Experience with hepatoblastoma treatment in small children – the use of preoperative 3D virtual analysis MeVis for liver resections
Authors:
J. Janek 1; P. Bician 2; P. Kenderessy 3; P. Kothaj 1; K. Novotná 4; J. Koňarčík 5; Ľ. Laca 6; J. Ulianko 1; I. Dedinská 6
Authors‘ workplace:
Chirurgická klinika SZU, FNsP F. D. Roosevelta, Banská Bystrica
prednosta: prof. MUDr. P. Kothaj, CSc
1; Klinika pediatrickej onkológie a hematológie SZU, DFN Banská Bystrica
prednosta: MUDr. E. Bubanská, PhD
2; The Harley Street Clinic, Children’s Hospital, London
clinical lead: Dr. D. Inwald, MB BChir MRCP FRCPCH PhD
3; Rádiologické oddelenie, FNsP F. D. Roosevelta, Banská Bystrica
primár: MUDr. S. Okapec
4; Martinské bioptické centrum s. r. o.
vedúci pracoviska: Prof. MUDr. L. Plank, CSc
5; Chirurgická klinika a transplantačné centrum, FN Martin
prednosta: prof. MUDr. L. Laca, PhD
6
Published in:
Rozhl. Chir., 2017, roč. 96, č. 1, s. 25-33.
Category:
Original articles
Overview
Introduction:
Hepatoblastoma is an uncommon but most frequent liver cancer in infants and children. The therapy is complex, including neoadjuvant, surgical, and adjuvant therapy. For surgery, the presence of a specialized surgeon and an anaesthesiologist is required. For planning the surgery, the 3D analysis MeVis is currently available. The objective of the work is the assessment of a group of children operated for a liver hepatoblastoma and the assessment of contribution of a pre-surgery virtual 3D analysis MeVis for a surgeon.
Methods:
It represents a retrospective assessment of the operated children for the given diagnosis. Upon confirming the disease, the patients underwent neoadjuvant therapy, and then the MeVis analysis of a liver, a surgery, and an adjuvant therapy. The oncologic treatment was performed according to the SIOPEL recommendations.
Results:
In the period of 2012 to 2016, we treated 5 infant patients with the diagnosed hepatoblastoma. The children were at the age between 4 and 37 months, 4 girls, 1 boy. The size of tumours according to the SIOPEL classification was PRETEXT II to IV. All children underwent a surgery without any complications and without any signs of post-operative failure of the post-resection remnant of the liver. The functional volume of the post-resection remnant of the liver was between 28%−70% according to the MeVis analysis. During the long-term monitoring, one patient underwent lung metastasectomy, all children are currently without any signs of relapse of the disease.
Conclusion:
In case of quick catching and correct management of a hepatoblastoma, the results of therapy are very good. For successful treatment, a surgeon experienced in liver resection, presence of a specialized paediatric anaesthesiologist, and a paediatric oncologist are is required. The exact volumetric analysis MeVis is a contribution for a pre-operational review of the finding, and for the preparation of the surgery. The disease is uncommon, and therefore, the groups of patients are small. Due to that reason, the treatment should be centralized to a specialized department.
Key words:
hepatoblastoma − MeVis − volumetry − liver resection
Sources
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Perspectives in Surgery
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