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PRETEXT II–III multifocal hepatoblastoma: significance of resection of satellite lesions irrespective of their disappearance after chemotherapy
- Source :
- Pediatric Surgery International. 31:573-579
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- To determine the outcomes of resection of satellite lesions in PRE-treatment Tumor EXTension (PRETEXT) II and III multifocal hepatoblastoma irrespective of their disappearance after chemotherapy. To compare the overall outcomes of multifocal and unifocal hepatoblastoma. Fourteen patients with PRETEXT II (n = 7) and III (n = 7) multifocal hepatoblastoma treated between April 2006 and July 2014 were analyzed and their outcomes were compared with PRETEXT II and III unifocal hepatoblastoma treated in the similar period. Satellite lesion or the affected segments with disappeared satellite lesions were resected in 11 patients. Amongst them, all relapses were distant except one in the liver. In contrast, two of three patients developed liver relapse when the affected segments were not resected. None of the patients receiving intensive chemotherapy based on SIOPEL-3 guidelines developed a relapse. The 3-year event-free and overall survival were 38.6 and 42.9 % in multifocal hepatoblastoma and 86.4 and 92.4 % in unifocal hepatoblastoma (p = 0.001). Multifocality (p = 0.002) and AFP >10,000 after induction chemotherapy significantly affected event-free survival (p = 0.01). Multifocal hepatoblastoma is associated with poor outcomes as compared to unifocal hepatoblastoma. These preliminary observations of relapse and the role of chemotherapy intensification deserve further study in a multicenter controlled trial setting.
- Subjects :
- Hepatoblastoma
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Gastroenterology
law.invention
Lesion
Randomized controlled trial
law
Internal medicine
Pediatric surgery
medicine
Humans
Child
Survival analysis
Chemotherapy
business.industry
Liver Neoplasms
Infant
Reproducibility of Results
Induction chemotherapy
General Medicine
medicine.disease
Survival Analysis
digestive system diseases
Surgery
Treatment Outcome
Liver
Child, Preschool
Pediatrics, Perinatology and Child Health
Pretext
Female
Neoplasm Recurrence, Local
medicine.symptom
Tomography, X-Ray Computed
business
Subjects
Details
- ISSN :
- 14379813 and 01790358
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Pediatric Surgery International
- Accession number :
- edsair.doi.dedup.....c28c879076452bef0f59932c9612ea46