Chemotherapy combined with surgery in successful treatment of hepatoblastoma.

Four patients presented with large intra-abdominal masses. Three patients were diagnosed as having hepatoblastomas of the right hepatic lobe, one of the left lobe. Initially these tumors were unresectable, and after biopsy each patient was treated with a standardized chemotherapy protocol. All tumors decreased remarkably in size and were resected successfully. Postoperative chemotherapy was then instituted and, as of this date, three of the children appear to be disease free; the fourth had a pulmonary metastatic lesion completely resected. Contrary to the dismal past history of patients with initially unresectable hepatoblastomas, treatment with preoperative chemotherapy, surgery and postoperative chemotherapy has had most rewarding results.