PAPS paperSurgical strategies for unresectable hepatoblastomas☆
Section snippets
Patients and methods
All 29 patients treated for hepatoblastoma at the two institutions (Kyushu University Hospital and Kyoto Prefectural University of Medicine Hospital) from 1998 through 2011 were retrospectively reviewed. This study was performed according to the Ethical Guidelines for Clinical Research published by the Ministry of Health, Labor, and Welfare of Japan on July 30, 2003 (revised 2008) and complies with the Helsinki Declaration of 1964 (revised 2008).
The tumors were evaluated using state-of-the-art
Results
Table 1 shows a summary of the 12 cases with PRETEXT III or IV and M (−) hepatoblastomas treated based on the JPLT-2 regimen. Ten cases were PRETEXT III, and 2 cases were PRETEXT IV. Three cases underwent liver transplantation. One case had a primary liver transplantation due to POST-TEXT IV at surgery, while the other 2 cases underwent rescue liver transplantations. Two of the 10 cases with PRETEXT III showed a downstaging to POST-TEXT II at the initial operation. Five cases underwent
Discussion
The current Children's Oncology Group (COG) hepatoblastoma protocol (AHEP0731), determines tumor extent from computed tomography (CT) imaging using the PRETEXT system [10], which is now referred to as POST-TEXT for studies obtained after treatment with neoadjuvant chemotherapy. Children with POST-TEXT III or IV tumors are referred to the pediatric liver transplant center and extreme liver resection at diagnosis if possible and no later than just after the second cycle of chemotherapy. This
Acknowledgments
The English used in this manuscript was reviewed by Brian Quinn (Editor-in-Chief, Japan Medical Communication).
References (10)
- et al.
Improved survival outcome for hepatoblastoma based on an optimal chemotherapeutic regimen. A report from the study group for pediatric solid malignant tumors in the Kyushu area, Japan
J Pediatr Surg
(2004) - et al.
Outcome of hepatoblastoma treated with the JPLT-1 (Japanese Study Group for Pediatric Liver Tumor) Protocol-1: a report from the Japanese Study Group for Pediatric Liver Tumor
J Pediatr Surg
(2002) - et al.
Survival after liver transplantation for hepatoblastoma: a 2-center experience
J Pediatr Surg
(2008) - et al.
Pretreatment prognostic factors for children with hepatoblatoma––results from the International Society of Paediatric Oncology (SIOP) Study SIOPEL 1
Eur J Cancer
(2000) - et al.
Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/ continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the Children's Cancer Group and the Pediatric Oncology Group
J Clin Oncol
(2000)
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2019, Seminars in Pediatric SurgeryCitation Excerpt :This requires careful review of imaging with experienced radiologists. Tijiri et al.37 retrospectively reviewed 12 patients with PRETEXT III and IV lesions without metastastic disease. Of four patients with P2V3 disease, three downstaged over the course of neoadjuvant treatment (one patient after two cycles and two after four cycles), and one was transplanted for persistent significant vascular involvement.
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2019, Seminars in Pediatric SurgeryCitation Excerpt :Patients with unifocal PRETEXT IV may become POSTEXT III and be resected with an extended hepatectomy or a mesohepatectomy. See Meyers et al.,36 Meyers et al.,37 Tahiri et al.38 In some multifocal tumors with PRETEXT II or III, a major resection for the main tumor with non-anatomic resection of satellite lesions has been reported, see Qureshi.39 What is still not recommended is to consider a multifocal PRETEXT IV for a localized extended resection if there is radiographic clearance of satellite lesions, and liver transplantation is the current recommendation for such cases.
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The authors declare that they have no conflicts of interest.