CHEMOTHERAPY EFFECTS ON HEPATOBLASTOMA - A HISTOLOGICAL STUDY

The histopathological features of hepatoblastoma in 17 patients treate d with preoperative chemotherapy were compared with those in 11 patien ts not subjected to chemotherapy during the same 11-year period. Tumor necrosis was more extensive in patients receiving preoperative chemot herapy. Two tumors, however, were apparently unaffected by chemotherap y. There was no obvious correlation between the extent of necrosis and the number of courses of chemotherapy. There also seems to be no evid ence of preferential ablation of a particular morphological type of tu mor. The most notable feature in cases treated with chemotherapy was t he extensive presence of osteoid. Osteoid was present in 36% of untrea ted cases, occupying < 5% of the surface area, compared with 82% in th e treated group. In seven cases, osteoid occupied > 40% of the surface area. This finding raises speculation about the role of chemotherapy in the maturation of tumors that have an inherent ability to different iate. A long-term study is needed to clarify the prognostic significan ce of mature heterologous elements in hepatoblastoma.