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Features predicting unresectability in hepatoblastoma
- Source :
- Università degli Studi di Padova-IRIS
- Publication Year :
- 2007
- Publisher :
- Wiley, 2007.
-
Abstract
- BACKGROUND. Approximately 20% of patients who have hepatoblastoma (HB) still have unresectable disease after preoperative chemotherapy (POC). In these circumstances, orthotopic liver transplantation (OLT) should be performed 1 month after POC. The authors sought to identify presenting features that would predict unresectability in patients with HB and to provide suggestions for early referral and listing for OLT. METHODS. Notes, radiology films, and histology from patients who were treated over the previous 20 years were reviewed. Unfeasible resection was defined by bilobar involvement, vascular extension, and metastatic disease after POC. Failed conservative treatment (FCT) was used to categorize patients who were not disease-free with their native liver � 1 year after surgery. RESULTS. Of 28 patients who were studied, 14 patients underwent resection, and 10 patients required OLT. Four patients did not undergo any type of surgery because of tumor progression. Overall, the 5-year survival rate was 76% (95% confidence interval, 54.8–89%). Predictors of FCT were multifocality (P 5 .006), a high pretreatment extent of tumor (PRETEXT) score (III or IV; P 5 .006), portal vein involvement (P 5 .02), hepatic vein involvement (P 5 .02), or vena cava involvement (P 5 .05). Patients who achieved a curative resection presented at a younger age (median, 0.7 years vs 4.2 years, P 5 .02). Patients who had multifocal lesions and those who had an a-fetoprotein (aFP) level
- Subjects :
- Adult
Hepatoblastoma
Male
Cancer Research
medicine.medical_specialty
Liver tumor
Adolescent
CHILDREN
neoplasia
medicine.medical_treatment
Liver transplantation
medicine
Humans
Child
Vein
Survival rate
Retrospective Studies
business.industry
Liver Neoplasms
Infant
Cancer
Combination chemotherapy
Prognosis
medicine.disease
Combined Modality Therapy
Survival Analysis
Liver Transplantation
Surgery
Transplantation
Treatment Outcome
medicine.anatomical_structure
Oncology
Child, Preschool
Female
alpha-Fetoproteins
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 10970142 and 0008543X
- Volume :
- 110
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi.dedup.....aef1d414a8f779d1b0121f1c6df94375