Treatment Outcomes for Hepatoblastoma: 15-years-experience of a Single
Institution – Sheikh Khalifa Medical City, Abu Dhabi, UAE
Abstract
Background: Hepatoblastoma is the most common malignant liver
tumor in children. Treatment protocols varies. In our center, we have
adopted the Children’s Oncology Group (COG) AHEP0731 protocol, in
addition to some experimental regimens for relapsed solid tumors.
Methods: We aimed to investigate the outcome of the current
hepatoblastoma treatment protocol at our center. 15 patients were
included between January 2008 and June 2023. A retrospective review was
carried to review the clinical presentation, serum α-fetoprotein (AFP)
level at diagnosis, histological subtype, treatment, and outcomes.
Results: 12 patients (80%) were symptomatic at time of
diagnosis, with abdominal mass being the most common presenting
complaint. Nine patients (60%) presented in stage 3 PRETEXT staging
system. Epithelial histopathological subtype was predominant subtype.
Thirteen patients have received preoperative chemotherapy, followed by
surgical resection; only one patient underwent upfront surgical
resection followed by chemotherapy. Preoperative chemotherapy consists
of 2 to 4 cycles of Cisplatin, Fluorouracil, Vincristine and Doxorubicin
(C5VD), followed by surgical resection. Four of them underwent
neoadjuvent experimental chemotherapy utilizing agents such as
Pazopanib, Pembrolizumab and Sorafenib. During follow-up, six patients
died of progressive disease. The median survival time was 42 months
(95% confidence interval: 18–42%). Five-year overall survival was
44.09% (95% confidence interval: 18–42%). Conclusions: The
combination of surgery and chemotherapy for hepatoblastoma is an
effective approach. Utilization of new-targeted therapies and relapsed
solid tumors regimens may prolong life in patients who did not respond
to standard therapy. Further studies are required to validate its usage
on patients with advanced hepatoblastoma.