Conference Proceeding

Multidisciplinary management of hepatoblastoma in children: Experience from a developing country

Dr. Vimal Kumar,
Consultant, Global Health City

Dr. Vimal Kumar G, carried his MD (Paediatrics) in SMS Medical College, Jaipur and later he started working as Senior Registrar, Paediatric Haemato- Oncology in Apollo Speciality Hospital, Chennai. Presently he is working as a Consultant, Paediatric Hematology, Oncology and Bone Marrow Transplantation in Global Health City, Chennai, Tamil Nadu, India.

Background: Advances in chemotherapy, liver resection techniques and pediatric liver transplantation have vastly improved survival in children with hepatoblastoma (HB). These are best managed by a multidisciplinary team in a setting where all treatment options are available. Until recently this was difficult to achieve in India.
Methods: Review of all children (< 16yrs) with HB treated in a pediatric liver surgery & transplantation unit between Jan 2011 and August 2015. Data regarding the clinical presentation, pre-operative management, surgical treatment, postoperative course and outcomes was extracted from a prospectively managed database.
Results: Thirty children were treated for HB during the study period. Nine children were PRETEXT 4, 7 were PRETEXT 3, 13 were PRETEXT 2 and one was PRETEXT 1. All children received neo adjuvant chemotherapy before surgery followed by adjuvant chemotherapy. Nineteen children had complete resection, while six underwent primary living donor liver transplantation. There were 6 mortalities including 5 children who poorly responded to chemotherapy with progressive tumor extension. At a median follow-up of 23 months, two children who underwent resection and one child who underwent liver transplant had disease recurrence.
Conclusion: Improved outcomes can be achieved in children with HB even in countries with limited resources when they are managed by multidisciplinary teams with expertise in pediatric oncology, liver resection and liver transplantation.

Published: 11 May 2017