title: Surgical treatment of childhood hepatoblastoma in the Netherlands (1990-2013).
abstract: BACKGROUND
  Achievement of complete surgical resection plays a key role in the successful treatment of children with hepatoblastoma. The aim of this study is to assess the surgical outcomes after partial liver resections for hepatoblastoma, focusing on postoperative complications, resection margins, 30-day mortality, and long-term survival.
  
  
  METHODS
  Chart reviews were carried out on all patients treated for hepatoblastoma in the Netherlands between 1990 and 2013.
  
  
  RESULTS
  A total of 103 patients were included, of whom 94 underwent surgery. Partial hepatectomy was performed in 76 patients and 18 patients received a liver transplant as a primary procedure. In 42 of 73 (58 %) patients, one or more complications were reported. In 3 patients, information regarding complications was not available. Hemorrhage necessitating blood transfusion occurred in 33 (45 %) patients and 9 (12 %) patients developed biliary complications, of whom 8 needed one or more additional surgical interventions. Overall, 5-year disease-specific survival was 82, 92 % in the group of patients who underwent partial hepatectomy, and 77 % in the group of patients who underwent liver transplantation.
  
  
  CONCLUSIONS
  Partial hepatectomy after chemotherapy in children with hepatoblastoma offers good chances of survival. This type of major surgery is associated with a high rate of surgical complications (58 %), which is not detrimental to survival.
authors.affiliation: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital-Academic Medical Center and VU Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands. l.a.d.busweiler@lumc.nl.
authors.forename: Linde A D
authors.initials: LA
authors.lastname: Busweiler
authors.affiliation: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital-Academic Medical Center and VU Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.|Department of Pediatric Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Marc H W A
authors.initials: MH
authors.lastname: Wijnen
authors.affiliation: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital-Academic Medical Center and VU Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.|Department of Pediatric Surgery, University Hospital, Geneva, Switzerland.
authors.forename: Jim C H
authors.initials: JC
authors.lastname: Wilde
authors.affiliation: Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Egbert
authors.initials: E
authors.lastname: Sieders
authors.affiliation: Department of Pediatric Surgery, Sophia Children's Hospital-Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Sheila E J
authors.initials: SE
authors.lastname: Terwisscha van Scheltinga
authors.affiliation: Department of Pediatric Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: L W Ernest
authors.initials: LW
authors.lastname: van Heurn
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital-Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ziros
authors.affiliation: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital-Academic Medical Center and VU Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: Bakx
authors.affiliation: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital-Academic Medical Center and VU Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Heij
mesh_terms: D001706:Biopsy; D002675:Child, Preschool; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D018197:Hepatoblastoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D000072662:Margins of Excision; D009426:Netherlands / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Biliary complications; Hemorrhage; Hepatoblastoma; Partial hepatectomy; Postoperative complications