Gauthier F, Valayer J, Thai B L, Sinico M, Kalifa C
J Pediatr Surg. 1986 May;21(5):424-9. doi: 10.1016/s0022-3468(86)80513-9.
Twenty-nine cases of liver malignancies, 26 hepatoblastomas (HB) and 3 hepatocarcinomas (HC), were treated in a 13-year period. All children were submitted to operation but four had nonresectable tumors, even after chemotherapy. Surgery in the 25 cases consisted of right lobectomy in 14, a left lobectomy in 9, and a tumorectomy in 2; a secondary operation had to be performed in 5 cases, either because of histologic doubt on the cut section of the presumed normal parenchyma, or for local recurrence. Preoperative chemotherapy, instituted on a routine basis since 1982, did appear to facilitate surgery in otherwise inoperable tumors. The benefits of preoperative embolization, done for three children, were minimal. Ten children died, one in the immediate postoperative period, eight others from the disease, and one from a complication of chemotherapy. Follow-up for the 18 surviving children, all recurrence and metastasis-free, with normal alphafetoprotein (AFP) is less than 2 years for four and from 2 to 11 years for 14. One teen-age girl, with a fibrolamellar carcinoma has just recently been reoperated because of recurrence three years later. In spite of the fact that 6 out of 7 children operated without adjunctive treatment are cured, a systematic course of preoperative chemotherapy has been prescribed in the more recent cases. Follow-up for these is yet too short.
在13年期间共治疗了29例肝脏恶性肿瘤，其中26例为肝母细胞瘤（HB），3例为肝癌（HC）。所有患儿均接受了手术，但有4例即使在化疗后仍有不可切除的肿瘤。25例手术中，14例行右叶切除术，9例行左叶切除术，2例行肿瘤切除术；5例因对假定正常实质的切缘组织学存在疑问或局部复发而需再次手术。自1982年起常规进行术前化疗，这确实似乎有助于对原本无法手术的肿瘤进行手术。对3名儿童进行的术前栓塞术效果甚微。10名儿童死亡，1例在术后即刻死亡，另外8例死于疾病，1例死于化疗并发症。18名存活儿童的随访情况如下，4名儿童随访时间不到2年，14名儿童随访时间为2至11年，所有儿童均无复发和转移，甲胎蛋白（AFP）正常。一名患有纤维板层癌的青少年女孩在3年后因复发最近再次接受了手术。尽管7名未接受辅助治疗而接受手术的儿童中有6例治愈，但在最近的病例中仍规定了系统的术前化疗疗程。对这些病例的随访时间仍太短。
