title: Efficacy of neoadjuvant therapy and surgical rescue for locally advanced hepatoblastomas: 10 year single-center experience and literature review.
abstract: OBJECTIVE
  To report our experience with long-term outcomes after multimodal management therapy.
  
  
  METHODS
  An observational retrospective study was performed containing seven patients with hepatoblastoma (Hbl) treated in our institution, a tertiary referral center, from 2003 to 2011. Demographic, preoperative, surgical, and outcome variables were collected. A survival analysis and a review of the current literature related to combination neoadjuvant chemotherapy and surgical resection on Hbl were performed.
  
  
  RESULTS
  The median age at surgery was 14.4 mo, with a male to female ratio of 4:3. Pretext staging at diagnosis was as follows: stage I, 4 cases; stage II, 2 patients; and stage III, 1 case. Mean pretreatment tumor volume was 735 cm(3). Five out of seven patients received neoadjuvant chemotherapy according to SIOPEL-3 or SIOPEL-6 protocols. Tumor volume and alpha-fetoprotein levels significantly dropped after neoadjuvant therapy. Surgical procedures performed included hemihepatectomies, segmentectomies and atypical resection. All patients received chemotherapy after surgery. Median postoperative hospital stay was 8 d. All patients were alive and disease-free after a median follow-up period of 23 mo. With regards to the literature review, seventeen articles were found that were related to our search.
  
  
  CONCLUSIONS
  Our series shows how multimodal management of Hbl, exhaustive control and a meticulous surgical approach leads to almost 100% complete resection with optimal postoperative results.
authors.affiliation: Dolores Ayllon Teran, Rubén Ciria Bru, Antonio Luque Molina, Pedro López Cillero, Javier Briceño Delgado, Department of Surgery, Reina Sofia Hospital, 14005 Córdoba, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Ayllon Teran
authors.affiliation: Dolores Ayllon Teran, Rubén Ciria Bru, Antonio Luque Molina, Pedro López Cillero, Javier Briceño Delgado, Department of Surgery, Reina Sofia Hospital, 14005 Córdoba, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Gómez Beltran
authors.affiliation: Dolores Ayllon Teran, Rubén Ciria Bru, Antonio Luque Molina, Pedro López Cillero, Javier Briceño Delgado, Department of Surgery, Reina Sofia Hospital, 14005 Córdoba, Spain.
authors.forename: Rubén
authors.initials: R
authors.lastname: Ciria Bru
authors.affiliation: Dolores Ayllon Teran, Rubén Ciria Bru, Antonio Luque Molina, Pedro López Cillero, Javier Briceño Delgado, Department of Surgery, Reina Sofia Hospital, 14005 Córdoba, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Mateos González
authors.affiliation: Dolores Ayllon Teran, Rubén Ciria Bru, Antonio Luque Molina, Pedro López Cillero, Javier Briceño Delgado, Department of Surgery, Reina Sofia Hospital, 14005 Córdoba, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Peña Rosa
authors.affiliation: Dolores Ayllon Teran, Rubén Ciria Bru, Antonio Luque Molina, Pedro López Cillero, Javier Briceño Delgado, Department of Surgery, Reina Sofia Hospital, 14005 Córdoba, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Luque Molina
authors.affiliation: Dolores Ayllon Teran, Rubén Ciria Bru, Antonio Luque Molina, Pedro López Cillero, Javier Briceño Delgado, Department of Surgery, Reina Sofia Hospital, 14005 Córdoba, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: López Cillero
authors.affiliation: Dolores Ayllon Teran, Rubén Ciria Bru, Antonio Luque Molina, Pedro López Cillero, Javier Briceño Delgado, Department of Surgery, Reina Sofia Hospital, 14005 Córdoba, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Briceño Delgado
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D018197:Hepatoblastoma / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000401:mortality; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013030:Spain; D062606:Tertiary Care Centers; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D000509:alpha-Fetoproteins
keywords: Chemotherapy; Liver surgery; Liver tumors; Multimodal management
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