Liver Transplantation for Pediatric Liver Cancer

Cancers

Louis Rapkin¹  Sarangarajan Ranganathan²  Sameh Tadros³  Andrew Bukowinski³  Rakesh Sindhi³  Vinayak Rohan⁴  Jean de Ville de Goyet⁵ 

[1] Department of Hematology/Oncology, UPMC-Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USA;Department of Pathology, Children’s Hospital Medical Center of Cincinnati, Cincinnati, OH 45229, USA;Hillman Center for Pediatric Transplantation, UPMC-Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USA;Medical University of South Carolina, Charleston, SC 29403, USA;Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), 90127 Palermo, Italy;

关键词: pediatric;    liver cancer;    liver transplantation;    hepatoblastoma;    hepatocellular carcinoma;    liver sarcoma;    neuroendocrine tumor;    chemotherapy;    pre-text;    histopathology;   

DOI  :  10.3390/cancers12030720

来源: DOAJ

【 摘 要 】

Unresectable hepatocellular carcinoma (HCC) was first removed successfully with total hepatectomy and liver transplantation (LT) in a child over five decades ago. Since then, children with unresectable liver cancer have benefitted greatly from LT and a confluence of several equally important endeavors. Regional and trans-continental collaborations have accelerated the development and standardization of chemotherapy regimens, which provide disease control to enable LT, and also serve as a test of unresectability. In the process, tumor histology, imaging protocols, and tumor staging have also matured to better assess response and LT candidacy. Significant trends include a steady increase in the incidence of and use of LT for hepatoblastoma, and a significant improvement in survival after LT for HCC with each decade. Although LT is curative for most unresectable primary liver sarcomas, such as embryonal sarcoma, the malignant rhabdoid tumor appears relapse-prone despite chemotherapy and LT. Pediatric liver tumors remain rare, and diagnostic uncertainty in some settings can potentially delay treatment or lead to the selection of less effective chemotherapy. We review the current knowledge relevant to diagnosis, LT candidacy, and post-transplant outcomes for these tumors, emphasizing recent observations made from large registries or larger series.

【 授权许可】

Unknown