OBJECTIVE@#To summarize and analyze the
treatment process, long-term
efficacy and clinical
economics of
children's
hepatoblastoma (HB) in multi-disciplinary team (MDT) mode, so as to provide basis for the rational choice of
diagnosis and
treatment.@*
METHODS@#From January 2014 to February 2019, 13 cases of
hepatoblastoma in
children who completed the whole
treatment course in the Pediatric
Hematology Tumor Ward of
Peking University First
Hospital were collected and analyzed, and were followed up until June 30, 2020. There were 9
males and 4
females who were diagnosed and treated according to the MDT process in the
hospital. The median age was 16 months (2-54 months), 69.23% (9/13) were under 2 years old. The characteristics,
diagnosis and
treatment process and
treatment effect of the cases were summarized, and the
cost of clinical
treatment was analyzed.@*RESULTS@#According to the pretreatment extent of
disease(PRETEXT), there were 1, 9 and 3
children with stages Ⅱ, Ⅲ and Ⅳ. 76.92% (10/13) of the
patients had the largest
tumor diameter > 10 cm. All the
patients received preoperative
neoadjuvant chemotherapy (8
patients received 4 cycles of
chemotherapy, and 6
patients changed the
chemotherapy plan), surgical
treatment and postoperative
chemotherapy, the
tumor volume decreased by more than 50% (64%-95%) in 12 cases, except 1 case with no significant increase of alpha fetal
protein and multiple lesions.The median
length of stay was 87 days (68-214 days), the median
cost of stay was 200 000 yuan (115 000-500 000 yuan), the median
length of stay was 7 days (5-17 days), the median
cost of stay was 20 000 yuan (15 000-60 000 yuan), and the
incidence of
postoperative complications was 7.69% (1/13). All the
patients were followed up for 16-69 months. All the
patients survived.@*CONCLUSION@#Under the MDT mode, the
treatment is seamless connection, the long-term
prognosis of
children with HB is good, and the total
hospitalization cost and
time are within the acceptable range. Standard preoperative
neoadjuvant chemotherapy can significantly reduce the
tumor, improve the resection rate, reduce
postoperative complications, reduce the total individual
expenditure, shorten the total
hospital stay, and further improve the long-term
disease-free survival rate.