title: Treatment of hepatoblastoma: less extensive hepatectomy after effective preoperative chemotherapy with cisplatin and adriamycin.
abstract: BACKGROUND
  Although the prognosis of hepatoblastoma was improved by the introduction of cisplatin and doxorubicin (Adriamycin) for adjuvant chemotherapy, extensive hepatectomy continues to be the usual practice. We retrospectively reviewed our recent experience with hepatoblastoma to determine whether the new modality of intensive chemotherapy could change the resectability, extent of hepatectomy, operative complications, and prognosis.
  
  
  METHODS
  The clinical features of 15 children with hepatoblastoma treated between 1985 and 1995 were reviewed. Intensive chemotherapy was added before surgical resection not only when a tumor was unresectable but also when it was large enough to increase the risk of operative morbidity.
  
  
  RESULTS
  There was 100% resectability, and the overall mortality rate was only 6.7%. Fourteen patients have been free of disease for 2 to 12 years. Preoperative chemotherapy enabled resection of six previously unresectable hepatoblastomas. Moreover, hepatic resection tended to be less invasive in several patients whose tumors had been much reduced after preoperative chemotherapy. Intraoperative and postoperative complications were minimal, with a short operative time and small amount of blood loss, especially in the group with delayed primary operation.
  
  
  CONCLUSIONS
  The preoperative administration of cisplatin and Adriamycin reduced the tumor size so that a safe hepatectomy could be performed with less blood loss and minimal technical complications. Unnecessary sacrifice of the normal hepatic tissue was avoided by performing the less extensive hepatectomy.
authors.affiliation: Department of Pediatric Surgery, Nagoya University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Seo
authors.forename: H
authors.initials: H
authors.lastname: Ando
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Harada
authors.forename: F
authors.initials: F
authors.lastname: Ito
authors.forename: K
authors.initials: K
authors.lastname: Kaneko
authors.forename: K
authors.initials: K
authors.lastname: Horibe
authors.forename: T
authors.initials: T
authors.lastname: Sugito
authors.forename: T
authors.initials: T
authors.lastname: Ito
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D018197:Hepatoblastoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins; D004317:Doxorubicin; D002945:Cisplatin