A study of therapy for pediatric hepatoblastoma: Prevention and treatment of pulmonary metastasis

Our results of treatment for pediatric hepatoblastoma are presented with sp ecial emphasis on pulmonary metastasis. The pulmonary metastasis rate of he patoblastoma was 44 % (11/25). In 19 patients with resected hepatoblastomas , the 5-year survival rate without pulmonary metastasis was 90 % (9/10); wh ile with pulmonary metastasis it was 22 % (2/9). Six patients with unresect ed hepatoblastomas all died within 4 months regardless of chemotherapy and/ or metastasis. To improve survival in patients with hepatoblastoma, preoper ative or postoperative chemotherapy was thought to be essential for tumors extending over 2 hepatic segments and having predictable factors for pulmon ary metastasis (large size or histological evidence of capsular invasion). A long-term multidisciplinary approach including hepatic lobectomy, current multiagent chemotherapy (including CDDP, THP-ADR), and partial pulmonary r esection for localized lung areas with metastases would ultimately be neede d.