title: Surgery for hepatoblastoma: from laparoscopic resection to liver transplantation.
abstract: OBJECTIVE
  Introduction of liver transplantation and the application of minimally invasive surgery for selected hepatoblastoma patients made a tailored surgical approach possible according to the tumor status.
  
  
  METHODS
  We retrospectively evaluated clinical outcomes of 38 pediatric patients with pathologically proven hepatoblastoma who underwent surgery at our institute between 1991 and 2009. Especially, we evaluated recent changes in clinical outcomes since the commencement of liver transplantations and laparoscopic resections for hepatoblastoma patients from 2007.
  
  
  RESULTS
  Complete hepatic tumor resections including 5 liver transplantations were performed in all patients, with 5-year overall survival and event free survival rates of 74.8% and 73.8%, respectively. From 2007, we performed 5 liver transplantations for unresectable cases. No tumor recurrences occurred in any case after a 19.9 (14.5-35.6) months median follow-up period. Totally laparoscopic partial hepatectomies were performed (2 cases) for selected patients. Both cases showed early recovery without any complications and were free of disease recurrence after 8.1 and 19.3 months follow-up period.
  
  
  CONCLUSIONS
  Though long term follow-up data is necessary for validation, we suggest that an individualized surgical strategy based on the accurate evaluation of the tumor extent might improve the clinical outcomes of patients with hepatoblastoma.
authors.affiliation: Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Taehoon
authors.initials: T
authors.lastname: Kim
authors.forename: Dae-Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Min Jeng
authors.initials: MJ
authors.lastname: Cho
authors.forename: Seong-Chul
authors.initials: SC
authors.lastname: Kim
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Seo
authors.forename: In-Koo
authors.initials: IK
authors.lastname: Kim
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006498:Hepatectomy; D018197:Hepatoblastoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies