Surgical resection and chemotherapy improve survival rate for patients with hepatoblastoma
Surgical resection and chemotherapy improve survival rate for patients with hepatoblastoma
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DOI：
10.1053/jpsu.2001.22953
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发表时间：
2001-05-01
影响因子：
2.4
通讯作者：
Bensoussan, AL
中科院分区：
文献类型：
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作者：
Carceller, A;Blanchard, H;Bensoussan, AL
背景：作者回顾了30例儿童肝母细胞瘤（HB）的治疗经验，尽管在过去20年中HB发病率呈上升趋势，但在术前或术后采用顺铂+阿霉素（阿霉素）或顺铂+长春新碱+ 5-氟尿嘧啶进行完全切除和化疗取得了令人鼓舞的治愈率。结果：女性10例，男性20例。从1963年到1980年有8名患者，1981年到1998年有22名患者。手术时的平均年龄为16个月（范围为3.5个月至5.5岁）。在切除的患者中，10例（42%）肿瘤定位于右肺叶，7例（29%）肿瘤定位于左肺叶，7例（29%）肿瘤定位于双肺叶。其中16例（67%）肿瘤大于10cm， 24例（80%）在化疗前后行肝切除术。1例（3%）肿瘤不可切除的患者接受了化疗和肝移植。5例患者（17%）肝脏受累范围太广，无法切除。7例为右肺叶切除术，6例为左肺叶切除术，8例为右三叶切除术，2例为左三叶切除术，1例为中肝切除术。在35年的研究中，总生存率为60%（30例中有18例）。结合手术和化疗（1981 - 1998），17例患者中有14例的生存率为82%。本研究的总体中位随访时间为8年（范围为2.5至24年）。结论：肝母细胞瘤的治疗效果有了显著的改善。以前，只有25%到30%的患者被治愈，而今天，通过化疗和手术的结合，75%到80%的患者可能被治愈。[J]儿科外科杂志36:755-759。W.B. Saunders Company版权所有(C) 2001。
Background: The authors reviewed retrospectively their experience in 30 children with hepatoblastoma (HB), Despite an increased trend in the incidence of HB during the last 2 decades, an encouraging cure rate has been achieved with complete resection of the tu mor a nd chemotherapy before or after surgery with cisplatin plus doxorubicin (Adriamycin) or cisplatin plus vincristine plus 5-Fluorouracil.Results: There were 10 female and 20 male patients. For the period from 1963 to 1980 there were 8 patients, and for the period from 1981 to 1998 there were 22 patients. Their mean age at surgery was 16 months (range, 3.5 months to 5.5 years). Tumors were localized to the right lobe in 10 (42%), to the left lobe in 7 (29%), and in both lobes in 7 (29%) of the resected patients. Tumors were greater than 10 cm in size in 16 (67%) of these patients, Twenty-four patients (80%), underwent liver resection before or after chemotherapy. One patient (3%) with an unresectable tumor received chemotherapy and a liver transplant. In 5 patients (17%) the hepatic involvement was too extensive for resection. The types of resection performed were right lobectomy in 7, left lobectomy in 6, right trisegmentectomy in 8, left trisegmentectomy in 2, and middle hepatectomy in 1. The overall survival rate for 35 years of the study was 60% (18 of 30). With the association of surgery and chemotherapy (1981 through 1998) survival rate is 82% (14 of 17). Overall median follow-up in our study is 8 years (range, 2.5 to 24 years).Conclusions: There has been a dramatic improvement in the results of treatment of hepatoblastoma. Formerly, only 25% to 30% of patients were cured, whereas today, with combination of chemotherapy and surgery, 75% to 80% may be cured. J Pediatr Surg 36:755-759. Copyright (C) 2001 by W.B. Saunders Company.