The Role Of Surgical Treatment In The Multidisciplinary Therapy For Hepatoblastoma

Background/Aims: The aim of this study was to evaluate the clinico-patholigical features and effects of multi-disciplinary therapy for pediatric patients with hepatoblastoma (HB). Methodology: Ten cases who underwent hepatectomy from 1996 to 2013 were studied. Our therapeutic protocol included neoadjuvant chemotherapy (NAC) + hepatectomy + adjuvant chemotherapy (AC). The regimens were CDDP+THP-ADR (n=2), CITA (n=1), PLADO (n=5), and CDDP(n = 1). One case with 18-trisomy underwent only hepatectomy. Medical records were reviewed to evaluate characteristics, the effects of chemotherapy and prognosis. Results: The median age at operation was 1.2 years (male: 7 and female: 3). PRETEXT classification was assigned to groups I (n=2), II (n=4), and III (n=4). 15 years overall survival and disease-free survival rates were 100% and 80%, respectively. Two cases, who had post-operative lung metastasis, underwent chemotherapy with or without complete resection of lung tumors. No further recurrence was observed in these two cases. One case with 18-trisomy underwent right hepatectomy for PRETEXT II HB and is still doing well 67 months after hepatectomy. Conclusion: It was found that multidisciplinary therapy based on surgery, including complete resections of recurrent lesions, offers long-term survival, even for cases which develop recurrent metastatic tumors or cases complicated with 18 trisomy.