A study of therapy for pediatric hepatoblastoma: prevention and treatment of pulmonary metastasis.
Our results of treatment for pediatric hepatoblastoma are presented with special emphasis on pulmonary metastasis. The pulmonary metastasis rate of hepatoblastoma was 44% (11/25). In 19 patients with resected hepatoblastomas, the 5-year survival rate without pulmonary metastasis was 90% (9/10); while with pulmonary metastasis it was 22% (2/9). Six patients with unresected hepatoblastomas all died within 4 months regardless of chemotherapy and/or metastasis. To improve survival in patients with hepatoblastoma, preoperative or postoperative chemotherapy was thought to be essential for tumors extending over 2 hepatic segments and having predictable factors for pulmonary metastasis (large size or histological evidence of capsular invasion). A long-term multidisciplinary approach including hepatic lobectomy, current multiagent chemotherapy (including CDDP, THP-ADR), and partial pulmonary resection for localized lung areas with metastases would ultimately be needed.
Uchiyama
M
M
Department of Pediatric Surgery, Niigata University School of Medicine, Japan.
Iwafuchi
M
M
Naito
M
M
Yagi
M
M
Iinuma
Y
Y
Kanada
S
S
Tsukada
K
K
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D018197:Hepatoblastoma / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D010348:Patient Care Team; D011013:Pneumonectomy; D015996:Survival Rate