Abstract
This study aimed to summarize the first experience with ultrasound-guided percutaneous ablation treatment (PAT) for recurrent hepatoblastoma (HB) after liver resection in children. From August 2013 to October 2014, PAT was used to treat 5 children with a total of 8 recurrent HB (mean size, 1.4 ± 0.8 cm; size range, 0.7–3.1 cm), including 4 patients with 7 tumors in the liver and 1 patient with 1 tumor in the lung. Technical success was achieved in all patients (5/5, 100%). The complete ablation rate after the first ablation session was 80% (4/5) on a patient-by-patient basis and 87.5% (7/8) on a tumor-by-tumor basis. Only 1 patient developed a fever with temperature >39 °C; it lasted 4 days after radiofrequency ablation (RFA) and was resolved by conservative therapy. During the follow-up period, new intrahepatic recurrences after PAT were detected in two patients. One died due to tumor progression 4 months after ablation. The median overall survival time after PAT was 13.8 months. PAT is a safe and promising therapy for children with recurrent HB after liver resection, and further investigation in large-scale randomized clinical trials is required to determine its role in the treatment of this disease.
Highlights
This study aimed to summarize the first experience with ultrasound-guided percutaneous ablation treatment (PAT) for recurrent hepatoblastoma (HB) after liver resection in children
The ablation procedures and outcomes of all 5 enrolled patients are shown in Percutaneous ethanol injection (PEI) was performed in another 2 children (No 2 and 3) with 4 tumors in the liver that were difficult to ablate using radiofrequency ablation (RFA) (1 patient with a tumor in the caudate lobe adjacent to the stomach and 3 tumors in segment 6 close to the liver capsule)
Chemotherapy is necessary for patients with recurrent HB after surgery
Summary
This study aimed to summarize the first experience with ultrasound-guided percutaneous ablation treatment (PAT) for recurrent hepatoblastoma (HB) after liver resection in children. Multiple studies have reported HB 5-year survival rates of 60% to 87.7%3–5 with a multidisciplinary treatment approach involving chemotherapy, surgical resection and liver transplantation. Despite this improvement, the outcome for patients with recurrent HB continues to be dismal. Percutaneous ablation therapy (PAT) techniques have begun to be used for an increasing number of patients for the treatment of tumors. RFA has been reported to achieve a complete response comparable to the response obtained with surgical liver resection with a lower morbidity rate of 5–18%8–10 and a lower mortality rate of 0–1.4%10–12. The aim of our study was to summarize and report our first experience of PAT for recurrent HB in children
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