Surgical resection and chemotherapy improve survival rate for patients with hepatoblastoma

Background: The authors reviewed retrospectively their experience in 30 chi ldren with hepatoblastoma (HB), Despite an increased trend in the incidence of HB during the last 2 decades, an encouraging cure rate has been achieve d with complete resection of the tu mor a nd chemotherapy before or after s urgery with cisplatin plus doxorubicin (Adriamycin) or cisplatin plus vincr istine plus 5-Fluorouracil. Results: There were 10 female and 20 male patients. For the period from 196 3 to 1980 there were 8 patients, and for the period from 1981 to 1998 there were 22 patients. Their mean age at surgery was 16 months (range, 3.5 mont hs to 5.5 years). Tumors were localized to the right lobe in 10 (42%), to t he left lobe in 7 (29%), and in both lobes in 7 (29%) of the resected patie nts. Tumors were greater than 10 cm in size in 16 (67%) of these patients, Twenty-four patients (80%), underwent liver resection before or after chemo therapy. One patient (3%) with an unresectable tumor received chemotherapy and a liver transplant. In 5 patients (17%) the hepatic involvement was too extensive for resection. The types of resection performed were right lobec tomy in 7, left lobectomy in 6, right trisegmentectomy in 8, left trisegmen tectomy in 2, and middle hepatectomy in 1. The overall survival rate for 35 years of the study was 60% (18 of 30). With the association of surgery and chemotherapy (1981 through 1998) survival rate is 82% (14 of 17). Overall median follow-up in our study is 8 years (range, 2.5 to 24 years). Conclusions: There has been a dramatic improvement in the results of treatm ent of hepatoblastoma. Formerly, only 25% to 30% of patients were cured, wh ereas today, with combination of chemotherapy and surgery, 75% to 80% may b e cured. J Pediatr Surg 36:755-759. Copyright (C) 2001 by W.B. Saunders Com pany.