Extensive Hepatectomy as an Alternative to Liver Transplant in Advanced Hepatoblastoma: A New Protocol Used in a Pediatric Liver Transplantation Center

Paganoti, Guilherme de Freitas; Tannuri, Ana Cristina Aoun; Marques, Ana Paula; Torres, R. R. A.; Gibelli, Nelson Elias Mendes; Tannuri, Uenis

doi:10.1016/j.transproceed.2019.03.004

Cited by 12 publications

(8 citation statements)

References 21 publications

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“…Radiation therapy is not indicated due to insufficient tumor sensitivity (56,57). Whether the patients benefit more from an extended resection or from a liver transplant is not clearly defined in the PHITT study, as there is not enough data on this (62). The decision to have an extensive liver resection is difficult, because this procedure is not always feasible.…”

Section: Time Of Surgical Proceduresmentioning

confidence: 99%

Hepatoblastoma

Hager

Sergi

2021

Liver Cancer

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Hepatoblastoma is the most common liver cancer in children aged 3 years and younger. The differential diagnosis of this neoplasm is crucial for the proper management. Recent additions to protocols of the International Society of Pediatric Oncology and Children' s Oncology Group have been key in tackling this oncological disease. This chapter provides an overview of the etiology, pathogenesis, epidemiology, incidence, symptoms, and therapeutic considerations of hepatoblastoma. The diagnostic measures necessary from a surgical point of view and the essential operational and technical considerations for the various stages of hepatoblastoma are discussed.

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Section: Time Of Surgical Proceduresmentioning

confidence: 99%

Hepatoblastoma

Hager

Sergi

2021

Liver Cancer

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“…In some cases, aggressive nonanatomic resection with vascular reconstruction, and/or interventional embolization depending on the tumor extent and available expertise, may still be possible [59]. As discussed above patients with POST-TEXT IV and centrally located POST TEXT III have historically been considered candidates for LT; however, patients who have responded to chemotherapy and aggressive resection have been described in some series [59][60][61].…”

Section: Chemotherapymentioning

confidence: 99%

Liver Transplantation for Pediatric Liver Cancer

Sindhi

Rohan

Tadros

et al. 2020

Cancers

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Unresectable hepatocellular carcinoma (HCC) was first removed successfully with total hepatectomy and liver transplantation (LT) in a child over five decades ago. Since then, children with unresectable liver cancer have benefitted greatly from LT and a confluence of several equally important endeavors. Regional and trans-continental collaborations have accelerated the development and standardization of chemotherapy regimens, which provide disease control to enable LT, and also serve as a test of unresectability. In the process, tumor histology, imaging protocols, and tumor staging have also matured to better assess response and LT candidacy. Significant trends include a steady increase in the incidence of and use of LT for hepatoblastoma, and a significant improvement in survival after LT for HCC with each decade. Although LT is curative for most unresectable primary liver sarcomas, such as embryonal sarcoma, the malignant rhabdoid tumor appears relapse-prone despite chemotherapy and LT. Pediatric liver tumors remain rare, and diagnostic uncertainty in some settings can potentially delay treatment or lead to the selection of less effective chemotherapy. We review the current knowledge relevant to diagnosis, LT candidacy, and post-transplant outcomes for these tumors, emphasizing recent observations made from large registries or larger series.

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“…Two patients in five who underwent liver transplantation experienced tumor recurrence and death within a mean period of 6 months, while 6 patients were recurrent in the extended hepatectomy group, with 63.2% event-free survival and 94.7% overall survival rate. The results support extensive surgical resection in patients of advanced tumor [35]. Although the surgical resection is complicated and sometimes remains positive or close negative margins, the patients could have good outcomes.…”

Section: Extended Hepatectomy or Liver Transplantationmentioning

confidence: 57%

Diagnosis and Treatment of Hepatoblastoma: An Update

Zhu¹,

Dong²,

Chen³

et al. 2021

Liver Pathology

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Hepatoblastoma is a rare but the most common solid tumor in children. The incidence is gradually increasing. The international collaboration among four centers in the world has greatly improved the prognosis of hepatoblastoma. They formed the Children's Hepatic Tumor International Collaboration (CHIC) to standardize the staging system (2017 PRETEXT system) and the risk factors for tumor stratification. Multimodal therapy has become the standard for the management of hepatoblastoma, including surgical resection, liver transplantation, chemotherapy, and so on. Surgery is the primary treatment of early stage hepatoblastoma. Threedimensional reconstruction is helpful for preoperative evaluation of large tumors, assisting extended hepatectomy for patients in PRETEXT III or IV. Neoadjuvant therapy is useful for reducing the tumor volume and increasing the resectability. Primary liver transplantation is recommended for advanced hepatoblastoma. The lungs are the most common metastatic organ, the treatment of which is critical for the patient's long-term survival. We reviewed the recent progress in the diagnosis and treatment of hepatoblastoma.

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Extensive Hepatectomy as an Alternative to Liver Transplant in Advanced Hepatoblastoma: A New Protocol Used in a Pediatric Liver Transplantation Center

Cited by 12 publications

References 21 publications

Hepatoblastoma

Hepatoblastoma

Liver Transplantation for Pediatric Liver Cancer

Diagnosis and Treatment of Hepatoblastoma: An Update

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