Preoperative transcatheter arterial chemoembolization of hepatoblastoma in infants.
OBJECTIVE
To evaluate the effect of preoperative transcatheter arterial chemoembolization of hepatoblastoma in infants.


METHODS
Clinical data of 21 infants with hepatoblastoma treated between July 2008 and July 2012 in a single hospital were retrospectively analyzed. After preliminary diagnosis, surgical resection was performed in 9 infants (group I), and transcatheter arterial chemoembolization was performed in 12 infants (group II) before conventional resection. Surgical resection was performed when the tumor bulk appeared sufficiently reduced after transcatheter arterial chemoembolization alone or transcatheter arterial chemoembolization following chemotherapy in cases of pulmonary metastases.


RESULTS
Tumor shrinkage ranged from 25%-91% with a mean reduction of 69% (t = 3.816, P = .003) in group II. α-Fetoprotein levels were markedly decreased from 49%-99% with a mean level of 95% (t = 4.871, P = .000) in group II. Specimens in group II showed massive necrosis with a mean percentage of 72% with no significant treatment-related toxicity. In group II, the surgical time was significantly shorter (t = 3.438, P = .003), intraoperative blood loss was considerably less (t = 3.459, P = .003), and the weight of the resected liver was significantly less (t = 3.785, P = .001). Of 21 patients, 16 survived for 50 months without recurrence.


CONCLUSIONS
Transcatheter arterial chemoembolization effectively reduced tumor volume, decreased α-fetoprotein, and reduced intraoperative hemorrhage. It represents a safe and effective adjuvant bridge to successful surgery for hepatoblastoma in infants.
Department of Interventional Therapy and Vascular Anomalies, 9 Jinsui Road, Guangzhou City, Guangdong Province 510623, China.
Xiaoyun
X
Tan
Department of Interventional Therapy and Vascular Anomalies, 9 Jinsui Road, Guangzhou City, Guangdong Province 510623, China. Electronic address: fejr@foxmail.com.
Jing
J
Zhang
Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, 9 Jinsui Road, Guangzhou City, Guangdong Province 510623, China.
Zhe
Z
Wen
Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, 9 Jinsui Road, Guangzhou City, Guangdong Province 510623, China.
Yan
Y
Zou
Department of Interventional Therapy and Vascular Anomalies, 9 Jinsui Road, Guangzhou City, Guangdong Province 510623, China.
Gang
G
Shen
Department of Interventional Therapy and Vascular Anomalies, 9 Jinsui Road, Guangzhou City, Guangdong Province 510623, China.
Shaoyi
S
Zhou
Department of Interventional Therapy and Vascular Anomalies, 9 Jinsui Road, Guangzhou City, Guangdong Province 510623, China.
Haibo
H
Li
Department of Interventional Therapy and Vascular Anomalies, 9 Jinsui Road, Guangzhou City, Guangdong Province 510623, China.
Hua
H
Jiang
D016063:Blood Loss, Surgical; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D002675:Child, Preschool; D002681:China; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D018197:Hepatoblastoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D009336:Necrosis; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000401:mortality; D061646:Operative Time; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden