Epidemiological Aspects, Clinical Features and Treatment Outcome in Children Suffering Hepatoblastoma

Hepatoblastoma (HBL) is the most common primary liver tumor within childhood. Entire tumor resection is basis for ultimate cure for HBL and supports the only pleasant chance of long-standing disease-free survival.

In the current survey, we attempted to evaluate the long-term survival of children with HBL with surgical resection in a referral children hospital in Iran within the last decade.

This retrospective descriptive study was conducted on all children who suffered HBL and undergone surgery between 2006 and 2016. Reviewing the recorded hospital files led to a sample of 30 eligible patients. The baseline characteristics of the patients were all collected by reviewing the files.

In total, 30 consecutive children (21 male and 9 female) suffering HBL were described. Of those, 40.0% aged less than 12 months and only 6.7% aged higher than 36 months. The most common clinical manifestations were asymptomatic abdominal mass (in 66.7%) followed by fever (in 10.0%) and pain (in 10.0%). In more than half of the patients (53.3%), right lobe involved, while left lobe involved in 16.7%. based on histological report,marginal involvement was found in 75.0% of children, margin intact in 15.0% and margin free feature in 5.0%. Forty percent of children suffered from epithelial subtype of tumor, 20.0% from mixed epithelial and mesenchymal subtypes, and 13.3% from embryonal pattern. In total, 63.3% were scheduled for complete surgical resection followed by chemotherapy. Postoperatively, 40.0% of children remained free of complications, whereas postoperative bleeding occurred in 20.0% and biloma in 40.0%. Overall, 76.9% of patients were completely cured, 7.7% suffered from pulmonary metastasis and 3.9% required liver transplantation. Postoperative death occurred in 11.5%.

Considering surgical resection followed by chemotherapy leads to high cure rate, however a notable number of affected children suffer postoperative complication, requiring liver transplantation, pulmonary metastasis, or even non-survived emphasizing a serious review of the treatment protocols.