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New concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years

OBJECTIVE: The aim of this study was to summarize the experience of a tertiary center in treating hepatoblastoma for the last 21 years. PATIENTS AND METHODS: Fifty-eight cases were included. The tumor extent and prognosis were assessed using the PRETEXT system. The following data were analyzed: age...

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Autores principales: Tannuri, Ana Cristina Aoun, Cristofani, Lilian Maria, Teixeira, Roberto Augusto Plaza, Filho, Vicente Odone, Tannuri, Uenis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462574/
https://www.ncbi.nlm.nih.gov/pubmed/26106955
http://dx.doi.org/10.6061/clinics/2015(06)01
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author Tannuri, Ana Cristina Aoun
Cristofani, Lilian Maria
Teixeira, Roberto Augusto Plaza
Filho, Vicente Odone
Tannuri, Uenis
author_facet Tannuri, Ana Cristina Aoun
Cristofani, Lilian Maria
Teixeira, Roberto Augusto Plaza
Filho, Vicente Odone
Tannuri, Uenis
author_sort Tannuri, Ana Cristina Aoun
collection PubMed
description OBJECTIVE: The aim of this study was to summarize the experience of a tertiary center in treating hepatoblastoma for the last 21 years. PATIENTS AND METHODS: Fifty-eight cases were included. The tumor extent and prognosis were assessed using the PRETEXT system. The following data were analyzed: age at diagnosis, comorbidities, prematurity, treatment modalities, histopathological findings, surgical details and complications, treatment outcomes, chemotherapy schedules, side effects and complications. Treatment outcomes included the occurrence of local or distant recurrence, the duration of survival and the cause of death. The investigation methods were ultrasonography, CT scan, serum alpha-fetoprotein level measurement and needle biopsy. Chemotherapy was then planned, and the resectability of the tumor was reevaluated via another CT scan. RESULTS: The mean numbers of neoadjuvant cycles and postoperative cycles of chemotherapy were 6±2 and 1.5±1.7, respectively. All children except one were submitted for surgical resection, including 50 partial liver resections and 7 liver transplantations. Statistical comparisons demonstrated that long-term survival was associated with the absence of metastasis (p=0.04) and the type of surgery (resection resulted in a better outcome than transplantation) (p=0.009). No associations were found between vascular invasion, incomplete resection, histological subtype, multicentricity and survival. The overall 5-year survival rate of the operated cases was 87.7%. CONCLUSION: In conclusion, the experience of a Brazilian tertiary center in the management of hepatoblastoma in children demonstrates that long survival is associated with the absence of metastasis and the type of surgery. A multidisciplinary treatment involving chemotherapy, surgical resection and liver transplantation (including transplantations using tissue from living donors) led to good outcomes and survival indexes.
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spelling pubmed-44625742015-06-26 New concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years Tannuri, Ana Cristina Aoun Cristofani, Lilian Maria Teixeira, Roberto Augusto Plaza Filho, Vicente Odone Tannuri, Uenis Clinics (Sao Paulo) Clinical Science OBJECTIVE: The aim of this study was to summarize the experience of a tertiary center in treating hepatoblastoma for the last 21 years. PATIENTS AND METHODS: Fifty-eight cases were included. The tumor extent and prognosis were assessed using the PRETEXT system. The following data were analyzed: age at diagnosis, comorbidities, prematurity, treatment modalities, histopathological findings, surgical details and complications, treatment outcomes, chemotherapy schedules, side effects and complications. Treatment outcomes included the occurrence of local or distant recurrence, the duration of survival and the cause of death. The investigation methods were ultrasonography, CT scan, serum alpha-fetoprotein level measurement and needle biopsy. Chemotherapy was then planned, and the resectability of the tumor was reevaluated via another CT scan. RESULTS: The mean numbers of neoadjuvant cycles and postoperative cycles of chemotherapy were 6±2 and 1.5±1.7, respectively. All children except one were submitted for surgical resection, including 50 partial liver resections and 7 liver transplantations. Statistical comparisons demonstrated that long-term survival was associated with the absence of metastasis (p=0.04) and the type of surgery (resection resulted in a better outcome than transplantation) (p=0.009). No associations were found between vascular invasion, incomplete resection, histological subtype, multicentricity and survival. The overall 5-year survival rate of the operated cases was 87.7%. CONCLUSION: In conclusion, the experience of a Brazilian tertiary center in the management of hepatoblastoma in children demonstrates that long survival is associated with the absence of metastasis and the type of surgery. A multidisciplinary treatment involving chemotherapy, surgical resection and liver transplantation (including transplantations using tissue from living donors) led to good outcomes and survival indexes. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2015-06 2015-06 /pmc/articles/PMC4462574/ /pubmed/26106955 http://dx.doi.org/10.6061/clinics/2015(06)01 Text en Copyright © 2015 Clinics http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Science
Tannuri, Ana Cristina Aoun
Cristofani, Lilian Maria
Teixeira, Roberto Augusto Plaza
Filho, Vicente Odone
Tannuri, Uenis
New concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years
title New concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years
title_full New concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years
title_fullStr New concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years
title_full_unstemmed New concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years
title_short New concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years
title_sort new concepts and outcomes for children with hepatoblastoma based on the experience of a tertiary center over the last 21 years
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462574/
https://www.ncbi.nlm.nih.gov/pubmed/26106955
http://dx.doi.org/10.6061/clinics/2015(06)01
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