Back
 SS  Vol.4 No.1 , January 2013
A Feasible Surgical Approach for Treating Extensive Hepatoblastoma Using a Backup for Living Donor Liver Transplantation: Case Report
Abstract: Hepatoblastoma is the most common type of malignant liver tumor in children and occurs most frequently in patients two years of age and younger. The outcomes for children with hepatoblastoma have been improving in recent years due to the introduction of cisplatin-based chemotherapy regimens. Recently, performing liver transplantation after neoadjuvant chemotherapy has become increasingly advocated as a primary surgical treatment for children with unresectable hepatoblastoma involving three or four sectors of the liver. Surgical exploration is frequently required to determine which tumors are resectable, which require liver transplantation and timing of resection. When the quality of the remnant liver is in question, the decision for transplantation versus resection should be made by a liver team in experienced center with capability of liver transplantation. This report presents the findings of the patient with hepatoblastoma who successfully underwent extreme resection with a backup for living donor liver transplantation. The patient was discharged home in good condition and the follow-up continued for three years with normal AFP levels observed.
Cite this paper: Uchida, H. , Sakamoto, S. , Hamano, I. , Shigeta, T. , Kanazawa, H. , Karaki, C. , Fukuda, A. , Nakazawa, A. and Kasahara, M. (2013) A Feasible Surgical Approach for Treating Extensive Hepatoblastoma Using a Backup for Living Donor Liver Transplantation: Case Report. Surgical Science, 4, 72-76. doi: 10.4236/ss.2013.41013.
References

[1]   C. Stocker, J. T. Ihsak, K.G., “Hepatoblastoma,” In: K. Okuda and K. G. Ishak, Eds., Neoplasms of the Liver, Springer-Verlag, Inc., New York, 1987, pp. 127-136.

[2]   D. C. Aronson, J. M. Schnater, C. R. Staalman, G. J. Weverling, J. Plaschkes, G. Perilongo, J. Brown, A. Phillips, et al., “Predictive Value of the Pretreatment Extent of Disease System in Hepatoblastoma: Results from the International Society of Pediatric Oncology Liver Tumor Study Group SIOPEL-1 Study,” Journal of Clinical Oncology, Vol. 23, No. 6, 2005, pp. 1245-1252. doi:10.1200/JCO.2005.07.145

[3]   G. Perilongo, R. Maibach, E. Shafford, L. Brugieres, P. Brock, B. Morland, et al., “Cisplatin versus Cisplatin plus Doxorubicin for Standard-Risk Hepatoblastoma,” New England Journal of Medicine, Vol. 22, No. 361, 2009, pp. 1662-1670. doi:10.1056/NEJMoa0810613

[4]   S. B. Moon, H. B. Shin, J. M. Seo and S. K. Lee, “Hepatoblastoma: 15-Year Experience and Role of Surgical Treatment,” Journal of Korean Surgical Society, Vol. 81, No. 2, 2011, pp. 134-140. doi:10.4174/jkss.2011.81.2.134

[5]   J. B. Otte and R. Meyers, “PLUTO First Report,” Pediatric Transplantation, Vol. 14, No. 7, 2012, pp. 830-835. doi:10.1111/j.1399-3046.2010.01395.x

[6]   S. Barrena, F. Hernandez, M. Miguel, C. A. de la Torre, A. M. Moreno, J. L. Encinas, et al., “High-Risk Hepatoblastoma: Results in a Pediatric Liver Transplantation Center,” European Journal of Pediatric Surgery, Vol. 21, No. 1, 2011, pp. 18-20. doi:10.1055/s-0030-1262798

[7]   J. Ninane, G. Perilongo, J. P. Stalens, M. Guglielmi, J. B. Otte and A. Mancini, “Effectiveness and Toxicity of Cisplatin and Doxorubisin (PLADO) in Childhood Hepatoblastoma and Hepatocellular Carcinoma: A SIOP Pilot Study,” Medical and Pediatric Oncology, Vol. 19, No. 3, 1991, pp. 199-203. doi:10.1002/mpo.2950190310

[8]   I. Penn, “Hepatic Transplantation for Primary and Metastatic Cancers of the Liver,” Surgery, Vol. 110, No. 4, 1991, pp. 726-735.

[9]   J. B. Otte, J. Pritchard, D. C. Aronson, J. Brown, P. Czauderna, R. Maibach, et al., “Liver Transplantation for Hepatoblastoma: Results from the International Society of Pediatric Oncology (SIOP) Study SIOPEL-1 and Review of the World Experience,” Pediatric Blood Cancer, Vol. 42, No. 1, 2004, pp. 74-83. doi:10.1002/pbc.10376

[10]   J. B. Otte, J. de Ville de Goyet and R. Reding, “Liver Transplantation for Hepatoblastoma: Indications and Contraindications in the Modern Era,” Pediatric Transplantation, Vol. 9, No. 5, 2005, pp. 557-565. doi:10.1111/j.1399-3046.2005.00354.x

[11]   J. Brown, G. Perlingo, E. Shafford, J. Keeling, J. Pritchard, P. Brock, et al., “Pretreatment Prognostic Factors for Children with Hepatoblastoma: Results from the International Society of Pediatric Oncology (SIOP). Study SIOPEL 1,” European Journal of Cancer, Vol. 36, No. 11, 2000, pp. 1418-1425. doi:10.1016/S0959-8049(00)00074-5

[12]   T. B. Lautz, T. Ben-Ami, N. Tantemsapya, Y. Gosiengfiao and R. A. Superina, “Successful Nontransplant Resection of POST-TEXT III and IV Hepatoblastoma,” Cancer, Vol. 117, No. 9, 2011, pp. 1976-1983. doi:10.1002/cncr.25722

[13]   T. Hishiki, T. Matsunaga, F. Sasaki, M. Yano, K. Ida, H. Horie, et al., “Outcome of Hepatoblastomas Treated Using the Japanese Study Group for Pediatric Liver Tumor (JPLT) Protocol-2: Report from the JPLT,” Pediatric Surgery International, Vol. 27, No. 1, 2011, pp. 1-8. doi:10.1007/s00383-010-2708-0

[14]   K. Urata, S. Kawasaki, H. Matsunami, Y. Hashikura, T. Ikegami, S. Ishizone, et al., “Calculation of Child and Adult Standard Liver Volume for Liver Transplantation,” Hepatology, Vol. 21, No. 5, 1995, pp. 1317-1321. doi:10.1002/hep.1840210515

[15]   A. P. Pimpalwar, K. Sharif, P. Ramani, M. Stevens, R. Grundy, B. Moriand, et al., “Strategy for Hepatoblastoma Management: Transplant versus Nontransplant Surgery,” Journal of Pediatric Surgery, Vol. 37, No. 2, 2002, pp. 240-245. doi:10.1053/jpsu.2002.30264

[16]   G. M. Tiao, N. Bobey, S. Allen, N. Nieves, M. Alonso, J. Bucuvalas, et al., “The Current Management of Hepatoblastoma: A Combination of Chemotherapy, Conventional Resection, and Liver Transplantation,” Journal of Pediatrics, Vol. 146, No. 2, 2005, pp. 204-211. doi:10.1016/j.jpeds.2004.09.011

[17]   V. D. Schweinitz, H. Hecker, G. Schmidt-von-Amdt and D. Harms, “Prognostic Factors and Staging Systems in Childhood Hepatoblastoma,” International Journal of Cancer, Vol. 74, No. 6, 1997, pp. 593-599. doi:10.1002/(SICI)1097-0215(19971219)74:6<593::AID-IJC6>3.0.CO;2-P

[18]   Y. Kita, Y. Ishida and K. Yanaga, “Evolution of Live Donor Liver Transplantation in Japan: A Historical Perspective,” Hungarian Medical Journal, Vol. 1, No. 2, 2007, pp. 157-163. doi:10.1556/HMJ.1.2007.2.3

[19]   W. Faraj, F. Dar, G. Marangoni, A. Bartlett, H. V. Melendez, D. Hadzic, et al., “Liver Transplantation for Hepatoblastoma,” Liver Transplantation, Vol. 14, No. 11, 2008, pp. 1614-1619. doi:10.1002/lt.21586

[20]   A. J. Millar, P. Harley, D. Khan, W. Spearman, S. Andronikou and H. Rode, “Extended Hepatic Resection with Transplantation Back-Up for An “Unresectable” Tumor,” Pediatric Surgery International, Vol. 17, No. 5-6, 2001, pp. 378-381. doi:10.1007/s003830000531

[21]   F. Guerin, F. Gauthier, H. Martelli, M. Fabre, C. Baujard, S. Franchi, et al., “Outcome of Central Hepatectomy for Hepatoblastoma,” Journal of Pediatric Surgery, Vol. 45, No. 3, 2010, pp. 555-563. doi:10.1016/j.jpedsurg.2009.09.025

[22]   M. Browne, D. Sher, D. Grant, E. Deluca, E. Alonso, P. F. Whitington, et al., “Survival after Liver Transplantation for Hepatoblastoma: A 2-Center Experience,” Journal of Pediatric Surgery, Vol. 43, No. 11, 2008, pp. 1973-1981. doi:10.1016/j.jpedsurg.2008.05.031

[23]   J. Zsiros, R. Maibach, E. Shafford, L. Brugieres, P. Brock, P. Czaudema, et al., “Successful Treatment of Childhood High-Risk Hepatoblastoma with Dose-Intensive Multiagent Chemotherapy and Surgery: Final Results of SIOPEL-3HR Study,” Journal of Clinical Oncology, Vol. 28, No. 15, 2010, pp. 2584-2590. doi:10.1200/JCO.2009.22.4857

[24]   D. Von Schweinitz, “Hepatoblastoma: Recent Developments in Research and Treatment,” Seminars in Pediatric Surgery, Vol. 21, No. 1, 2012, pp. 21-30.

[25]   M. Kasahara, M. Ueda, H. Haga, H. Hiramatsu, M. Kobayashi, S. Adachi, et al., “Living-Donor Liver Transplantation for Hepatoblastoma,” American Journal of Transplantation, Vol. 5, No. 9, 2005, pp. 2229-2235. doi:10.1111/j.1600-6143.2005.01003.x

 
 
Top