Hepatoblastoma: Transplantation for unresectable disease

Anton I. Skaro, Riccardo A Superina*

*Corresponding author for this work

Research output: Contribution to journalReview article

Abstract

PURPOSE OF REVIEW: Hepatoblastoma is the commonest primary liver tumor in children and may pose a significant treatment dilemma. Determination of the resectability can be challenging. For those tumors deemed unresectable, liver transplantation now offers real hope for cure. RECENT FINDINGS: Modern chemotherapy has improved long-term survival, but complete resection of the tumor is still essential for cure. Liver transplantation, as a primary surgical intervention, has emerged as a viable treatment option for unresectable hepatoblastoma, rivaling the results obtained after resection of lesser stage lesions. In contrast, rescue transplantation for disease relapse after partial hepatectomy has been associated with less favorable long-term results. Pretransplant chemotherapy given to reduce tumor bulk in hopes of making a tumor resectable should be limited so that posttransplant chemotherapy can be given if possible. SUMMARY: Posttransplant chemotherapy should be entertained in all children undergoing transplantation. The treatment of patients with central lesions adjacent to the main hepatic/portal veins, or multifocal and solitary tumors involving all four sectors should be undertaken in a transplant center. The choice of resection versus transplantation may not always be obvious and the decision should be made by an experienced team taking into consideration all factors in order to obtain the best chance for cure.

Original languageEnglish (US)
Pages (from-to)521-527
Number of pages7
JournalCurrent Opinion in Organ Transplantation
Volume11
Issue number5
DOIs
StatePublished - Oct 1 2006

Keywords

  • Chemotherapy
  • Hepatoblastoma
  • Liver transplantation
  • Resection

ASJC Scopus subject areas

  • Immunology and Allergy

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