Successful nontransplant resection of POST-TEXT III and IV hepatoblastoma

Timothy B Lautz, Tamar Ben-Ami, Niramol Tantemsapya, Yasmin C Gosiengfiao, Riccardo A Superina

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

BACKGROUND: Liver transplantation is increasingly advocated as primary surgical therapy for children with hepatoblastoma involving 3 or 4 sectors of the liver after neoadjuvant chemotherapy. This study evaluated the results of nontransplant hepatectomy in children who might otherwise have been considered for liver transplantation. METHODS: All children who underwent resection at a single institution from 1998 to 2009 for POST-TEXT IV or centrally located POST-TEXT III hepatoblastoma after neoadjuvant chemotherapy were reviewed. RESULTS: Fourteen children (7 boys) with a median age of 8 months at diagnosis met study criteria. Pulmonary metastases in 3 patients were resected in 2 and resolved with chemotherapy in 1 patient. Preoperative grouping after neoadjuvant chemotherapy was POST-TEXT IV in 3 patients and POST-TEXT III in 11 patients. Thirteen of 14 (93%) children who underwent aggressive resection despite being potential candidates for primary transplantation were alive and tumor-free with a median follow-up of 57 months. Observed survival rates at 1, 2, and 5 years were 93%, 91%, and 88% respectively. Event-free survival rates at 1, 2, and 5 years were 93%, 91%, and 75%, respectively. CONCLUSIONS: Excellent survival (93%) was obtained with aggressive resection in children with POST-TEXT III and IV hepatoblastoma meeting criteria for transplant referral. The 1 death occurred in a patient with unfavorable small cell histology. These children should be managed at institutions experienced in both advanced pediatric hepatobiliary surgery and transplantation. Operative exploration was frequently required to ultimately determine which tumors can be resected and which require transplantation. Cancer 2011;117:1976-83.

Original languageEnglish (US)
Pages (from-to)1976-1983
Number of pages8
JournalCancer
Volume117
Issue number9
DOIs
StatePublished - May 1 2011

Fingerprint

Hepatoblastoma
Drug Therapy
Transplantation
Liver Transplantation
Survival Rate
Neoplasms
Hepatectomy
Disease-Free Survival
Histology
Referral and Consultation
Pediatrics
Neoplasm Metastasis
Transplants
Lung
Survival
Liver

Keywords

  • hepatectomy
  • hepatoblastoma
  • liver transplantation
  • tumor staging, pediatrics

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Lautz, Timothy B ; Ben-Ami, Tamar ; Tantemsapya, Niramol ; Gosiengfiao, Yasmin C ; Superina, Riccardo A. / Successful nontransplant resection of POST-TEXT III and IV hepatoblastoma. In: Cancer. 2011 ; Vol. 117, No. 9. pp. 1976-1983.
@article{750586b37a6245749388fb5cc65d597f,
title = "Successful nontransplant resection of POST-TEXT III and IV hepatoblastoma",
abstract = "BACKGROUND: Liver transplantation is increasingly advocated as primary surgical therapy for children with hepatoblastoma involving 3 or 4 sectors of the liver after neoadjuvant chemotherapy. This study evaluated the results of nontransplant hepatectomy in children who might otherwise have been considered for liver transplantation. METHODS: All children who underwent resection at a single institution from 1998 to 2009 for POST-TEXT IV or centrally located POST-TEXT III hepatoblastoma after neoadjuvant chemotherapy were reviewed. RESULTS: Fourteen children (7 boys) with a median age of 8 months at diagnosis met study criteria. Pulmonary metastases in 3 patients were resected in 2 and resolved with chemotherapy in 1 patient. Preoperative grouping after neoadjuvant chemotherapy was POST-TEXT IV in 3 patients and POST-TEXT III in 11 patients. Thirteen of 14 (93{\%}) children who underwent aggressive resection despite being potential candidates for primary transplantation were alive and tumor-free with a median follow-up of 57 months. Observed survival rates at 1, 2, and 5 years were 93{\%}, 91{\%}, and 88{\%} respectively. Event-free survival rates at 1, 2, and 5 years were 93{\%}, 91{\%}, and 75{\%}, respectively. CONCLUSIONS: Excellent survival (93{\%}) was obtained with aggressive resection in children with POST-TEXT III and IV hepatoblastoma meeting criteria for transplant referral. The 1 death occurred in a patient with unfavorable small cell histology. These children should be managed at institutions experienced in both advanced pediatric hepatobiliary surgery and transplantation. Operative exploration was frequently required to ultimately determine which tumors can be resected and which require transplantation. Cancer 2011;117:1976-83.",
keywords = "hepatectomy, hepatoblastoma, liver transplantation, tumor staging, pediatrics",
author = "Lautz, {Timothy B} and Tamar Ben-Ami and Niramol Tantemsapya and Gosiengfiao, {Yasmin C} and Superina, {Riccardo A}",
year = "2011",
month = "5",
day = "1",
doi = "10.1002/cncr.25722",
language = "English (US)",
volume = "117",
pages = "1976--1983",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

Successful nontransplant resection of POST-TEXT III and IV hepatoblastoma. / Lautz, Timothy B; Ben-Ami, Tamar; Tantemsapya, Niramol; Gosiengfiao, Yasmin C; Superina, Riccardo A.

In: Cancer, Vol. 117, No. 9, 01.05.2011, p. 1976-1983.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Successful nontransplant resection of POST-TEXT III and IV hepatoblastoma

AU - Lautz, Timothy B

AU - Ben-Ami, Tamar

AU - Tantemsapya, Niramol

AU - Gosiengfiao, Yasmin C

AU - Superina, Riccardo A

PY - 2011/5/1

Y1 - 2011/5/1

N2 - BACKGROUND: Liver transplantation is increasingly advocated as primary surgical therapy for children with hepatoblastoma involving 3 or 4 sectors of the liver after neoadjuvant chemotherapy. This study evaluated the results of nontransplant hepatectomy in children who might otherwise have been considered for liver transplantation. METHODS: All children who underwent resection at a single institution from 1998 to 2009 for POST-TEXT IV or centrally located POST-TEXT III hepatoblastoma after neoadjuvant chemotherapy were reviewed. RESULTS: Fourteen children (7 boys) with a median age of 8 months at diagnosis met study criteria. Pulmonary metastases in 3 patients were resected in 2 and resolved with chemotherapy in 1 patient. Preoperative grouping after neoadjuvant chemotherapy was POST-TEXT IV in 3 patients and POST-TEXT III in 11 patients. Thirteen of 14 (93%) children who underwent aggressive resection despite being potential candidates for primary transplantation were alive and tumor-free with a median follow-up of 57 months. Observed survival rates at 1, 2, and 5 years were 93%, 91%, and 88% respectively. Event-free survival rates at 1, 2, and 5 years were 93%, 91%, and 75%, respectively. CONCLUSIONS: Excellent survival (93%) was obtained with aggressive resection in children with POST-TEXT III and IV hepatoblastoma meeting criteria for transplant referral. The 1 death occurred in a patient with unfavorable small cell histology. These children should be managed at institutions experienced in both advanced pediatric hepatobiliary surgery and transplantation. Operative exploration was frequently required to ultimately determine which tumors can be resected and which require transplantation. Cancer 2011;117:1976-83.

AB - BACKGROUND: Liver transplantation is increasingly advocated as primary surgical therapy for children with hepatoblastoma involving 3 or 4 sectors of the liver after neoadjuvant chemotherapy. This study evaluated the results of nontransplant hepatectomy in children who might otherwise have been considered for liver transplantation. METHODS: All children who underwent resection at a single institution from 1998 to 2009 for POST-TEXT IV or centrally located POST-TEXT III hepatoblastoma after neoadjuvant chemotherapy were reviewed. RESULTS: Fourteen children (7 boys) with a median age of 8 months at diagnosis met study criteria. Pulmonary metastases in 3 patients were resected in 2 and resolved with chemotherapy in 1 patient. Preoperative grouping after neoadjuvant chemotherapy was POST-TEXT IV in 3 patients and POST-TEXT III in 11 patients. Thirteen of 14 (93%) children who underwent aggressive resection despite being potential candidates for primary transplantation were alive and tumor-free with a median follow-up of 57 months. Observed survival rates at 1, 2, and 5 years were 93%, 91%, and 88% respectively. Event-free survival rates at 1, 2, and 5 years were 93%, 91%, and 75%, respectively. CONCLUSIONS: Excellent survival (93%) was obtained with aggressive resection in children with POST-TEXT III and IV hepatoblastoma meeting criteria for transplant referral. The 1 death occurred in a patient with unfavorable small cell histology. These children should be managed at institutions experienced in both advanced pediatric hepatobiliary surgery and transplantation. Operative exploration was frequently required to ultimately determine which tumors can be resected and which require transplantation. Cancer 2011;117:1976-83.

KW - hepatectomy

KW - hepatoblastoma

KW - liver transplantation

KW - tumor staging, pediatrics

UR - http://www.scopus.com/inward/record.url?scp=79955379083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955379083&partnerID=8YFLogxK

U2 - 10.1002/cncr.25722

DO - 10.1002/cncr.25722

M3 - Article

VL - 117

SP - 1976

EP - 1983

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 9

ER -