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Resection, including transplantation, for hepatoblastoma and hepatocellular carcinoma: Impact on survival

Tagge, EP and Tagge, DU and Reyes, J and Tzakis, A and Iwatsuki, S and Starzl, TE and Wiener, ES (1992) Resection, including transplantation, for hepatoblastoma and hepatocellular carcinoma: Impact on survival. Journal of Pediatric Surgery, 27 (3). 292 - 297. ISSN 0022-3468

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Abstract

Long-term survival in children with primary hepatic malignancies can not be expected without complete tumor resection. In the last ten years we have treated 21 children with hepatocellular carcinoma (HCC) and 21 children with hepatoblastoma (HEP), with tumor extirpation our surgical goal. Operative treatment included partial hepatectomy ([PH] 20), either primary (10) or delayed (following chemotherapy) (10), total hepatectomy and orthotopic liver transplantation ([OLT] 13), or upper abdominal exenteration and multiple organ transplantation (2). Two patients had both PH and subsequent total hepatectomy and OLT. Overall survival was 48% ( 20 42), with 9 patients dying of progressive disease prior to removal of their tumor. HEP patient survival was 67% ( 14 21), including 2 of 6 who underwent primary PH, 7 of 8 who had delayed PH, and 5 of 6 who underwent OLT. Survival for the children with HCC was 29% ( 6 21), including 1 of 4 after primary PH, 1 of 2 following delayed PH, 3 of 7 following OLT, and 1 of 2 after exenteration and multiple organ transplantation. Preoperative chemotherapy facilitated removal of 10 initially unresectable tumors (8 HEP, 2 HCC) at a second-look procedure. Total hepatectomy and OLT markedly improved survival in patients with disease unresectable by standard methods. Partial hepatectomy, either primary or delayed, should be attempted in all children with hepatic malignancies. Total hepatectomy and OLT appears to be a viable adjunct in the treatment of childhood malignancies, and should be used for otherwise unresectable tumors as part of a carefully planned protocol. © 1992.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Tagge, EP
Tagge, DU
Reyes, J
Tzakis, A
Iwatsuki, S
Starzl, TEtes11@pitt.eduTES11
Wiener, ES
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1992
Date Type: Publication
Journal or Publication Title: Journal of Pediatric Surgery
Volume: 27
Number: 3
Page Range: 292 - 297
DOI or Unique Handle: 10.1016/0022-3468(92)90849-3
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0022-3468
Other ID: uls-drl:31735062113166, Starzl CV No. 1523
Date Deposited: 08 Apr 2010 17:25
Last Modified: 14 Oct 2017 11:55
URI: http://d-scholarship.pitt.edu/id/eprint/4909

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