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Management of Hepatoblastoma: ICMR Consensus Document

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Abstract

Dramatic advancement has been made in the management of children with hepatoblastoma (HB) over the past 3 decades owing to the improvement in diagnostic imaging, new chemotherapeutic agents, better surgical care and availability of liver transplantation. These advances are the end results of contributions from 4 major study groups across the globe including International Society of Pediatric Oncology – Liver Tumor Strategy Group (SIOPEL), Children’s Oncology Group (COG), German Pediatric Hematology Oncology Group (GPOH) and Japanese Pediatric Liver Tumor Study Group (JPLT). The current manuscript is written with the objective of developing a consensus guideline for practitioners at a National level. Based on literature and personal experience over last 3 decades, the Indian Council of Medical Research (ICMR) Expert group has made recommendations for management of children with HB in resource-challenged nations including India.

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References

  1. Aronson DC, Czauderna P, Maibach R, Perilongo G, Morland B. The treatment of hepatoblastoma: its evolution and the current status as per the SIOPEL trials. J Indian Assoc Pediatr Surg. 2014;19:201–7.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ortega JA, Douglass EC, Feusner JH, et al. Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the children’s cancer group and the pediatric oncology group. J Clin Oncol. 2000;18:2665–75.

  3. Pritchard J, Brown J, Shafford E, et al. Cisplatin, doxorubicin, and delayed surgery for childhood hepatoblastoma: a successful approach--results of the first prospective study of the International Society of Pediatric Oncology. J Clin Oncol. 2000;18:3819–28.

    Article  CAS  PubMed  Google Scholar 

  4. Perilongo G, Maibach R, Shafford E, et al. Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma. N Engl J Med. 2009;361:1662–70.

    Article  CAS  PubMed  Google Scholar 

  5. Hishiki T, Matsunaga T, Sasaki F, et al. Outcome of hepatoblastomas treated using the Japanese study Group for Pediatric Liver Tumor (JPLT) protocol-2: report from the JPLT. Pediatr Surg Int. 2011;27:1–8.

    Article  PubMed  Google Scholar 

  6. Sasaki F, Matsunaga T, Iwafuchi M, et al; Japanese Study Group for Pediatric Liver Tumor. Outcome of hepatoblastoma treated with the JPLT-1 (Japanese Study Group for Pediatric Liver Tumor) Protocol-1: a report from the Japanese Study Group for Pediatric Liver Tumor. J Pediatr Surg. 2002;37:851–6.

  7. Perilongo G, Shafford E, Maibach R et al. International Society of Paediatric Oncology-SIOPEL 2. Risk-adapted treatment for childhood hepatoblastoma. final report of the second study of the International Society of Paediatric Oncology-SIOPEL 2. Eur J Cancer. 2004;40:411–21.

  8. Fuchs J, Rydzynski J, Von Schweinitz D, et al; Study Committee of the Cooperative Pediatric Liver Tumor Study HB 94 for the German Society for Pediatric Oncology and Hematology. Pretreatment prognostic factors and treatment results in children with hepatoblastoma: a report from the German cooperative pediatric liver tumor study HB 94. Cancer. 2002;95:172–82.

  9. Häberle B, Bode U, von Schweinitz D. Differentiated treatment protocols for high- and standard-risk hepatoblastoma--an interim report of the German Liver Tumor Study HB99. Klin Padiatr. 2003;215:159–65.

    Article  PubMed  Google Scholar 

  10. Katzenstein HM, Rigsby C, Shaw PH, et al; Novel therapeutic approaches in the treatment of children with hepatoblastoma. J Pediatr Hematol Oncol. 2002;24:751–5.

    Article  PubMed  Google Scholar 

  11. Katzenstein HM, Chang KW, Krailo M, et al. Children’s Oncology Group. Amifostine does not prevent platinum-induced hearing loss associated with the treatment of children with hepatoblastoma: a report of the Intergroup Hepatoblastoma Study P9645 as a part of the Children's Oncology Group. Cancer. 2009;115:5828–35.

  12. Couinaud C. Liver lobes and segments: notes on the anatomical architecture and surgery of the liver. Presse Med. 1954;62:709–12.

    CAS  PubMed  Google Scholar 

  13. von Schweinitz D. Management of liver tumors in childhood. Semin Pediatr Surg. 2006;15:17–24.

    Article  Google Scholar 

  14. Evans AE, Land VJ, Newton WA, Randolph JG, Sather HN, Tefft M. Combination chemotherapy (vincristine, adriamycin, cyclophosphamide, and 5-fluorouracil) in the treatment of children with malignant hepatoma. Cancer. 1982;50:821–6.

    Article  CAS  PubMed  Google Scholar 

  15. Black CT, Cangir A, Choroszy M, Andrassy RJ. Marked response to preoperative high-dose cis-platinum in children with unresectable hepatoblastoma. J Pediatr Surg. 1991;26:1070–3.

    Article  CAS  PubMed  Google Scholar 

  16. Douglass EC, Green AA, Wrenn E, Champion J, Shipp M, Pratt CB. Effective cisplatin (DDP) based chemotherapy in the treatment of hepatoblastoma. Med Pediatr Oncol. 1985;13:187–90.

    Article  CAS  PubMed  Google Scholar 

  17. Malogolowkin MH, Katzenstein HM, Meyers RL, et al. Complete surgical resection is curative for children with hepatoblastoma with pure fetal histology: a report from the Children's oncology group. J Clin Oncol. 2011;29:3301–6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Zsíros J, Maibach R, Shafford E, et al. Successful treatment of childhood high-risk hepatoblastoma with dose-intensive multiagent chemotherapy and surgery: final results of the SIOPEL-3HR study. J Clin Oncol. 2010;28:2584–90.

    Article  PubMed  Google Scholar 

  19. Katzenstein HM, London WB, Douglass EC, et al. Treatment of unresectable and metastatic hepatoblastoma: a pediatric oncology group phase II study. J Clin Oncol. 2002;20:3438–44.

    Article  PubMed  Google Scholar 

  20. Meyers RL, Tiao GM, Dunn SP, Langham MR Jr. Liver transplantation in the management of unresectable hepatoblastoma in children. Front Biosci (Elite Ed). 2012;4:1293–302.

  21. Lautz TB, Ben-Ami T, Tantemsapya N, Gosiengfiao Y, Superina RA. Successful nontransplant resection of POST-TEXT III and IV hepatoblastoma. Cancer. 2011;117:1976–83.

    Article  PubMed  Google Scholar 

  22. Guérin F, Gauthier F, Martelli H, et al. Outcome of central hepatectomy for hepatoblastomas. J Pediatr Surg. 2010;45:555–63.

    Article  PubMed  Google Scholar 

  23. Meyers RL, Aronson DC, von Schweinitz D, et al. Pediatric liver tumors. In: Pizzo PA, Poplack DG, editors. Principles and Practice in Pediatric Oncology. Philadelphia, PA: Wolters Kluwer, Lippincott. Williams Wilkins; 2011. p. 838–60.

  24. Meyers RL, Otte J-B. Liver transplantation for unresectable liver tumors in children. In: Zimmermann A, Perilongo G, Malogolowkin M, von Schweinitz D, editors. Pediatric liver tumors. Heidelberg: Springer; 2011. p. 133–52.

    Chapter  Google Scholar 

  25. Gupta AA, Gerstle JT, Ng V, et al. Critical review of controversial issues in the management of advanced pediatric liver tumors. Pediatr Blood Cancer. 2011;56:1013–8.

    Article  PubMed  Google Scholar 

  26. Otte JB, Meyers R. PLUTO first report. Pediatr Transplant. 2010;14:830–5.

    Article  PubMed  Google Scholar 

  27. Meyers RL, Katzenstein HM, Krailo M, McGahren 3rd ED, Malogolowkin MH. Surgical resection of pulmonary metastatic lesions in children with hepatoblastoma. J Pediatr Surg. 2007;42:2050–6.

    Article  PubMed  Google Scholar 

  28. Arora RS. Outcomes of hepatoblastoma in the Indian context. Indian Pediatr. 2012;49:307–9.

    Article  CAS  PubMed  Google Scholar 

  29. Shukla PJ, Barreto SG, Qureshi SS, et al. Hepatoblastoma: a single institutional experience of 18 cases. Pediatr Surg Int. 2008;24:799–802.

    Article  PubMed  Google Scholar 

  30. Singh T, Satheesh CT, Appaji L, et al. Hepatoblastoma: experience from a single center. Indian J Cancer. 2010;47:314–6.

    Article  CAS  PubMed  Google Scholar 

  31. Agarwala S, Bakshi S, Bajpai M, et al. Validation of PRETEXT staging system and risk categorization for prognostication and outcome in hepatoblastoma- results from AIIMS-HB94 trial [abstract]. Pediatr Blood Cancer. 2007;49:401–2.

    Google Scholar 

  32. Zsíros J, Brugières L, Brock P, et al. Efficacy of irinotecan single drug treatment in children with refractory or recurrent hepatoblastoma--a phase II trial of the childhood liver tumour strategy group (SIOPEL). Eur J Cancer. 2012;48:3456–64.

    Article  PubMed  Google Scholar 

  33. Blohm ME, Vesterling-Hörner D, Calaminus G, Göbel U. Alpha 1-fetoprotein (AFP) reference values in infants up to 2 years of age. Pediatr Hematol Oncol. 1998;15:135–42.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This article is prepared as an outcome of Indian Council of Medical Research (ICMR) Sub-Committee on Pediatric Lymphomas and Solid Tumors coordinated by the Division of Non-Communicable Diseases, ICMR.

Contributions

SA and AG: Writing and literature search; DB, GK, TV, MP, GC, BA, VR and SL: Review and revisions; TK: Administrative support; RSD and GKR: Administrative support; SB: Writing, review and revisions. SA will act as guarantor for the paper.

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Authors and Affiliations

  1. Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India

    Sandeep Agarwala & Alisha Gupta

  2. Pediatric Hematology Oncology Unit, Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Deepak Bansal

  3. Department of Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, India

    Tushar Vora, Maya Prasad, Brijesh Arora & Girish Chinnaswamy

  4. Department of Pediatric Hematology & Oncology, Rajiv Gandhi Cancer Institute and Research Center, Delhi, India

    Gauri Kapoor

  5. Department of Medical Oncology and Pediatric Oncology, Cancer Institute (W.I.A), Adyar, Chennai, India

    Venkatraman Radhakrishnan

  6. Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India

    Siddharth Laskar

  7. NCD Division, Indian Council of Medical Research (ICMR), New Delhi, India

    Tanvir Kaur & Rupinder Singh Dhaliwal

  8. Dr. B.R.A Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

    G. K. Rath

  9. Department of Medical Oncology, Dr. B.R.A Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

    Sameer Bakhshi

Authors
  1. Sandeep Agarwala
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  2. Alisha Gupta
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  9. Venkatraman Radhakrishnan
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  10. Siddharth Laskar
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  11. Tanvir Kaur
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  14. Sameer Bakhshi
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Corresponding author

Correspondence to Sandeep Agarwala.

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ICMR organized the meeting and funded the travel.

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Agarwala, S., Gupta, A., Bansal, D. et al. Management of Hepatoblastoma: ICMR Consensus Document. Indian J Pediatr 84, 456–464 (2017). https://doi.org/10.1007/s12098-017-2301-9

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  • DOI: https://doi.org/10.1007/s12098-017-2301-9

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