PURPOSE: Hepatoblastoma is commonly unresectable at presentation, necessitating induction chemotherapy before definitive resection. To refine the paradigm for timing of resection, we questioned whether a plateau in hepatoblastoma responsiveness to neoadjuvant therapy could be detected by calculating tumor volume (TV) and serum alpha-fetoprotein (sAFP) kinetics. METHODS: To calculate TV and sAFP as measures of treatment responsiveness over time, infants having initially unresectable epithelial-type hepatoblastomas were identified at a single institution (1996-2008). Effects of therapy type, therapy duration, and lobe of liver involvement on TV, sAFP, margin status, and toxicity were analyzed. RESULTS: Of 24 infants treated for epithelial-type hepatoblastoma during this interval, 5 were resected primarily, and 15 had complete digital films for kinetics analysis. Both TV and sAFP decreased dramatically over time (P < .0001). No statistically significant difference in mean TV or sAFP was detected after chemotherapy cycle 2. Left lobe tumors had greater presenting levels of and significantly slower decay in sAFP compared with right lobe tumors (P = .005), although no statistically significant differences in TV existed between liver lobes. Resection margins did not change with therapy duration. CONCLUSIONS: Measuring TV and sAFP kinetics accurately reflects hepatoblastoma responsiveness to induction therapy. Treatment toxicities may be reduced by earlier resection and tailoring of chemotherapeutic regimens. Copyright 2010 Elsevier Inc. All rights reserved.
PURPOSE:Hepatoblastoma is commonly unresectable at presentation, necessitating induction chemotherapy before definitive resection. To refine the paradigm for timing of resection, we questioned whether a plateau in hepatoblastoma responsiveness to neoadjuvant therapy could be detected by calculating tumor volume (TV) and serum alpha-fetoprotein (sAFP) kinetics. METHODS: To calculate TV and sAFP as measures of treatment responsiveness over time, infants having initially unresectable epithelial-type hepatoblastomas were identified at a single institution (1996-2008). Effects of therapy type, therapy duration, and lobe of liver involvement on TV, sAFP, margin status, and toxicity were analyzed. RESULTS: Of 24 infants treated for epithelial-type hepatoblastoma during this interval, 5 were resected primarily, and 15 had complete digital films for kinetics analysis. Both TV and sAFP decreased dramatically over time (P < .0001). No statistically significant difference in mean TV or sAFP was detected after chemotherapy cycle 2. Left lobe tumors had greater presenting levels of and significantly slower decay in sAFP compared with right lobe tumors (P = .005), although no statistically significant differences in TV existed between liver lobes. Resection margins did not change with therapy duration. CONCLUSIONS: Measuring TV and sAFP kinetics accurately reflects hepatoblastoma responsiveness to induction therapy. Treatment toxicities may be reduced by earlier resection and tailoring of chemotherapeutic regimens. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: Carol L Clericuzio; Emily Chen; Dawn Elizabeth McNeil; Timothy O'Connor; Elaine H Zackai; Livija Medne; Gail Tomlinson; Michael DeBaun Journal: J Pediatr Date: 2003-08 Impact factor: 4.406
Authors: J A Ortega; E C Douglass; J H Feusner; M Reynolds; J J Quinn; M J Finegold; J E Haas; D R King; W Liu-Mares; M G Sensel; M D Krailo Journal: J Clin Oncol Date: 2000-07 Impact factor: 44.544
Authors: Angela D Trobaugh-Lotrario; Gail E Tomlinson; Milton J Finegold; Lia Gore; James H Feusner Journal: Pediatr Blood Cancer Date: 2009-03 Impact factor: 3.167
Authors: Ernesto P Molmenti; Krissy Wilkinson; Hebe Molmenti; Jay S Roden; Robert H Squires; Carlos G Fasola; Gail Tomlinson; David E Nagata; Lisa D'Amico; M James Lopez; Leo M Savino; Shigeru Marubashi; Edmund Q Sanchez; Robert M Goldstein; Marion F Levy; Walter Andrews; John A Andersen; Goran B Klintmalm Journal: Am J Transplant Date: 2002-07 Impact factor: 8.086
Authors: Marcio H Malogolowkin; Howard M Katzenstein; Mark Krailo; Zhengjia Chen; John J Quinn; Marleta Reynolds; Jorge A Ortega Journal: J Clin Oncol Date: 2008-05-10 Impact factor: 44.544
Authors: Andrew J Murphy; Gregory D Ayers; Melissa A Hilmes; Kaushik Mukherjee; Kevin J Wilson; Wade M Allen; Israel Fernandez-Pineda; Myrick C Shinall; Zhiguo Zhao; Wayne L Furman; Mary Beth McCarville; Andrew M Davidoff; Harold N Lovvorn Journal: J Pediatr Surg Date: 2013-06 Impact factor: 2.545
Authors: Rosa Nguyen; M Beth McCarville; April Sykes; Shenghua Mao; Jianrong Wu; Max R Langham; Wayne L Furman Journal: Int J Clin Oncol Date: 2018-05-09 Impact factor: 3.402