Retrospective study with follow up of children with Hepatoblastoma

Soumitra Saha, (2014) Retrospective study with follow up of children with Hepatoblastoma. Masters thesis, Christian Medical College, Vellore.

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Abstract

� INTRODUCTION: Hepatoblastoma (HB) accounts around 80% of malignant liver tumor among pediatric age group1,2. It is a rare pediatric a pediatric neoplasm. Its incidence is about 1.5 per million. It comprises only about 1% of all pediatric malignancies. Till 1970, surgery was only treatment modality for HB. In the past children with HB were treated with surgery alone and there was around 30% relapse rate. Then we gradually came to know that HB is a chemo sensitive tumor. Tremendous advances in chemotherapy occurred in last 2 decades. In recent era, successful treatment of HB includes neoadjuvant chemotherapy, surgery and adjuvant chemotherapy. Studies related to HB published in different Indian journals were comparatively dealt with small number of study group and study period as compared to western studies. This study deals with our experience in the management of hepatoblastoma. AIMS AND OBJECTIVES: To retrospectively review our single centre experience with neoadjuvant chemotherapy and surgery in hepatoblastoma. MATERIALS AND METHODS: This is a retrospective study with follow-up of children with hepatoblastoma during the period from January 2003 to December 2012 at Christian Medical College and Hospital, Vellore (CMCH). All 28 (N=28) cases diagnosed and completely treated in CMCH under pediatric surgery and pediatric oncology were included in this study._Data were retrospectively collected from surgical and medical records. Patient characteristics, mode of diagnosis, treatment modalities, follow-up and disease free survival were analyzed._ Data entry was done using Microsoft excel. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 16. RESULTS: Mean age of presentation was 28.22 months. Male : female ratio was 3.6:1. 27 cases had raised AFP at presentation. Most patients were managed after needle biopsy with 4 cycles of PLADO, surgery and 2 more cycles of PLADO. Among 28 patients, 7 patients did not undergo surgery. 1 patient is disease free after getting full course of chemotherapy without surgery. Remaining 20 patients underwent hepatic resection. There was no intra operative mortality. Among these 20 patients, 13 patients are disease free with near follow-up 3 years. Other 7 patients died. CONCLUSION: 65% patients who underwent hepatic resection are disease free after mean follow-up of approximately 3 years. One patient is disease free after getting full course of chemotherapy without surgery. However 7 patients who were originally seen did not undergo surgery for a variety of reasons making the overall survival 50%.

Item Type: Thesis (Masters)
Additional Information: Reg.No.18113304
Uncontrolled Keywords: Hepatoblastoma, alpha-fetoprotein (AFP), PLADO
Subjects: MEDICAL > Paediatric Surgery
Depositing User: Subramani R
Date Deposited: 16 Feb 2020 02:59
Last Modified: 16 Feb 2020 02:59
URI: http://repository-tnmgrmu.ac.in/id/eprint/11955

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