Ann Surg 1991 Feb;213(2):118-21

Liver transplantation for hepatoblastoma. The American experience

Koneru B, Flye MW, Busuttil RW, Shaw BW, Lorber MI, Emond JC, Kalayoglu M,
Freese DK, Starzl TE

Department of Surgery, University of Pittsburgh, Pennsylvania

Abstract
The current role of liver transplantation in treating malignant tumors of the
liver is uncertain, except for select histologic types. Pooled data on the
results of liver transplantation in 12 children with hepatoblastoma is presented
here. One half of the children are alive 24 to 70 (44 +/- 19) months after
transplantation with no evidence of recurrence. Three patients (25%) died of
tumor recurrence and three (25%) died of other causes. Unifocal and intrahepatic
tumors were associated with better prognosis compared to the multifocal tumors
and tumors with extrahepatic spread (p = 0.04 and 0.13). Microscopically
vascular invasion and the predominance of embryonal and/or anaplastic epithelium
were associated with a poor prognosis compared to the tumors with no vascular
invasion and with predominantly fetal epithelium (p = 0.08 and 0.1). It is
concluded that continued efforts to treat unresectable hepatoblastomas by liver
transplantation is justified and the role of adjuvant chemotherapy in improving
the results needs to be better defined