Conference Proceeding

Recent advances in the management of hepatoblastomas

Juluis Scott,
Shri Ramswaroop Memorial University, India

Dr. Julius Scott carried out his postdoctoral research in the Women’s and Children’s Hospital, Adelaide, Australia. Later he started working as a Professor at Sri Ramachandra Medical University, Porur, Chennai. He has many honors and awards. Presently he is working as Head, Division of Pediatric, Hematology and Oncology services, Sri Ramachandra Medical University, Chennai, India.

Background: Hepatoblastomas (HB) constitutes 1% of childhood cancers, usually occurs in children aged between 6 months and 3 years, but cases in neonates and adolescents have been reported rarely. Next to neuroblastoma, Wilms Tumor, hepatoblastomas are the third most common intraabdominal malignancy in children. With survival rates increasing from 20% to 80% over the past decades, the treatment of HB has been one of the great success stories in pediatric oncology.
Aims: To describe the dramatic revolutionary improvement in the diagnosis, treatment and outcome of children diagnosed with HB that has occurred in the past four decades.
Discussion: Important milestones were the risk stratification of HB that allowed tailoring down therapy for standard risk HB and intensifying treatment for high-risk HB. The multi-institutional international cooperative SIOPEL trials, the Children's Oncology Group (COG), the national study groups from Germany (GPOH) and Japan (JPLT) led the progress of the treatment. The use of one staging system (PRETEXT) and the outcome after incorporating liver transplantation increased the outcome. Currently the treatment of relapsed HB is challenging. In recurrent refractory alternative strategies and combinations of new agents are currently tested, like irinothecan, targeted agents like sorafenib which we have seen good results.

Published: 11 May 2017