Outcome of Liver Resection for Hepatoblastoma in Children from a General Pediatric Surgery Referral Center.

BACKGROUND

Hepatoblastoma (HB) is the most common malignant liver tumor in children under 3 years of age. Surgical resection, combined with neoadjuvant chemotherapy, is essential for optimal outcomes. We present a 10-year institutional experience focusing on technical tips for liver resection in children with HB.

MATERIALS AND

METHODS

A retrospective review of pediatric HB patients who underwent liver resection at a tertiary care Children's hospital from January 2014 to June 2024 was conducted. All patients received preoperative PLADO (cisplatin + doxorubicin) chemotherapy per SIOPEL guidelines. Surgical resection type, outcomes, recurrence, and survival data were analyzed. Technical considerations for standard and complex hepatectomies were described.

RESULTS

Out of 26 children with HB (mean age 15 months), 19 (73%) underwent liver resection. Right hepatectomy was the most common (42%), followed by left hepatectomy and segmentectomies. No patient developed postoperative liver failure. Two patients (10.5%) experienced recurrence; one was salvaged successfully. The disease-free survival rate was 89.5%, and overall survival at 3 and 5 years was 81.8%. Surgical margins were negative in all patients. Technical tips adopted to improve visualization, minimize blood loss, avoid bile duct injury, and vascular inflow and outflow control are detailed.

CONCLUSION

Liver resection with adjuvant chemotherapy (PLADO and SIOPEL) results in favorable outcome in children with HB. Understanding the anatomical nuances and meticulous surgical technique improves outcomes and minimizes complications.