Outcomes of Extended Hepatic Resection for POST-TEXT III and IV
Hepatoblastoma: a single center experience
Abstract
Objective: To investigate the long-term outcomes of extended hepatectomy
for POST-TEXT III and IV hepatoblastoma. Methods: The clinical data of
35 patients with POST-TEXT III and IV hepatoblastoma from January 2009
to June 2019 were analyzed retrospectively. Results: There were 34 cases
of POST-TEXT III and 1 cases of POST-TEXT IV, respectively. All 35 cases
underwent hepatic resection, including 7 cases of hepatic
trisectionectomy, 8 cases of extended hemihepatectomy, 4 cases of
irregular hepatectomy, 12 cases of mesohepatectomy and 4 cases of ALPPS
procedure. Pringle maneuver and Glissonean approach was used in 4 and 22
patients, respectively. The average blood loss of patients with
Glissonean approach (147.73 ± 137.46ml) was significantly less than that
of patients without the approach (387.69 ± 235.69ml; P = 0.001). The
5-year overall survival rate and event-free survival rate was 79.2% and
73.7%, respectively. According to the classification of tumor margin
distance, the 5-year overall survival rates of the tumors with margin
> 1cm, 0.5-1cm, < 0.5cm and close to the tumor
margin were 100%, 78.0%, 83.3% and 53.3%, respectively (P=0.371).
Seven patients developed recurrence which occurred within 1 year after
tumor resection. Conclusion: Non-transplant extended hepatic resection
is a feasible approach for POST-TEXT III and IV hepatoblastomas. On the
basis of mastering the Glisson approach and ensuring a certain resection
margin, it is possible to achieve a similar oncological outcome to liver
transplantation.