소아 간모세포종의 임상적 고찰
Clinical Study of Hepatoblastoma in Children
박진완, 박재범, 한상아, 우종국, 서정민, 이석구,
소속 상세정보
박진완 ( Park Jin-Wan )
성균관대학교 의과대학 삼성서울병원 소아외과
박재범 ( Park Jae-Berm )
성균관대학교 의과대학 삼성서울병원 소아외과
한상아 ( Han Sang-Ah )
성균관대학교 의과대학 삼성서울병원 소아외과
우종국 ( Woo Jong-Gook )
성균관대학교 의과대학 삼성서울병원 소아외과
서정민 ( Seo Jeong-Meen )
성균관대학교 의과대학 삼성서울병원 소아외과
이석구 ( Lee Suk-Koo )
성균관대학교 의과대학 삼성서울병원 소아외과
KMID : 0371320020630040337
Abstract
Purpose: By the help of neoadjuvant chemotherapy, resectability and survival rate of hepatoblastoma have improved. To evaluate recent treatment outcome of hepat-oblastoma, pediatric hepatoblastoma in our institute were reviewed.
Methods: The medical records of 11 pediatric hepatoblastoma patients were analysed retrospectively.
Results: All but one patient old were under 3 years old at diagnosis (range: 1∼150 months). The male to female ratio was 6：5. Two patients were treated without neoadjuvant chemotherapy. One of them received right lobectomy for initially
resectable tumor. Another one patient received a liver transplant for multiple unresectable tumors and liver cirrhosis. Nine patients received neoadjuvant chemotherapy based on the CCG-823F or CCG-8881A protocol. Two of them showed lung metastasis,
but
the metastatic nodules were reduced in size and number in one patient, disappeared in another patient after neoadjuvant chemotherapy. The mean tumor size at diagnosis in 9 patients was 10.5 ㎝ (range: 6.4∼14 ㎝). After neoadjuvant chemotherapy,
the
mean size reduction was 53% (range: 37∼67%) in 9 patients. In 8 out of 9 patients (88%) a curative resection was performed after average 4 cycles of neoadjuvant chemotherapy. All the patients were followed for a median duration of 21 months
(range:
5∼88 months). Nine of all 11 patients are still alive without tumor recurrence.
Conclusion: Neoadjuvant chemotherapy was able to increase the resectability of an initially unresectable hepatoblastoma and should not be abandoned even with a distant metastasis such as the lung. Liver transplantation is a good back-up for
an
unresectable hepatoblastoma.
키워드
술전 항암약물요법; 간모세포종; 간이식; Neoadjuvant chemotherapy; Hepatoblastoma; Liver transplantation;
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