Effect of Initial Surgical Resection on Prognosis of Children with Hepatoblastoma
Objective Objective To investigate whether long-term disease control can be achieved in very low-risk and low-risk patients with hepatoblastoma(HB)undergoing initial surgical resection.Methods Forty-seven patients with very low-risk and low-risk HB admitted to the Affiliated Children's Hospital of Capital Institute of Pediatrics from January 2009 to December 2017 were included,of which 24 patients underwent initial surgical resection.All patients were followed up for more than 5 years after surgery,and the cumula-tive dose of overall chemotherapy platinum drugs was calculated to explore the impact of initial surgical resection on the prognosis of pa-tients.Results Surgeries went uneventfully and there were no surgical complications in all patients.23 patients received 2-6 cycles of preoperative neoadjuvant chemotherapy,and all patients received 2-4 cycles of postoperative adjuvant chemotherapy.There was no statis-tically significant difference in the 5-year event-free survival(EFS)and 5-year overall survival(OS)between patients who under-went initial surgical resection and those who underwent surgery after neoadjuvant chemotherapy(EFS:91.67％vs 86.96％,P=0.590;OS:95.83％vs 95.65％,P=0.988).The overall cumulative dose of platinum drugs in patients undergoing initial surgical resection was significantly lower than that in patients undergoing surgery after neoadjuvant chemotherapy(251.3±66.9mg/m2 vs 598.7±68.4mg/m2),and the difference was statistically significant(P＜0.001).Conclusion Initial surgical resection of HB in very low-risk and low-risk patients can achieve long-term disease control and significantly reduce the overall cumulative dose of platinum drugs.
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