. P., Sharif, K., Ramani, P., Stevens, M., Grundy, R., Morland, B., Lloyd, C., Kelly, D. A., Buckles, J. A. C., & De Ville De Goyet, J. (2002). Strategy for hepatoblastoma management: Transplant versus nontransplant surgery. Journal of Pediatric Surgery, 37(2), 240-245. https://doi.org/10.1053/jpsu.2002.30264