Improved Survival Outcome for Hepatoblastoma Based on an Optimal Chemotherapeutic Regimen—A Report from the Study Group for Pediatric Solid Malignant Tumors in the Kyushu Area

Abstract Background/purpose The survival outcome for patients with hepatoblastoma normally depends on the resectability of the tumor. In Japan, the pre and/or postoperative chemotherapy protocol using a combination of cisplatin (CDDP) and tetrahydropyranyl-Adriamycin (THP-ADR) has been the standard treatment since 1991. This study aims to assess exactly what influence the establishment of this chemotherapy protocol has had on both the tumor resectability and the outcome of patients with hepatoblastoma. Methods From 1982 to 1997, 60 patients with hepatoblatoma were treated in the Kyushu area, Japan. Based on the pretreatment extent of disease (PRETEXT), the outcome and tumor resectability were compared between group A (1982 to 1990, n=27, PRETEXT I:5, II:8, III:6, IV:8) and group B (1991 to 1997, n=33, PRETEXT I:9, II:9, III:5, IV:10). Results The 5-year survival rates (group A and group B) were 33% and 73% for all cases ( P P P P P P P Conclusions The optimal chemotherapeutic regimen of CDDP and THP-ADR was thus found to greatly contribute to the improved survival rate of hepatoblastoma patients. Preoperative chemotherapy resulted in an increased resectability of the tumor, whereas postoperative chemotherapy played an important role in the increased cure rate of cases with either an incomplete tumor resection or metastasis. However, refractory cases with PRETEXT IV or metastasis may still require the development of an even more effective treatment modality, including the use of blood stem cell transplantation.