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Effectiveness of Preoperative Transcatheter Arterial Chemoembolization in Hepatoblastoma

Journal of the Korean Pediatric Society 2000;43(8):1098-1105.
Published online August 15, 2000.
Effectiveness of Preoperative Transcatheter Arterial Chemoembolization in Hepatoblastoma
Pyoung Han Hwang, Dae Sun Jo, Dae Yeol Lee, Jung Soo Kim
Department of Pediatrics, Medical School, Chonbuk National University, Chonju, Korea
간모세포종의 수술 전 치료로서 경동맥 화학색전술의 효과
황평한, 조대선, 이대열, 김정수
전북대학교 의과대학 소아과학교실
Abstract
Purpose
: To evaluate the effectiveness of transcatheter arterial chemoembolization(TACE) as a preoperative treatment for initially unresectable hepatoblastomas.
Methods
: From January 1995 to July 1999, we identified two boys and three girls(age range : 5- 27 months; mean age : 12 months) with pathologically-confirmed hepatoblastoma. To assess response to treatment, we utilized an identical TACE procedure for all the patients. A second TACE procedure was performed 3 weeks after the first TACE procedure and patients underwent tumor resection approximately 1 month following the second TACE procedure. The therapeutic responses to TACE were assessed by measuring of tumor size, shape, observation of tumor properties using abdominal computed tomography(CT), gross and microscopic pathologic findings, levels of alpha- feto protein(AFP) and clinical adverse events to TACE.
Results
: In these patients, hepatoblastomas showed marked reductions in tumor size. Massive tumor necrosis and homogeneous distribution of lipiodol created a clear margin bordered by surrounding normal liver tissue. At initial diagnosis, the mean AFP level=867.4ng/mL, 47.4ng/mL after second TACE, and 8.6ng/mL at 6 months after surgical resection. Transient fever was observed following TACE and elevations of levels of AST and ALT were observed but these normalized 2 weeks following TACE. No major complications were associated with TACE.
Conclusion
: We suggest that preoperative TACE is an effective, safe, and useful method for patients with initially unresectable hepatoblastoma.
Key Words: Hepatoblastoma, Transcathter arterial chemoembolization(TACE)


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