Efficacy of neoadjuvant therapy and surgical rescue for locally advanced hepatoblastomas: 10 year single-center experience and literature review.
World J Gastroenterol
; 20(29): 10137-43, 2014 Aug 07.
Article
em En
| MEDLINE
| ID: mdl-25110441
ABSTRACT
AIM:
To report our experience with long-term outcomes after multimodal management therapy.METHODS:
An observational retrospective study was performed containing seven patients with hepatoblastoma (Hbl) treated in our institution, a tertiary referral center, from 2003 to 2011. Demographic, preoperative, surgical, and outcome variables were collected. A survival analysis and a review of the current literature related to combination neoadjuvant chemotherapy and surgical resection on Hbl were performed.RESULTS:
The median age at surgery was 14.4 mo, with a male to female ratio of 43. Pretext staging at diagnosis was as follows stageâ I, 4 cases; stage II, 2 patients; and stage III, 1 case. Mean pretreatment tumor volume was 735 cm(3). Five out of seven patients received neoadjuvant chemotherapy according to SIOPEL-3 or SIOPEL-6 protocols. Tumor volume and alpha-fetoprotein levels significantly dropped after neoadjuvant therapy. Surgical procedures performed included hemihepatectomies, segmentectomies and atypical resection. All patients received chemotherapy after surgery. Median postoperative hospital stay was 8 d. All patients were alive and disease-free after a median follow-up period of 23 mo. With regards to the literature review, seventeen articles were found that were related to our search.CONCLUSION:
Our series shows how multimodal management of Hbl, exhaustive control and a meticulous surgical approach leads to almost 100% complete resection with optimal postoperative results.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
/
Hepatoblastoma
/
Terapia Neoadjuvante
/
Hepatectomia
/
Neoplasias Hepáticas
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article