Ismail H, Broniszczak D, Kaliciński P, Markiewicz-Kijewska M, Teisseyre J, Stefanowicz M, Szymczak M, Dembowska-Bagińska B, Kluge P, Perek D, Kościesza A, Dzik E, Lembas A, Teisserye M
Departments of Pediatric Surgery and Organ Transplantation, Children's Memorial Health Institute, Warsaw, Poland.
Pediatr Transplant. 2009 Sep;13(6):682-92. doi: 10.1111/j.1399-3046.2009.01062.x. Epub 2009 May 21.
HCC constitutes 25-30% of primary malignant liver tumors in children. Conventional surgical excision is not possible in more than 50% of patients. LTx has recently become an important therapeutic option for adults and children with primary liver tumors. The aim of this study was a retrospective analysis of the clinical and pathological data of children with HCC treated with LTx in relation to Milan criteria assessed at diagnosis and then immediately before transplantation, in comparison with a group of patients treated conventionally. Between 1990 and 2007 we have treated 21 children diagnosed with HCC. Patients were divided into two groups: group I, 10 children treated conventionally and group II, 11 children treated with LTx regardless of previous therapy. The outcome of our patients treated conventionally with resection and chemotherapy is very poor--the disease-free survival rate is 30%. In contrast, despite that only 3 children having fulfilled adult Milan criteria, early clinical results of LTx are much superior. Total hepatectomy followed by LTx is the main treatment option for the majority of children with HCC. Decisions on the type of surgical treatment is made individually, but very early in the course of treatment.
肝癌占儿童原发性恶性肝肿瘤的25%-30%。超过50%的患者无法进行传统手术切除。肝移植最近已成为患有原发性肝肿瘤的成人和儿童的重要治疗选择。本研究的目的是对接受肝移植治疗的肝癌儿童的临床和病理数据进行回顾性分析，这些数据与诊断时以及移植前即刻评估的米兰标准相关，并与一组接受传统治疗的患者进行比较。1990年至2007年间，我们治疗了21例诊断为肝癌的儿童。患者分为两组：第一组，10例接受传统治疗的儿童；第二组，11例接受肝移植治疗的儿童，无论之前接受过何种治疗。我们的患者接受手术切除和化疗的传统治疗效果非常差——无病生存率为30%。相比之下，尽管只有3名儿童符合成人米兰标准，但肝移植的早期临床结果要好得多。全肝切除术后进行肝移植是大多数肝癌儿童的主要治疗选择。手术治疗类型的决定是个体化的，但在治疗过程中要非常早地做出。
