Pre-operative diagnostic biopsy and surgery in paediatric liver tumours--the Amsterdam experience.
OBJECTIVE
To report 24 years of pre-treatment biopsy and surgical experience in primary liver tumours in children.


METHODS
Between 1979 and 2003, 53 children presented with a primary liver tumour of whom 48 who underwent surgical resection were evaluated (two died, two were unresectable, and one was transplanted). Biopsy data, per- and post-operative complications, mortality, and survival were retrospectively reviewed.


RESULTS
Benign tumours were diagnosed in eight patients. Surgical resection for a malignant tumour was performed in 40 patients (26 hepatoblastomas (HB), eight hepatocellular carcinomas (HCC) (four had fibrolamellar HCC), three rhabdomyosarcomas (RMS), one neuroblastoma, one non-hodgkin lymphoma (NHL), and one teratoma). Primary resection was performed in one HB, and four HCCs. The cumulative survival without evidence of disease was 73% for HB (median 7 years) and 88% for HCC (median 3.5 years).


CONCLUSIONS
The treatment results are comparable with those of larger international series except for HCC. The existing diagnostic pitfalls in differentiating between the various liver malignancies justify the use of a diagnostic biopsy.
Schnater
J M
JM
Pediatric Surgical Centre, Emma Children's Hospital AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Kuijper
C F
CF
Zsiros
J
J
Heij
H A
HA
Aronson
D C
DC
D000293:Adolescent; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006498:Hepatectomy; D018197:Hepatoblastoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D009426:Netherlands; D011300:Preoperative Care; D016019:Survival Analysis