Our Experience in Hepatoblastoma Surgery

Objective: In this study, we aimed to present our patients with hepatoblastoma who had undergone surgery. Materials and Methods: The patients who had been operated for hepatoblastoma in the last ten years at Çukurova University Hospital were included in the study. The age, gender, complaints, blood alpha-fetoprotein level, whether neoadjuvant chemotherapy was administered, size, stage, surgical findings, distant metastasis, postoperative complications, outcome, and mortality were assessed. Results: We operated on 22 patients with hepatoblastoma in the last ten years. We could access data of 17 patients. The mean age of the patients was 22 months (4-96 months). 88% of the patients were aged younger than 5 years and 76% younger than 3 years. Seven patients were male, and ten were female. Fourteen patients presented with abdominal distention and swelling. One patient was admitted to the hospital with weight loss, one with diarrhea and one with a fever. In the first evaluation, eight patients were in stage 2 and nine in stage 3 according to the PRETEXT staging. We did not have any stage 1 or 4 patients. Alpha-fetoprotein level levels were high in 16 patients. The mean size of the mass was 11.5 cm at the first evaluation. One patient underwent surgery for trans-arterial chemoembolization since the tumor could not be excised after chemotherapy; we were able to excise the tumor totally following trans-arterial chemoembolization. Two patients had portal vein thrombosis and one was excised during surgery. Seven patients had undergone right, three patients right-expanded, three patients left-expanded, one patient segmental 6-7, and three patients left hepatectomy. Distant metastases were present in two patients (lungs). Mortality occurred in one patient. Conclusion: Multidisciplinary approach is fundamental in hepatoblastoma and other malignant masses. Not only pediatric oncology but also alternative treatment options such as trans-arterial chemotherapy should be considered.