Objective: To evaluate the effect of preoperative transcatheter arterial chemoembolization (TACE) in hepatoblastoma (HB) of infants.
Methods: We retrospectively analyzed clinical data of 21 infants with hepatoblastoma treated between July 2008 and July 2012 in Guangzhou Women and Children’s Medical Center. Following preliminary diagnosis, surgical resection was performed in nine cases (Group I), and TACE in twelve cases (Group II) prior to conventional resection. Surgical resection was carried out when the tumor bulk appeared sufficiently reduced, following TACE alone or TACE following chemotherapy in case of pulmonary metastases.
Results: Tumor shrinkage rate ranged from 25.22% to 91.24% with a mean level of 68.77% (t = 3.816, P = 0.003). AFP levels showed marked decrease from 48.69% to 99.96% with a mean level of 94.96% (t = 4.871, P = 0.000). Specimens showed massive necrosis with a mean percentage of 72.27%, with no significant treatment-related toxicity. The surgical time was significantly shorter in Group II (t = 3.438, P = 0.003). The intraoperative blood loss was considerably less in the group II (t = 3.459, P = 0.003) and the weight of the resected liver was significantly less in Group II (t = 3.785, P = 0.001). Sixteen of 21 cases survived for fifty months without recurrence.
Conclusion: TACE is effective in shrinking the tumor volume, decreasing AFP and reducing intraoperative hemorrhage. It’s a safe and effective adjuvant bridge to successful surgery for hepatoblastoma in infant..