title: The Role Of Surgical Treatment In The Multidisciplinary Therapy For Hepatoblastoma.
abstract: OBJECTIVE
  The aim of this study was to evaluate the clinico-patholigical features and effects of multi-disciplinary therapy for pediatric patients with hepatoblastoma (HB).
  
  
  METHODS
  Ten cases who underwent hepatectomy from 1996 to 2013 were studied. Our therapeutic protocol included neoadjuvant chemotherapy (NAC) + hepatectomy + adjuvant chemotherapy (AC). The regimens were CDDP+THP-ADR (n = 2), CITA (n = 1), PLADO (n = 5), and CDDP(n = 1). One case with 18-trisomy underwent only hepatectomy. Medical records were reviewed to evaluate characteristics, the effects of chemotherapy and prognosis.
  
  
  RESULTS
  The median age at operation was 1.2 years (male: 7 and female: 3). PRETEXT classification was assigned to groups I (n = 2), II (n = 4), and III (n = 4). 15 years overall survival and disease-free survival rates were 100% and 80%, respectively. Two cases, who had post-operative lung metastasis, underwent chemotherapy with or without complete resection of lung tumors. No further recurrence was observed in these two cases. One case with 18 trisomy underwent right hepatectomy for PRETEXT II HB and is still doing well 67 months after hepatectomy.
  
  
  CONCLUSIONS
  It was found that multidisciplinary therapy based on surgery, including complete resections of recurrent lesions, offers long-term survival, even for cases which develop recurrent metastatic tumors or cases complicated with 18 trisomy.
authors.forename: Keigo
authors.initials: K
authors.lastname: Yada
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Sato
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D018197:Hepatoblastoma / Q000235:genetics / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy; D008297:Male; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014314:Trisomy / Q000235:genetics; D000073842:Trisomy 18 Syndrome