Outcomes of children with hepatoblastoma managed at a tertiary hospital in China

Objective: To summarise our experiences in hepatoblastoma management in South ChinaMethods: We diagnosed 135 children with hepatoblastoma at our institution between January 2010 and December 2017. Information regarding demographics, clinical data, and outcomes were retrospectively collected and analysed. Results: Ninety-three patients underwent liver resection and were enrolled in this study. Thirty-six, 23, 3, and 31 patients had PRETEXT stages II, III, IV, and unspecified tumours, respectively. Seven patients had ruptured tumour, 9 had lung metastasis, and 1 had portal vein thrombosis. Sixteen patients underwent primary liver resection, 22 received neoadjuvant chemotherapy and delayed surgery, 25 received preoperative transarterial chemoembolisation and delayed surgery, and 30 received a combination of neoadjuvant chemotherapy, transarterial chemoembolisation, and delayed surgery. Forty patients had both PRETEXT and POST-TEXT information available for analysis. Twelve cases were downstaged after preoperative treatment: 2 from stage IV to III, 8 from stage III to II, and 2 from stage II to I. Ten patients with unspecified PRETEXT stage were confirmed to have POST-TEXT stages II (n=8) and I (n=2) tumours. The PRETEXT and POST-TEXT stages were significantly different. Seven tumours were associated with positive surgical margins, and 12 patients had microvascular involvement. During a median follow-up period of 30.5 months, 84 patients survived without relapse, 9 experienced tumour recurrence, and 4 died. The two-year EFS and OS rates were significantly better among patients without metastasis. The two-year EFS and OS rates were similar among patients treated with different preoperative strategies.Conclusion: The outcomes of hepatoblastoma after resection were excellent.