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

Busweiler, Linde A. D.; Wijnen, Marc H. W. A.; Wilde, Jim C. H.; Sieders, Egbert; Scheltinga, Sheila E J Terwisscha van; Heurn, L. W. Ernest van; Ziros, Joseph; Bakx, Roel; Heij, Hugo A.

doi:10.1007/s00383-016-3989-8

Cited by 34 publications

(34 citation statements)

References 37 publications

(52 reference statements)

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“…There were no complications requiring reoperation either. However, this rate was around 10% in the literature [18]. This difference may be explained due to the low number of patients in our study.…”

Section: Discussioncontrasting

confidence: 60%

Hepatoblastoma experience in terms of surgery

et al. 2020

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Introduction: Although hepatoblastoma is a rare tumor, it is the most common abdominal malignant tumor after nephroblastoma and neuroblastoma in children under 3 years of age. In addition, 95% of primary liver tumors in children are hepatoblastoma. In this study, we aimed to present the patients with hepatoblastoma who had undergone surgery. Materials and Methods: Patients who were operated for hepatoblastoma in the last 10 years at Çukurova University Hospital were included in the study. Age, gender, complaints, blood Alpha Feto Protein (AFP) levels, whether or not neoadjuvant chemotherapy, size, stage, surgical findings, the presence of distant metastasis, post-operative complication, follow-up, and mortality were evaluated. Results: We operated on 22 patients with hepatoblastoma in the last 10 years. We have access to 17 patients’ data. The mean age of the patients was 22.4 years (4 months - 8 years). 88% of the patients were younger than 5 years old and 76% were younger than 3 years of age. Seven patients were male and 10 were female. Fourteen patients presented with abdominal distention and swelling. One was admitted to the hospital with weight loss, one with diarrhea and one with fever. In the first evaluation, 8 patients were stage 2 and 9 patients were stage 3 according to PRETEXT staging. We did not have stage 1 or 4 patients. Two patients had a tumor in the caudate lobe. AFP levels were high in 16 patients. The mean size of the mass was 11.5 cm in the first evaluation. The tru-cut biopsy was performed all the patients before taking neo-adjuvant chemotherapy. Thereafter, the patients underwent surgery. One patient was undergoing surgery for trans-arterial chemo-embolization (TACE) due to the fact that the tumor could not be excised after chemotherapy, and after TACE, the tumor was able to totally removed. In one patient, the surgical margin was excised positively due to the invasion of the vena cava. Two patients had portal vein thrombus and one was excised during surgery. Seven patients had right, 3 patients had right expanded, 3 patients had left expanded, 1 patient had segment 6-7 and 3 patients had left hepatectomy. The distant metastasis was in 2 patients (lungs). Mortality was in 1 patient. Conclusion: Multidisciplinary approach is very important in hepatoblastoma and other malignant masses. Not only pediatric oncology but also alternative treatment options such as trans-arterial chemotherapy should be evaluated.

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Section: Discussioncontrasting

confidence: 60%

Hepatoblastoma experience in terms of surgery

et al. 2020

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“…In comparison, Busweiler and his colleagues reported 8% infection rate with reoperation on two occasions. Also, they reported vascular complications in 3% of their cases in the form of Budd Chiari Syndrome in one patient and thrombosis of the portal and left hepatic veins in another case [9].…”

Section: Discussionmentioning

confidence: 99%

“…In comparison, intraoperative blood loss was less than 500 ml in all our cases. In a study published in 2017 [9], Busweiler and his colleagues reported blood transfusion in 45% of 73 patients underwent partial hepatectomy. In our series, 18.5% of our patients received blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

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Hepatic resection in children: highlighted and revisited steps

Abdel-Kader

Abdel-Latif

Abdel-Sattar

et al. 2019

Egypt Pediatric Association Gaz

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Background: Hepatectomy in children deserves exhaustive preoperative and intraoperative tools to define the anatomy, minimize blood loss, and confirm adequacy of liver tissue left. The aim of this study is to report our experience in surgical management of liver tumors. Results: All liver resections performed in Ain-Shams University Hospital, by the same team, between July 2013 and June 2018 were retrospectively reviewed. Data related to basic demographics, indication for resection, methods of parenchymal resection, blood loss, hospital stay, morbidity, and mortality was collected. The study included 27 patients who underwent different types of hepatectomies. There was a male predominance. Age ranged from 6 months to 13 years. Weight ranged from 5.7 to 33.7 kg. Total operative time ranged from 68 to 322 min, while resection time ranged from 34 to 144 min. Blood loss ranged from 53 to 259 ml. Surgical morbidities included five patients with minor biliary leak, three patients had surgical site infection, and one patient had torsion of the remnant liver necessitating repositioning. Recurrence of the mass was faced in three patients with hepatoblastoma. There were two mortalities; one occurred as a sequela of massive intraoperative bleeding and the other took place due to postoperative hepatic insufficiency. Conclusion: For a safe hepatectomy, thorough familiarity of the hepatic segmental anatomy together with the various techniques for parenchymal resection and vascular control is fundamental. Complications such as biliary leak and torsion of remnant can be easily avoided by simple measures.

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“…1 The 5 year overall survival (OS) rate has significantly improved from 35% to 83% over the last four decades due to advances in chemotherapy and surgery, 2,3 but children with metastatic HB at presentation still suffer from an event-free survival (EFS) rate of 20%-76%. [4][5][6] In efforts to increase the survival rate of children with HB that present with lung metastases, the Children's Hepatic Tumors International Collaboration (CHIC) singled out metastatic disease (M) as a separate risk factor compared to hepatic veins (V), portal veins (P), contiguous extrahepatic (E), multifocal (F) and rupture (R), while they were creating a unified global approach to risk stratification of HB. 7 Almost 70% of the children in metastatic HB who succumbed to their disease had never had their lungs cleared, which seems to be the main reason for their poor outcomes.…”

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confidence: 99%

Novel treatment of refractory / recurrent pulmonary hepatoblastoma

Zhang

Chang

Yao

et al. 2020

Pediatrics International

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Background There is no consensus about how to manage pulmonary metastasis in patients with hepatoblastoma. We reviewed a treatment with a combination of oxaliplatin, vincristine, and topotecan (OVT) paired with radiofrequency ablation (RFA) of 12 patients with multiple refractory / recurrent pulmonary hepatoblastoma. Methods The medical records from patients with ≤21 years of age presenting with multiple deposits (≥2) of refractory / recurrent pulmonary hepatoblastoma were reviewed. The following data were extracted from each patient: age, gender, histological subtyping, cycles of OVT, tumor size, biomarkers, chemotherapy regimen and dosage, RFA details, treatment response, follow up, and patient outcomes. The primary outcome measure was the complete response (CR) of pulmonary diseases, and secondary outcomes were event‐free survival rate and overall survival rate. Results Of 12 assessable patients, three (25%) (95% CI, 46.3–104) patients achieved PR (partial resopnse) after they finished OVT. After RFA, five (41.7%) (95% CI, 8.95–74.4) patients achieved CR (complete response). The 2 year event‐free survival rate was 33% (95% CI, 20.5–64.6). The 2 year overall survival for the study group was 41.7% (95% CI, 8.9–74.4). All toxicity events were handled satisfactorily and no toxic related deaths were observed. Conclusions Our review report shows that OVT combined with RFA can be a successful treatment modality for previously heavily treated refractory / recurrent pulmonary metastatic lesions from hepatoblastoma.

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

Cited by 34 publications

References 37 publications

Hepatoblastoma experience in terms of surgery

Hepatoblastoma experience in terms of surgery

Hepatic resection in children: highlighted and revisited steps

Novel treatment of refractory / recurrent pulmonary hepatoblastoma

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