[Evaluation of the methods of treatment of children with liver neoplasms].

Unfavorable prognosis for children with malignant liver tumors, is caused not only because of late diagnosis in this children, but because of imperfet methods of treatment. These methods taken from adults oncology have to be adapted for pediatric patients in front of their differences in biology, pharmacodynamic reactivity and tumor-host relationships in developing organism. Some methods of treatment can be done the same way as in adults, but another (intraarterial treatment) can be used in children with much better results then in adults. Primary malignant tumors in children are hepatoblastoma and hepatocelullar carcinoma (minority) and metastatic tumors are nephroblastoma or neuroblastoma. That makes probably basic difference with liver tumors in adults, as well as absence of hepatic cirrhosis in children. 42 children with primary and metastatic liver tumors were treated by the author in Clinical Department of Pediatric Oncology, Institute of Mother and Child, Warsaw. 19 of them was given intra-arterial chemotherapy for unoperable primary tumors, 6--systemic chemotherapy for the same reason, 5--radiotherapy (all of them neuroblastomas) and 15 was submited to surgery-From this group 13 was operated radicaly by means of right extended or left lobectomy. Only in one case, middle lobectomy was done. 3 children operated radicaly was previously treated with intra-arterial chemotherapy and only after significant remission, surgery was done. As a result 6 children is RFS for more than 3 years. One of them exclusively grace to intra-arterial treatment. Experimental investigation done in monkeys shown no long term morphological and/or functional disturbances after long time hepatic infusion with chemotherapeutic drugs. In conclusion it is to state that surgery is the best method of treatment in primary liver tumors, some time preceded with intra-aterial chemotherapy that is safe for normal liver tissue. In metastatic neuroblastoma in liver, radiotherapy with systemic chemotherapy can give 60% of RFS (recurrent free survival).