Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma
<i>Background and Objectives</i>: In children, hepatoblastoma preferentially is managed by liver resection (LR). However, in irresectable cases, liver transplantation (LT) is required. The aim of our study was to compare short- and long-term results after LR and LT for the curative treat...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-08-01
|
Series: | Medicina |
Subjects: | |
Online Access: | https://www.mdpi.com/1648-9144/57/8/819 |
_version_ | 1797523012600201216 |
---|---|
author | Simon Moosburner Moritz Schmelzle Wenzel Schöning Anika Kästner Philippa Seika Brigitta Globke Tomasz Dziodzio Johann Pratschke Robert Öllinger Safak Gül-Klein |
author_facet | Simon Moosburner Moritz Schmelzle Wenzel Schöning Anika Kästner Philippa Seika Brigitta Globke Tomasz Dziodzio Johann Pratschke Robert Öllinger Safak Gül-Klein |
author_sort | Simon Moosburner |
collection | DOAJ |
description | <i>Background and Objectives</i>: In children, hepatoblastoma preferentially is managed by liver resection (LR). However, in irresectable cases, liver transplantation (LT) is required. The aim of our study was to compare short- and long-term results after LR and LT for the curative treatment of hepatoblastoma. <i>Materials and Methods</i>: Retrospective analysis of all patients treated surgically for hepatoblastoma from January 2000 until December 2019 was performed. Demographic and clinical data were collected before and after surgery. The primary endpoints were disease free survival and patient survival. <i>Results</i>: In total, 38 patients were included into our analysis (<i>n</i> = 28 for LR, <i>n</i> = 10 for LT) with a median follow-up of 5 years. 36 patients received chemotherapy prior to surgery. Total hospital stay and intensive care unit (ICU) stay were significantly longer within the LT vs. the LR group (ICU 23 vs. 4 days, hospital stay 34 vs. 16 days, respectively; <i>p</i> < 0.001). Surgical complications (≤Clavien–Dindo 3a) were equally distributed in both groups (60% vs. 57%; <i>p</i> = 1.00). Severe complications (≥Clavien–Dindo 3a) were more frequent after LT (50% vs. 21.4%; <i>p</i> = 0.11). Recurrence rates were 10.7% for LR and 0% for LT at 5 years after resection or transplantation (<i>p</i> = 0.94). Overall, 5-year survival was 90% for LT and 96% for LR (<i>p</i> = 0.44). <i>Conclusions</i>: In irresectable cases, liver transplantation reveals excellent outcomes in children with hepatoblastoma with an acceptable number of perioperative complications. |
first_indexed | 2024-03-10T08:37:23Z |
format | Article |
id | doaj.art-b798fb24c9f94c00977ba240717f0f84 |
institution | Directory Open Access Journal |
issn | 1010-660X 1648-9144 |
language | English |
last_indexed | 2024-03-10T08:37:23Z |
publishDate | 2021-08-01 |
publisher | MDPI AG |
record_format | Article |
series | Medicina |
spelling | doaj.art-b798fb24c9f94c00977ba240717f0f842023-11-22T08:36:35ZengMDPI AGMedicina1010-660X1648-91442021-08-0157881910.3390/medicina57080819Liver Transplantation Is Highly Effective in Children with Irresectable HepatoblastomaSimon Moosburner0Moritz Schmelzle1Wenzel Schöning2Anika Kästner3Philippa Seika4Brigitta Globke5Tomasz Dziodzio6Johann Pratschke7Robert Öllinger8Safak Gül-Klein9Deparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, GermanyDeparment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany<i>Background and Objectives</i>: In children, hepatoblastoma preferentially is managed by liver resection (LR). However, in irresectable cases, liver transplantation (LT) is required. The aim of our study was to compare short- and long-term results after LR and LT for the curative treatment of hepatoblastoma. <i>Materials and Methods</i>: Retrospective analysis of all patients treated surgically for hepatoblastoma from January 2000 until December 2019 was performed. Demographic and clinical data were collected before and after surgery. The primary endpoints were disease free survival and patient survival. <i>Results</i>: In total, 38 patients were included into our analysis (<i>n</i> = 28 for LR, <i>n</i> = 10 for LT) with a median follow-up of 5 years. 36 patients received chemotherapy prior to surgery. Total hospital stay and intensive care unit (ICU) stay were significantly longer within the LT vs. the LR group (ICU 23 vs. 4 days, hospital stay 34 vs. 16 days, respectively; <i>p</i> < 0.001). Surgical complications (≤Clavien–Dindo 3a) were equally distributed in both groups (60% vs. 57%; <i>p</i> = 1.00). Severe complications (≥Clavien–Dindo 3a) were more frequent after LT (50% vs. 21.4%; <i>p</i> = 0.11). Recurrence rates were 10.7% for LR and 0% for LT at 5 years after resection or transplantation (<i>p</i> = 0.94). Overall, 5-year survival was 90% for LT and 96% for LR (<i>p</i> = 0.44). <i>Conclusions</i>: In irresectable cases, liver transplantation reveals excellent outcomes in children with hepatoblastoma with an acceptable number of perioperative complications.https://www.mdpi.com/1648-9144/57/8/819hepatoblastomapediatric liver transplantationpediatric liver resectionsurvivalpostoperative complications |
spellingShingle | Simon Moosburner Moritz Schmelzle Wenzel Schöning Anika Kästner Philippa Seika Brigitta Globke Tomasz Dziodzio Johann Pratschke Robert Öllinger Safak Gül-Klein Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma Medicina hepatoblastoma pediatric liver transplantation pediatric liver resection survival postoperative complications |
title | Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma |
title_full | Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma |
title_fullStr | Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma |
title_full_unstemmed | Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma |
title_short | Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma |
title_sort | liver transplantation is highly effective in children with irresectable hepatoblastoma |
topic | hepatoblastoma pediatric liver transplantation pediatric liver resection survival postoperative complications |
url | https://www.mdpi.com/1648-9144/57/8/819 |
work_keys_str_mv | AT simonmoosburner livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT moritzschmelzle livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT wenzelschoning livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT anikakastner livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT philippaseika livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT brigittaglobke livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT tomaszdziodzio livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT johannpratschke livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT robertollinger livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma AT safakgulklein livertransplantationishighlyeffectiveinchildrenwithirresectablehepatoblastoma |