Hepatoblastoma: 16-years’ experience from a tertiary cancer centre in India

Manuprasad, Avaronnan; Radhakrishnan, Venkatraman; J, Sunil B.; Ramakrishnan, A.S.; Ganesan, Trivedi S.; Ganesan, Prasanth; Ramamurthy, Jaikumar; Dhanushkodi, Manikandan; Sagar, Tenali Gnana

doi:10.1016/j.phoj.2018.01.002

Cited by 5 publications

(14 citation statements)

References 11 publications

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“…In India, it has not been a priority. In addition to this, limited financial resources, difficulty in accessing healthcare, and lack of awareness contribute to the late stages of presentation [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Profile of Hepatoblastoma: Experience From a Tertiary Care Centre in a Resource-Limited Setting

Dhali¹,

Mandal²,

Das³

et al. 2022

Cureus

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BackgroundHepatoblastoma (HB) is a rare neoplasm of the liver, accounting for about 1% of all pediatric cancers. The aim of the present study is to report our experience with HBs over a period of five years from a tertiary center in Eastern India. MethodologyThis is a retrospective observational study. The data of all patients who were diagnosed with HB between August 2015 and December 2020 was reviewed. ResultsTwenty-three patients who were diagnosed and treated for HB at our center were included in the study. Sixteen (69.5%) of them were male. The median age of presentation was 14 (range, 3-58) months. An abdominal lump (n=23, 100%) and abdominal pain (n=11, 47.8%) were the most common presenting symptoms. The median level of serum alpha-fetoprotein at the time of initial evaluation was 8000 (878-1,280,000) ng/dL. The mean size of the largest focus in its largest dimension was 12.03±3.77 cm. The epithelial variant (n=22, 95.7%) was the most common histological subtype. One (4.3%), 10 (43.4%), 11 (47.8%), and one (4.3%) patient were found to have pre-treatment extent of tumor (PRETEXT) stages 1, 2, 3, and 4, respectively. Fifteen (65.2%) children were classified as standard risk and seven (34.7%) children as high risk.All the patients received neoadjuvant chemotherapy (NACT). The most commonly performed surgery was right hepatectomy (n=12, 52.1%). There were three (13%) cases of perioperative mortality. Four postoperative complications developed in three (13%) patients. Four (17.3%) patients developed chemotherapy-related complications. The median duration of follow-up was 31 (range, 0-58) months. Three (13%) patients developed relapses of the disease. Overall, five-year survival in our series was 73.9%. ConclusionThis study shows that the overall outcomes of HB in a resource-limited setting such as ours are good with the adoption of multi-modality treatment. Managing chemotherapy-induced complications and making liver transplantation more feasible will improve the results further.

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Section: Introductionmentioning

confidence: 99%

Clinical Profile of Hepatoblastoma: Experience From a Tertiary Care Centre in a Resource-Limited Setting

Dhali¹,

Mandal²,

Das³

et al. 2022

Cureus

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“…Based on pretreatment characteristics, hepatoblastomas have been stratified to determine the prognosis and identify the need for more aggressive chemotherapy schedules in the high‐risk variant. Despite this approach, patients with a high‐risk variant have a markedly poorer outcome.…”

Section: Introductionmentioning

confidence: 99%

“…Although paediatric tumours are highly treatable, 80 per cent of children with malignancy die because they live in low‐income countries where access to medical care is often inadequate. Some of these countries, notably India, have launched cancer initiatives, concentrating treatment resources in regional cancer centres. Government initiatives, non‐governmental organizations and crowd funding have also provided financial support for the treatment of these children.…”

Section: Introductionmentioning

confidence: 99%

“…Government initiatives, non‐governmental organizations and crowd funding have also provided financial support for the treatment of these children. Tertiary paediatric liver transplant centres have achieved outcomes similar to those in Western centres, but there are few data on outcomes for hepatoblastoma, and none for high‐risk hepatoblastoma.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes for high-risk hepatoblastoma in a resource-challenged setting

et al. 2020

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Background: Outcomes of high-risk hepatoblastoma have been dismal, especially in resource-challenged countries where access to chemotherapy and paediatric liver transplantation is limited for the underprivileged. This study aimed to assess the results of treatment of high-risk hepatoblastoma in a tertiary centre, including patients who had non-transplant surgical procedures in the form of extended resection. Methods: A review of patients with high-risk hepatoblastoma treated between January 2012 and May 2018 was carried out. Perioperative data and long-term outcomes were analysed. Results: Of 52 children with hepatoblastoma, 22 were considered to have high-risk hepatoblastoma (8 girls and 14 boys). The mean(s.d.) age at diagnosis was 35(20) months. Of these 22 children, five died without surgery. Of the remaining 17 who underwent surgery, six had a resection (4 right and 2 left trisectionectomies) and 11 underwent living-donor liver transplantation. Median follow-up was 48 (range 12-90) months. Thirteen of the 17 children were alive at last follow-up and four developed disseminated disease (3 had undergone liver transplantation and 1 liver resection). The overall survival rate at 1, 3 and 5 years was 77, 64 and 62 per cent for the whole cohort with high-risk hepatoblastoma. In children who had surgery, 1-, 3-and 5-year survival rates were 91, 82 and 73 per cent for transplantation and 100, 83 and 83 per cent for resection. There was no difference in survival between the two surgical groups. Conclusion: Excellent results in the treatment of high-risk hepatoblastoma are possible, even in resource-challenged countries.

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“…Hepatoblastoma accounts for 1% of pediatric cancers with an incidence peak in the first 5 years of life and a slight male preponderance. [1,2] Clinical presentation may include from rapidly enlarging abdominal mass to abdominal pain, abdominal pain, failure to thrive in young children, or loss of weight in adolescents. Paraneoplastic manifestations are commonly described.…”

Section: Introductionmentioning

confidence: 99%

Malignant Hypertension Secondary to Renin-Producing Hepatoblastoma

Sfrijan

Scurtu

Paca

et al. 2020

Indian Journal of Medical and Paediatric Oncology

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Clinical presentation of hepatoblastoma is often insidious and its paraneoplastic manifestations are not uncommon. We report an extremely rare case of a renin-secreting hepatoblastoma inducing malignant hypertension remarked in our clinic. The hepatic malignancy classified as PRETEXT IV and a multidisciplinary approach according to SIOPEL III was made with a poor outcome. Hepatoblastoma in children should be considered as possible etiology of hypertension in children.

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Hepatoblastoma: 16-years’ experience from a tertiary cancer centre in India

Cited by 5 publications

References 11 publications

Clinical Profile of Hepatoblastoma: Experience From a Tertiary Care Centre in a Resource-Limited Setting

Clinical Profile of Hepatoblastoma: Experience From a Tertiary Care Centre in a Resource-Limited Setting

Outcomes for high-risk hepatoblastoma in a resource-challenged setting

Malignant Hypertension Secondary to Renin-Producing Hepatoblastoma

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