Multidisciplinary management of hepatic malignant turners in children. Report of six cases

Citation
Jm. Herrera et al., Multidisciplinary management of hepatic malignant turners in children. Report of six cases, REV MED CHI, 127(11), 1999, pp. 1351-1358
Citations number
34
Language
SPAGNOLO
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
REVISTA MEDICA DE CHILE
ISSN journal
0034-9887 → ACNP
Volume
127
Issue
11
Year of publication
1999
Pages
1351 - 1358
Database
ISI
SICI code
0034-9887(199911)127:11<1351:MMOHMT>2.0.ZU;2-X
Abstract
Background: Malignant hepatic tumors (Mht) are rare in children. Among them hepatoblastoma (HB) is the most common. Aim: To report the results of the multidisciplinary management in 6 consecutive children: five HB and one met astatic Wilms tumor (MWT). Patients and methods: The mean age of patients w as 42 months. All HB patients had elevated serum alfafetoprotein (median 15 0, 000 ng/ml). All patients received preoperative chemotherapy: HB patients received carboplatin/doxorrubicin alternating with cisplatin, and the MWT patient, vincristine alone. Surgery included two formal right and two forma l left hepatectomies, one extensive central resection with partial left seg mentectomy, and one lateral segmentectomy. Extracorporeal circulation was u sed in the child with atrial involvement. All patients received postoperati ve chemotherapy. Results: All tumors had variable regression on preoperativ e chemotherapy. Complete resection with negative margins was achieved in al l patients. The degree of tumor necrosis on histology ranged from 60% to 90 %. Alfafetoprotein levels fell to under 10 ng/ml in all HB cases, one to th ree months after surgery. all patients survive free of disease at a median follow up of 19 months. Conclusion: A multidisciplinary approach including the well timed used of chemotherapy and surgery is highly effective in the management of pediatric malignant tumors.