Liver Transplantation for Pediatric Liver Cancer
Open Access
- 19 March 2020
- Vol. 12 (3), 720
- https://doi.org/10.3390/cancers12030720
Abstract
Unresectable hepatocellular carcinoma (HCC) was first removed successfully with total hepatectomy and liver transplantation (LT) in a child over five decades ago. Since then, children with unresectable liver cancer have benefitted greatly from LT and a confluence of several equally important endeavors. Regional and trans-continental collaborations have accelerated the development and standardization of chemotherapy regimens, which provide disease control to enable LT, and also serve as a test of unresectability. In the process, tumor histology, imaging protocols, and tumor staging have also matured to better assess response and LT candidacy. Significant trends include a steady increase in the incidence of and use of LT for hepatoblastoma, and a significant improvement in survival after LT for HCC with each decade. Although LT is curative for most unresectable primary liver sarcomas, such as embryonal sarcoma, the malignant rhabdoid tumor appears relapse-prone despite chemotherapy and LT. Pediatric liver tumors remain rare, and diagnostic uncertainty in some settings can potentially delay treatment or lead to the selection of less effective chemotherapy. We review the current knowledge relevant to diagnosis, LT candidacy, and post-transplant outcomes for these tumors, emphasizing recent observations made from large registries or larger series.This publication has 93 references indexed in Scilit:
- Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): a prospective, single-arm, feasibility studyThe Lancet Oncology, 2013
- Widening Spectrum of Liver Angiosarcoma in ChildrenJournal of Pediatric Gastroenterology and Nutrition, 2011
- The anticancer immune response: indispensable for therapeutic success?JCI Insight, 2008
- 2005 PRETEXT: a revised staging system for primary malignant liver tumours of childhood developed by the SIOPEL groupPediatric Radiology, 2006
- The Spectrum of APC Mutations in Children with Hepatoblastoma from Familial Adenomatous Polyposis KindredsThe Journal of Pediatrics, 2005
- β-Catenin and Met Deregulation in Childhood HepatoblastomasPediatric and Developmental Pathology, 2005
- Risk-adapted treatment for childhood hepatoblastoma: final report of the second study of the International Society of Paediatric Oncology—SIOPEL 2European Journal of Cancer, 2004
- The surgical management of children with incompletely resected hepatic cancer is facilitated by intensive chemotherapyJournal of Pediatric Surgery, 1991
- Effective cisplatin (DDP) based chemotherapy in the treatment of hepatoblastomaMedical and Pediatric Oncology, 1985
- Association between hepatoblastoma and polyposis coli.Archives of Disease in Childhood, 1983