Effect of neoadjuvant chemotherapy on resectability of stage III and IV hepatoblastoma

Venkatramani, Rajkumar; Stein, James E.; Sapra, Amit; Genyk, Yuri; Jhaveri, Vidhi; Malogolowkin, Marcio H.; Mascarenhas, Leo

doi:10.1002/bjs.9681

Cited by 25 publications

(23 citation statements)

References 14 publications

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“…PRETEXT III intermediate-risk tumors, however, should be considered for resection after the second cycle and no later than after the fourth cycle, with trisectionectomy or extreme resection often required (Figure 3). In one study of 20 patients, the majority of PRETEXT III and IV tumors achieved radiographic resectability after completion of two chemotherapy cycles [25], thus allowing for earlier resection and reduction in chemotherapy.…”

Section: Surgical Resectionmentioning

confidence: 99%

Hepatoblastoma—The Evolution of Biology, Surgery, and Transplantation

et al. 2018

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The most common primary malignant liver tumor of childhood, hepatoblastoma has increased in incidence over the last 30 years, but little is still known about its pathogenesis. Discoveries in molecular biology provide clues but have yet to define targeted therapies. Disease-free survival varies according to stage, but is greater than 90% in favorable risk populations, in part due to improvements in chemotherapeutic regimens, surgical resection, and earlier referral to liver transplant centers. This article aims to highlight the principles of disease that guide current treatment algorithms. Surgical treatment, especially orthotopic liver transplantation, will also be emphasized in the context of the current Children’s Oncology Group international study of pediatric liver cancer (AHEP-1531).

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Section: Surgical Resectionmentioning

confidence: 99%

Hepatoblastoma—The Evolution of Biology, Surgery, and Transplantation

et al. 2018

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“…There have been and are several ongoing attempts to determine which patients should proceed to OLT and after how many cycles of chemotherapy . Currently, the COG recommends evaluation for surgery after two rounds of neoadjuvant chemotherapy; however, a more recent study by Venkatramani and colleagues demonstrated that some tumors continue to regress between cycles two and four.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the COG recommends evaluation for surgery after two rounds of neoadjuvant chemotherapy; however, a more recent study by Venkatramani and colleagues demonstrated that some tumors continue to regress between cycles two and four. Giving four vs. two rounds of neoadjuvant therapy increased the percentage of tumors downstaged from 30% to 45%, but increased the percentage deemed “resectable” from 65% to 80%, leading the authors to suggest that additional chemotherapy, if tolerated, may allow for more patients to undergo successful resection . Resection avoids the possible risks of post‐transplant immunosuppression and some authors have endorsed extreme resection techniques such as extended and non‐anatomic hepatectomy to achieve negative margins .…”

Section: Discussionmentioning

confidence: 99%

Effects of an early referral system on liver transplantation for hepatoblastoma at Texas Children's Hospital

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Rana

et al. 2016

Pediatric Transplantation

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The purposes of this study were to analyze the effects of an ERS on time to transplantation and to describe our center's experience with OLT for HB. Patients who received OLT for HB between 2000 and 2013 were included. Patient and allograft characteristics, chemotherapy regimens, and prior surgical therapies were examined. The interval between diagnosis and OLT prior to and following the institution of an ERS for transplant was compared. Survival and tumor recurrence were analyzed. Nineteen patients received OLT for HB (mean age 33 months). All children received grafts from deceased donors. Two patients underwent prior resections. Tumor recurred in four patients (21.1%). Both patients who received salvage transplants experienced post-OLT recurrence. Three of the four recurrences occurred in spite of adjuvant chemotherapy. There were three deaths: two from metastatic disease. One- and five-yr survivals were 86.1% and 73.8%. After the institution of the ERS, the mean interval between tissue diagnosis and OLT was significantly reduced. Our series of 19 patients demonstrates a 21% recurrence of HB following OLT despite chemotherapy. Five-yr survival reached 73.8%. A system of early referral can effectively reduce times between diagnosis and transplant.

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“…Ancak iki kür tedavi sonrasında tümörün çok küçülmeyeceğini belirterek, daha fazla ısrar etmeden karaciğer nakli önerenler bulunmaktadır. Bu şekilde kemoterapiye bağlı işitme kaybı veya kalp yetmezliği komplikasyonlarının da azaltılabileceği vurgulanmaktadır (15) . …”

Section: Hepatoblastom Yaygınlığını Değerlendirmeunclassified