Surgical resection of pulmonary metastatic lesions in children with hepatoblastoma

Meyers, Rebecka L.; Katzenstein, Howard M.; Krailo, Mark; McGahren, Eugene D.; Malogolowkin, Marcio H.

doi:10.1016/j.jpedsurg.2007.08.030

Cited by 100 publications

(71 citation statements)

References 15 publications

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“…For pulmonary relapses, resection of the tumor by means of thoracotomy provides long-term cure in only 30 % of the cases [32,33]. In this study, 6 of 12 (50 %) patients with pulmonary relapse survived (Fig.…”

Section: Discussionmentioning

confidence: 58%

Surgical treatment of childhood hepatoblastoma in the Netherlands (1990–2013)

et al. 2016

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Background Achievement of complete surgical resection plays a key role in the successful treatment of children with hepatoblastoma. The aim of this study is to assess the surgical outcomes after partial liver resections for hepatoblastoma, focusing on postoperative complications, resection margins, 30-day mortality, and long-term survival. Method Chart reviews were carried out on all patients treated for hepatoblastoma in the Netherlands between 1990 and 2013. Results A total of 103 patients were included, of whom 94 underwent surgery. Partial hepatectomy was performed in 76 patients and 18 patients received a liver transplant as a primary procedure. In 42 of 73 (58 %) patients, one or more complications were reported. In 3 patients, information regarding complications was not available. Hemorrhage necessitating blood transfusion occurred in 33 (45 %) patients and 9 (12 %) patients developed biliary complications, of whom 8 needed one or more additional surgical interventions. Overall, 5-year disease-specific survival was 82, 92 % in the group of patients who underwent partial hepatectomy, and 77 % in the group of patients who underwent liver transplantation. Conclusions Partial hepatectomy after chemotherapy in children with hepatoblastoma offers good chances of survival. This type of major surgery is associated with a high rate of surgical complications (58 %), which is not detrimental to survival.

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Section: Discussionmentioning

confidence: 58%

Surgical treatment of childhood hepatoblastoma in the Netherlands (1990–2013)

et al. 2016

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“…To cure hepatoblastoma patients, it is very important to extirpate all of the disease lesions [1,2], including the chemotherapy-resistant metastatic lesions [3][4][5][6]. We have undertaken a program to thoroughly extirpate hepatoblastoma metastatic lesions since 2009.…”

Section: Discussionmentioning

confidence: 99%

“…To maintain a high possibility of survival, complete surgical resection is essential [2], including chemotherapy-resistant metastatic lesion resection [3][4][5][6]. To find small pulmonary metastatic lesions, we have previously relied on sight and finger palpitation, but this relies upon the surgeon's ability.…”

Section: Introductionmentioning

confidence: 99%

Navigation using indocyanine green fluorescence imaging for hepatoblastoma pulmonary metastases surgery

et al. 2015

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To achieve precise and sensitive detection of chemotherapy-resistant hepatoblastoma pulmonary metastases, we performed surgery using indocyanine green (ICG) fluorescence imaging navigation. Lung metastasectomies were performed in 10 patients aged from 1 to 11 years. ICG (0.5 mg/kg) was injected intravenously 24 h before the operation. After a thoracotomy had been performed, a 760-nm infrared ray was applied to the lung using a generator and the 830-nm evoked fluorescence was collected and visualized on a real-time display. In total, 250 fluorescence-positive lesions were extirpated in 37 operations. All of the pathologically positive lesions were clearly fluorescence positive. The diameter of the smallest detectable lesion was 0.062 mm. In two patients, there were 29 extirpated lesions that were pathologically proven not to be hepatoblastoma metastases. Although a problem of false positive remains, this method is very useful for the detection of small pulmonary metastases.

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“…Metastasectomy is necessary when residual disease remains in the lungs. Meyers et al [27] reported on 38 patients presented with hepatoblastoma and pulmonary metastasis. Eight of nine of the patients who underwent thoracotomy and pulmonary metastasectomy experience long-term survival.…”

Section: Discussionmentioning

confidence: 99%

“…In our series, two patients with HB who presented with lung metastases were downstaged by neoadjuvant chemotherapy or metastasectomy. Patients with metastatic disease at diagnosis can still be considered for liver transplantation in cases of complete regression of these lesions after chemotherapy or surgical resection, while the primary tumor remains unresectable [17,21,23,25,27,29]. It has been emphasized that complete eradication of metastatic disease is a paramount prerequisite for transplantation [30].…”

Section: Discussionmentioning

confidence: 99%