Multicenter retrospective analysis of various primary pediatric malignant hepatic tumors--management in a series of 47 Polish patients (1985-1995).

Forty-seven children treated in various Polish centers between 1985 and 1995 for primary malignant liver tumors were retrospectively analyzed. Hepatoblastoma (HB) prevailed--it was found in 39 cases. There were 6 hepatocarcinoma (HCC) cases and 2 cases of undifferentiated sarcoma (UDS). In 44% of HB patients the tumor involved both liver lobes. 18% of children with HB presented with pulmonary metastases at diagnosis. Chemotherapy was applied in 92% of cases (preoperatively in 67%). Tumor resection was performed in 56% of HB patients. Overall survival of patients with hepatoblastoma was 43.6%, while it was 50% for hepatocarcinoma and 100% for undifferentiated sarcoma (2 cases only). Mean observation time was 58 months. The hepatoblastoma subgroup, being the largest (83% of all cases), was analyzed separately for prognostic factors. Completeness of tumor excision strongly influenced survival. Involvement of both lobes of the liver and multifocality of the tumor were other adverse prognostic factors.

[Experience in the use of Broviac catheters in children with hematologic neoplastic diseases]. / Doswiadezenia wlasne ze stosowaniem cewników Broviàca u dzieci z chorobami rozrostowymi ukladu krwiotwórczego.

Between 1990 and 1994, 61 Broviac catheters were implanted in 53 children with haematological neoplastic diseases. The mean duration of catheter function was 206 days (range 14-615 days). The total observation time was 12544 days, during which 84 catheter-related complications were recorded, i.e. 6.7 per 1000 catheter use days. Infections occurred with a frequency of 3.8 episodes/1000 cath, days, the majority of which were bacteriemias (2.6/1000 cath, days). Gram-positive and Gram-negative strains were the isolated etiologic agents with equal frequency. Most of infectious episodes (85%) responded well to initial empiric antibiotics treatment without removal of the catheters. Mechanica complications (occlusion, displacement or catheter leakage) occurred significant less frequently and were managed by repairing or replacing the device or clearing the block. No deaths were related to catheter complications. In conclusion indwelling Broviac catheters offer a safe and effective method of long-term venous access. Infections are the most frequent catheter-related complications.

[Fever in children with hematologic neoplastic diseases and implanted Broviac-Hickman catheters]. / Goraczka u dzieci chorych na nowotwory krwi z wszczepionymi cewnikami Broviaca-Hickmana.

A safe and effective method of venous access is important in the care and treatment of patients with malignancies. Thirty-seven Broviac-Hickman catheters were inserted in 32 children with haematological neoplastic disease. The mean indwelling time of the catheters was 7014 days. The catheters were used to administer chemotherapy and other drugs, blood products, and as well as to draw blood. Fever occurred 96 times. Forty-three percent of fever episodes were related to clinically documented infections and in 15% of cases, to catheter-related bacteremia caused by Gram-positive and Gram-negative strains in equivalent proportions. Fever was observed with a two fold greater incidence in patients with severe granulocytopenia (< 0.5 G/l).