Liver Transplantation for Unresectable Liver Tumors in Children

Meyers, Rebecka L.; Otté, Jean-Bernard

doi:10.1007/978-3-642-14504-9_11

Cited by 6 publications

(4 citation statements)

References 96 publications

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“…Although liver transplantation has proven effective even in cases that may have initially presented with metastatic disease, controversy exists regarding what constitutes the best therapy for tumors that are very large or critically positioned and impinge on essential vascular structures, or tumors that are multicentric and present in all four sectors of the liver before neoadjuvant therapy [3,[14][15][16][17][18][19]. Although some have argued that all PRETEXT stage IV tumors and centrally placed PRETEXT stage III, particularly those that are intimately involved with vascular structures, should be transplanted after a course of neoadjuvant chemotherapy [20].…”

Section: Surgical Resection Versus Transplant: Pretext IV and Multifomentioning

confidence: 99%

“…Choosing the most appropriate one is the key decision that must be taken after no more than four courses of neoadjuvant therapy. Retrospective single institutional reviews, such as those provided by Lautz et al [17], may offer direction and guidance in how future investigations should proceed but are not substitutes for prospective rigorously controlled trials [16,38]. The PLUTO registry and the AHEP-0731 COG trial are specifically designed to compare the results of extreme resection versus transplantation in POST-TEXT IV and POST-TEXT III þVþP patients [20].…”

Section: Surgical Resection Versus Transplant: Pretext IV and Multifomentioning

confidence: 99%

See 1 more Smart Citation

Hepatoblastoma state of the art

Meyers

Tiao

Goyet

et al. 2014

Current Opinion in Pediatrics

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155

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Section: Surgical Resection Versus Transplant: Pretext IV and Multifomentioning

confidence: 99%

Section: Surgical Resection Versus Transplant: Pretext IV and Multifomentioning

confidence: 99%

Hepatoblastoma state of the art

Meyers

Tiao

Goyet

et al. 2014

Current Opinion in Pediatrics

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155

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“…Pre-operative chemotherapy may be administered to treat extrahepatic and metastatic disease and reduce tumour size, rendering a patient eligible for surgery [9][10][11][12]. When partial liver resection does not completely remove the tumour, whilst preserving a sufficient liver remnant, orthotopic liver transplantation (OLT) should be considered [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcome of Children with a Malignant Liver Tumour in The Netherlands: A Retrospective Consecutive Cohort Study

et al. 2022

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Introduction: Six to eight children are diagnosed with a malignant liver tumour yearly in the Netherlands. The majority of these tumours are hepatoblastoma (HB) and hepatocellular carcinoma (HCC), for which radical resection, often in combination with chemotherapy, is the only curative treatment option. We investigated the surgical outcome of children with a malignant liver tumour in a consecutive cohort in the Netherlands. Methods: In this nationwide, retrospective observational study, all patients (age < 18 years) diagnosed with a malignant liver tumour, who underwent partial liver resection or orthotopic liver transplantation (OLT) between January 2014 and April 2021, were included. Children with a malignant liver tumour who were not eligible for surgery were excluded from the analysis. Data regarding tumour characteristics, diagnostics, treatment, complications and survival were collected. Outcomes included major complications (Clavien–Dindo ≥ 3a) within 90 days and disease-free survival. The results of the HB group were compared to those of a historical HB cohort. Results: Twenty-six children were analysed, of whom fourteen (54%) with HB (median age 21.5 months), ten (38%) with HCC (median age 140 months) and one with sarcoma and a CNSET. Thirteen children with HB (93%) and three children with HCC (30%) received neoadjuvant chemotherapy. Partial hepatic resection was possible in 19 patients (12 HB, 6 HCC, and 1 sarcoma), whilst 7 children required OLT (2 HB, 4 HCC, and 1 CNSET). Radical resection (R0, margin ≥ 1.0 mm) was obtained in 24 out of 26 patients, with recurrence only in the patient with CNSET. The mean follow-up was 39.7 months (HB 40 months, HCC 40 months). Major complications occurred in 9 out of 26 patients (35% in all, 4 of 14, 29% for HB). There was no 30- or 90-day mortality, with disease-free survival after surgery of 100% for HB and 80% for HCC, respectively. Results showed a tendency towards a better outcome compared to the historic cohort, but numbers were too small to reach significance. Conclusion: Survival after surgical treatment for malignant liver tumours in the Netherlands is excellent. Severe surgical complications arise in one-third of patients, but most resolve without long-term sequelae and have no impact on long-term survival.

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“…However, patients with advanced HB have poor prognosis, especially those with distant metastases (i.e., cancer has spread to other organs and tissues of the body) (Honeyman and La Quaglia, 2012). Currently, the main treatment methods include surgery, chemotherapy, liver transplantation, and local infusion chemotherapy (Czauderna et al, 2006;von Schweinitz, 2006;Gupta et al, 2011;Meyers and Otte, 2011;Perilongo et al, 2011). Reports on stage IV and progress stage HB with high-dose chemotherapy and autologous peripheral blood stem cell transplantation (APBSCT) are rare.…”

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy and Prognosis Factors for Advanced Hepatoblastoma in Children: A 6-year Retrospective Study

Zhang

Zhang²,

Huang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Objective: This study aimed to investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma (HB) and the factors affecting prognosis. Methods: A total of 35 children underwent multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. The patients were followed up every month. Results: Serum AFP levels in 33 out of 35 patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the values of serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the 35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases with locally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventional treatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33 patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission (PR), 1 became disease progressive (DP) , and 10 died. The remission and overall survival rates were 66.7% (22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than the epithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P < 0.001). Conclusion: Multimodality treatment can effectively improve remission rate and prolong the survival of children with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors, HB pathological classification, and staging are highly useful in predicting prognosis.

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Liver Transplantation for Unresectable Liver Tumors in Children

Cited by 6 publications

References 96 publications

Hepatoblastoma state of the art

Hepatoblastoma state of the art

Surgical Outcome of Children with a Malignant Liver Tumour in The Netherlands: A Retrospective Consecutive Cohort Study

Clinical Efficacy and Prognosis Factors for Advanced Hepatoblastoma in Children: A 6-year Retrospective Study

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