演題抄録

International Session(Oral)

開催概要
開催回
第51回・2013年・京都
 

Chemotherapy and liver transplantation for advanced hepatoblastoma

演題番号 : ISO1-7

[筆頭演者]
Ryuhei Tanaka:1 
[共同演者]
Atsuko Watanabe:1、Seisuke Sakamoto:2、Hiriyuki Kanazawa:2、Nobuhiro Tanno:1、Takeshi Komaki:1、Mureo Kasahara:2

1:Pediatric Oncol/Hematol, Int Natl Med Centr, Saitama Med Univ, Japan、2:Transplantation Center, National Center for Child Health and Development , Japan

 

Hepatoblastoma (HB) is exceedingly rare but the most common liver malignancy in childhood. For solid tumors, including HB as is the case of epithelial cancers in adults, complete tumor removal by surgery is mandatory to obtain the long-term survival and the chance of cure. Even the chemosensitive cancers, effective preoperative chemotherapy (Cx) is essential to achieve the complete resection and eradicate the possible micrometastasis of the HB initiating cells that could be the seeds of the recurrence. Lately, orthotopic liver transplantation (OLTx) from living related donor is applied for the treatment of HB. OLTx will provide the ability to obtain complete resection of otherwise unresectable HBs and increasing numbers of promising results have been reported. Within the last two years, we have experienced three cases of advanced HB with pulmonary metastasis. All of the cases have been received five to seven courses of preoperative Cx and achieved the suitable condition to perform the complete resection with OLTx from family donor or preparing family donor as a standby setting. (PATIENTS) Age: 1 y.o. - 3 y.o., Sex: F 0, M 3., Stage at presentation: Stage IV in all cases., AFP values at presentation: 467,234 - 692,673 ng/mL., Preoperative Cx: CDDP + ADR, CDDP + 5-FU + VCR, and IFO + ETP + CBDCA., Lung metastasis at surgery: Not detectable in all cases. (RESULTS) Total hepatectomy was carried out in one patient with OLTx from his mother and alive more than one year with perfect PS. Right lobectomy was performed in another patient with the standby setting of OLTx. The last patient is going to receive surgical management within a month. (DISCUSSION) For advanced HBs, preoperative Cx is seems to be essential and it will tell us the effectiveness of Cx as adjuvant setting. In addition, OLTx is a reliable treatment of choice for advanced HBs. Well-designed nationwide clinical studies are warranted because HB is quite rare cancer.

キーワード

臓器別:肝臓

手法別:移植・細胞療法

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