ABSTRACT
Background: The cornerstones of successful treatment of hepatoblastoma (HB) include preoperative chemotherapy followed by complete anatomical resection of tumor, followed by chemotherapy. Advances in chemotherapy in the last 2 decades have been associated with a higher rate of tumor response and possibly a greater potential for resectability. Aims: We analyzed our single center experience with neoadjuvant chemotherapy (NACT) and surgery in HBs. Settings and Design: Our study included all children with HBs who received NACT and underwent surgical excision from January 1997 to July 2004. Materials and Methods: Patient characteristics, clinical features, clinical course, treatment modalities, and long-term outcome were analyzed. Results: There were 9 boys and 3 girls, aged 5-60 months (median age at tumor diagnosis was 24 months). All received NACT containing cisplatin and doxorubicin. Of the 12 children, 9 underwent hepatectomy and among them, 4 patients each had right and left hepatectomy and 1 patient underwent right extended hepatectomy. After surgery, all patients completed rest of the chemotherapy course (total 6 cycles). R0 resection was carried out in all the 9 cases with no life-threatening complications. Conclusions: Our experience of the 9 cases, although less in number, reaffirms the advantages of NACT followed by surgery. The prognosis for patients with resectable tumors is fairly good in combination with chemotherapy.
Subject(s)
Academic Medical Centers , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Child, Preschool , Cisplatin/administration & dosage , Doxorubicin/administration & dosage , Female , Follow-Up Studies , Hepatectomy , Hepatoblastoma/diagnosis , Hepatoblastoma/pathology , Hepatoblastoma/physiopathology , Hepatoblastoma/therapy , Humans , Infant , Male , Neoadjuvant Therapy , Prognosis , Treatment OutcomeABSTRACT
El hepatoblastoma es el tumor hepático primario maligno más frecuente en el niño; en el adulto, es extremadamente raro y sólo 27 casos han sido descritos en la literatura. El pronóstico de esta neoplasia es malo debido a que habitualmente se descubre en forma tardía. La cirugía, la quimioterapia y el trasplante hepático han sido utilizados como tratamiento con malos resultados. Presentamos dos pacientes adultos a quienes se les diagnósticó hepatoblastoma epitelial. Se hace una revisión de su patogénesis, características clínicas, histológicas y manejo actual