PDF下载 ( 1836 KB)
儿童肝脏恶性肿瘤的肝移植适应证
DOI: 10.3969/j.issn.1001-5256.2021.02.004
作者贡献声明:张海明负责文献收集和文章撰写；朱志军负责拟定主要论点、提纲，修改文章并最后定稿。
Indications for liver transplantation in children with hepatic malignancies
-
摘要: 儿童肝脏恶性瘤与成人肝脏恶性肿瘤的起源和发展存在明显差别，即使是同一种肝脏恶性肿瘤，在儿童体内的发生、发展、治疗方法和治疗效果方面，也与成人存在较大的差别。 肝脏恶性肿瘤的组织学表现和解剖定位可以反映出这些肿瘤侵袭转移的特性、外科手术根治的难度和药物治疗的敏感性。 因此在治疗方式选择上，需要依据这些特点进行判断。 儿童的肝脏恶性肿瘤对化疗等辅助治疗的敏感性更高。 肝移植术前或术后，配合使用化疗等辅助治疗可以获得更为满意的疗效，肝移植的适应证范围也因此得到了一定的扩展。 儿童肝脏恶性肿瘤中，肝母细胞瘤、肝细胞癌和未分化胚胎肉瘤较为常见，均可以通过肝移植进行治疗，且多数患者预后满意。 儿童肝脏恶性肿瘤如果肝切除治疗预期效果不佳，而肿瘤局限于肝内，均可考虑肝移植。Abstract: There are significant differences in origin and development between pediatric liver malignancies and adult liver malignancies, and even for the same type of liver cancer, there are still differences in its development, progression, therapies, and treatment outcome between children and adults. The histological manifestation and anatomical location of pediatric liver malignancies can reflect the characteristics of invasion and metastasis, the difficulty in surgical treatment, and the sensitivity of drug therapy. Therefore, treatment modalities should be selected based on these characteristics. Pediatric liver malignancies are more sensitive to adjuvant therapy such as chemotherapy, and the combination with adjuvant therapies, such as chemotherapy, before or after liver transplantation may achieve satisfactory results and thus expand the indications for liver transplantation. Among pediatric liver malignancies, hepatoblastoma, hepatocellular carcinoma, and undifferentiated embryonal sarcoma is more common and can be treated by liver transplantation with satisfactory prognosis. Liver transplantation should be considered for children with malignant liver tumors confined to the liver and poor response to liver resection.
-
Key words:
- Liver Neoplasms /
- Liver Transplantation /
- Child
-
[1] LITTEN JB, TOMLINSON GE. Liver tumors in children[J]. Oncologist, 2008, 13(7): 812-820. DOI: 10.1634/theoncologist.2008-0011 [2] NG K, MOGUL DB. Pediatric liver tumors[J]. Clin Liver Dis, 2018, 22(4): 753-772. DOI: 10.1016/j.cld.2018.06.008 [3] SINDHI R, ROHAN V, BUKOWINSKI A, et al. Liver transplantation for pediatric liver cancer[J]. Cancers (Basel), 2020, 12(3): 720. DOI: 10.3390/cancers12030720 [4] SUNIL BJ, PALANIAPPAN R, VENKITARAMAN B, et al. Surgical resection for hepatoblastoma-updated survival outcomes[J]. J Gastrointest Cancer, 2018, 49(4): 493-496. DOI: 10.1007/s12029-017-0005-z [5] SHARMA D, SUBBARAO G, SAXENA R. Hepatoblastoma[J]. Semin Diagn Pathol, 2017, 34(2): 192-200. DOI: 10.1053/j.semdp.2016.12.015 [6] WANG LL, FILIPPI RZ, ZURAKOWSKI D, et al. Effects of neoadjuvant chemotherapy on hepatoblastoma: A morphologic and immunohistochemical study[J]. Am J Surg Pathol, 2010, 34(3): 287-299. DOI: 10.1097/PAS.0b013e3181ce5f1e [7] ZSIROS J, BRUGIERES L, BROCK P, et al. Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): A prospective, single-arm, feasibility study[J]. Lancet Oncol, 2013, 14(9): 834-842. DOI: 10.1016/S1470-2045(13)70272-9 [8] TRIANA JUNCO P, CANO EM, DORE M, et al. Prognostic factors for liver transplantation in unresectable hepatoblastoma[J]. Eur J Pediatr Surg, 2019, 29(1): 28-32. DOI: 10.1055/s-0038-1668148 [9] FUCHS J, CAVDAR S, BLUMENSTOCK G, et al. POST-TEXT Ⅲ and Ⅳ hepatoblastoma: Extended hepatic resection avoids liver transplantation in selected cases[J]. Ann Surg, 2017, 266(2): 318-323. DOI: 10.1097/SLA.0000000000001936 [10] RAMMOHAN A, RELA M, KUMAR GV, et al. Outcomes for high-risk hepatoblastoma in a resource-challenged setting[J]. BJS Open, 2020, 4(4): 630-636. DOI: 10.1002/bjs5.50297 [11] TROBAUGH-LOTRARIO AD, MEYERS RL, TIAO GM, et al. Pediatric liver transplantation for hepatoblastoma[J]. Transl Gastroenterol Hepatol, 2016, 1: 44. DOI: 10.21037/tgh.2016.04.01 [12] OTTE JB, PRITCHARD J, ARONSON DC, et al. Liver transplantation for hepatoblastoma: Results from the International Society of Pediatric Oncology (SIOP) study SIOPEL-1 and review of the world experience[J]. Pediatr Blood Cancer, 2004, 42(1): 74-83. DOI: 10.1002/pbc.10376 [13] MARIN J, CIVES-LOSADA C, ASENSIO M, et al. Mechanisms of anticancer drug resistance in hepatoblastoma[J]. Cancers (Basel), 2019, 11(3): 407. DOI: 10.3390/cancers11030407 [14] KHANNA R, VERMA SK. Pediatric hepatocellular carcinoma[J]. World J Gastroenterol, 2018, 24(35): 3980-3999. DOI: 10.3748/wjg.v24.i35.3980 [15] LEE CL, KO YC. Survival and distribution pattern of childhood liver cancer in Taiwan[J]. Eur J Cancer, 1998, 34(13): 2064-2067. DOI: 10.1016/S0959-8049(98)00281-0 [16] MOORE SW, MILLAR AJ, HADLEY GP, et al. Hepatocellular carcinoma and liver tumors in South African children: A case for increased prevalence[J]. Cancer, 2004, 101(3): 642-649. DOI: 10.1002/cncr.20398 [17] CHANG MH, CHEN CJ, LAI MS, et al. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group[J]. N Engl J Med, 1997, 336(26): 1855-1859. DOI: 10.1056/NEJM199706263362602 [18] CHANG MH, YOU SL, CHEN CJ, et al. Decreased incidence of hepatocellular carcinoma in hepatitis B vaccinees: A 20-year follow-up study[J]. J Natl Cancer Inst, 2009, 101(19): 1348-1355. DOI: 10.1093/jnci/djp288 [19] MURAWSKI M, WEEDA VB, MAIBACH R, et al. Hepatocellular carcinoma in children: Does modified platinum- and doxorubicin-based chemotherapy increase tumor resectability and change outcome? Lessons learned from the SIOPEL 2 and 3 studies[J]. J Clin Oncol, 2016, 34(10): 1050-1056. DOI: 10.1200/JCO.2014.60.2250 [20] CZAUDERNA P, MACKINLAY G, PERILONGO G, et al. Hepatocellular carcinoma in children: Results of the first prospective study of the International Society of Pediatric Oncology group[J]. J Clin Oncol, 2002, 20(12): 2798-2804. DOI: 10.1200/JCO.2002.06.102 [21] SHI Y, ROJAS Y, ZHANG W, et al. Characteristics and outcomes in children with undifferentiated embryonal sarcoma of the liver: A report from the National Cancer Database[J]. Pediatr Blood Cancer, 2017, 64(4): e26272. DOI: 10.1002/pbc.26272 [22] PLANT AS, BUSUTTIL RW, RANA A, et al. A single-institution retrospective cases series of childhood undifferentiated embryonal liver sarcoma (UELS): Success of combined therapy and the use of orthotopic liver transplant[J]. J Pediatr Hematol Oncol, 2013, 35(6): 451-455. DOI: 10.1097/MPH.0b013e318271c948 -
本文二维码
计量
- 文章访问数: 466
- HTML全文浏览量: 122
- PDF下载量: 36
- 被引次数: 0
下载:
