Survival after liver transplantation for hepatoblastoma: a 2-center experience
Section snippets
Materials and methods
All patients who were transplanted for unresectable hepatoblastoma at 2 different institutions between the years of 1990 and 2004 were included in this analysis. A retrospective review of their records was performed. The variables that were analyzed included age, sex, previous tumor resection, pretransplantation α-fetoprotein (AFP) response to chemotherapy, metastatic disease at diagnosis, histological vascular invasion, tumor histology, and administration of posttransplantation chemotherapy. α
Results
Fourteen patients received 15 transplants for hepatoblastoma. One was retransplanted for hepatic artery thrombosis 10 days after the first transplant. All patients received neoadjuvant chemotherapy, and 5 (36%) received adjuvant chemotherapy after the transplant. Table 1 outlines the agents received, the number of cycles, and the PRETEXT staging before transplantation. After diagnosis, each child completed at least 2 cycles of neoadjuvant chemotherapy before being considered for transplantation
Discussion
It is possible in most children with hepatoblastoma to completely resect the tumor without transplantation. However, even with aggressive contemporary chemotherapy, a small but significant number of patients, because of location or size or multicentricity of the tumor, can only have the tumor adequately excised by a complete hepatectomy For these children, LT offers the only hope for cure. Liver transplantation is indicated for children whose tumors cannot be resected without leaving them with
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