title: Mortality and morbidity in primarily resected hepatoblastomas in Japan: Experience of the JPLT (Japanese Study Group for Pediatric Liver Tumor) trials.
abstract: BACKGROUND
  In the Japanese Study Group for Pediatric Liver Tumor (JPLT) protocols (JPLT-1 and 2) for evaluating the cure rate of risk-stratified hepatoblastoma, primary resection was permitted in PRETEXT I and II cases, followed by postoperative chemotherapy.
  
  
  METHODS
  In approximately 500 enrolled cases, resection was performed as the initial treatment in 60 cases, including all 18 PRETEXT I, 30 PRETEXT II, and 12 ruptured cases. The clinical features, surgical procedures, complications, and survival rates were compared in these three groups.
  
  
  RESULTS
  All 18 PRETEXT I cases underwent complete resection by lobectomy or segmentectomy (n=14) or nonanatomical partial hepatectomy (NPH) (n=4). The 30 PRETEXT II cases underwent primary resection by right or left lobectomy (n=16), NPH (n=10), or other procedures (n=4). Of these 30 cases, operational death occurred in 1 newborn, and recurrence occurred in 7 cases (14.6%), including 6 NPH cases and 4 older cases (aged >3years). Of the 12 ruptured cases, 7 (58.3%) showed recurrence. Event-free survival rates at 5years in the 3 groups were 88%, 70%, and 32%, respectively.
  
  
  CONCLUSIONS
  Primary resection for PRETEXT I or II HB cases should be performed by anatomical resection according to strict surgical guidelines. More intensified chemotherapy is required for primary resected cases whose tumors have ruptured.
authors.affiliation: Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima 734-8551 Japan; Japanese Study Group for Pediatric Liver Tumor. Electronic address: eiso@hiroshima-u.ac.jp.
authors.forename: Eiso
authors.initials: E
authors.lastname: Hiyama
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Tomoro
authors.initials: T
authors.lastname: Hishiki
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Kohmei
authors.initials: K
authors.lastname: Ida
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yano
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Oue
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Iehara
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Ken
authors.initials: K
authors.lastname: Hoshino
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Koh
authors.affiliation: Japanese Study Group for Pediatric Liver Tumor.
authors.forename: Yukichi
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima 734-8551 Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Kurihara
authors.affiliation: Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima 734-8551 Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima 734-8551 Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Onitake
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D018197:Hepatoblastoma / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Complication; Hepatoblastoma; Primary resection, survival; Prognosis