Preoperative chemotherapy for initially unresectable hepatoblastoma in children. Survival in two cases.

In two children with hepatoblastoma, response to chemotherapy permitted subsequent surgical resection. Initially, in both patients, the tumor was thought to be unresectable because of size and/or extent. Chemotherapy with vincristine sulfate and cyclophosphamide resulted in substantial reduction in tumor size, and laparotomy for excision was performed after nine months and four months of therapy, respectively. In case 1, the tumor was localized in the right hepatic lobe and the right hepatic lobectomy was performed. In case 2, the tumor was located in both right and left lobes, but was encapsulated and it was possible to enucleate the tumor with complete gross excision. Both children are living and well without evidence of recurrence of tumor 11 and 23 months after operation.