Treatment and precautions for liver tumors in children

As in adults, secondary liver tumors are more common in children than primary liver tumors. Primary liver malignancies account for 1.2% to 5% of pediatric tumors, of which hepatoblastoma and hepatocellular carcinoma are the most common. So, what are the treatments and precautions for pediatric liver tumors?

1. Treatment

The most effective treatment for pediatric liver tumors is surgical resection of the lesion. Both benign and malignant tumors can be surgically removed, and about 95% of the lesions can be completely removed. Liver tissue can be quickly repaired 4 to 6 weeks after surgery. At this time, CT, AFP and B-ultrasound should be rechecked as a basis for future reexaminations. Tumors are relatively insensitive to radiotherapy. The combined use of cisplatin and doxorubicin (adriamycin) is effective for hepatoblastoma, which can transform unresectable tumors into lesions that can be surgically removed, and can also eliminate lung metastases.

There is currently no effective treatment for patients with extensive benign liver tumors who cannot undergo liver resection. For children with unresectable hemangiomas that invade the left and right lobes of the liver and cause heart failure, if the hepatic hemangiomas cannot be removed, hepatic artery ligation can be performed. Currently, hepatic artery catheterization and embolization are recommended.

(II) Precautions

The survival rate of hepatoblastoma is 85% after complete surgical resection, while the survival rate of hepatocellular carcinoma is only 9% to 35%. Patients with incomplete tumor resection often have local recurrence and eventually die. The results of liver transplantation are not optimistic either.

Other common primary liver tumors include cavernous hemangioma and hemangioendothelioma. The former can compress liver tissue and cause liver cell degeneration due to tumor growth. When there is an arteriovenous shunt in the tumor, it can cause heart failure in children or death due to tumor rupture and bleeding. Hemangioendothelioma may have no clinical symptoms due to its slow tumor growth.

Hemangioendothelioma is a malignant tumor with a slow course but a poor prognosis.

There is currently no effective treatment for patients with extensive benign liver tumors who cannot undergo liver resection.

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