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Surgical Treatment

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Pediatric Liver Tumors

Part of the book series: Pediatric Oncology ((PEDIATRICO))

Abstract

Tumor resection principally remains the mainstay of treatment and a prerequisite of cure in most cases of pediatric liver tumors. While in the past tumor biopsies were taken by open surgery before treatment, this can now be done percutaneously with a tru-cut needle. Treatment of hepatoblastoma without a biopsy is reserved to selected cases. The international SIOPEL group recommends, as a rule, for hepatoblastomas a resection after neo-adjuvant chemotherapy, while hepatocellular carcinomas should undergo a primary complete resection whenever possible. While microscopic residual tumor does not necessarily worsen the prognosis in pretreated and regressive hepatoblastomas, a radical resection is essential in hepatocellular carcinoma and other malignomas with poor response to chemotherapy or radiation. Anatomical resections are strongly advised as standard procedures for the operation of primary liver tumors in childhood and atypical resections as well as those with special techniques should be reserved for only very rare special cases. Here, the SIOPEL PRETEXT staging system helps judge a tumor’s resectability from imaging besides a reliable determination of the patient’s prognosis. The main surgical complications are major bleeding and bile leakage. Resection of pulmonary metastases and locally recurrent tumor from hepatoblastoma responsive to chemotherapy can increase the chance of cure for these patients.

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Authors and Affiliations

  1. Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, Ul. Nowe Ogrody 1-6, 80-803, Gdansk, Poland

    Piotr Czauderna

  2. Kinderchirurgische Klinik im Dr. von Haunerschen Kinderspital, Universität München, Lindwurmstrasse 4, D-80337, München, Germany

    Dietrich von Schweinitz

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  1. Piotr Czauderna
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  2. Dietrich von Schweinitz
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Correspondence to Piotr Czauderna .

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Editors and Affiliations

  1. Inst. Pathologie, Universität Bern, Murtenstr. 31, Bern, 3010, Switzerland

    Arthur Zimmermann

  2. Dipto. Pediatria, Unità di Oncoematologia Pediatrica, Università di Padova, Via Giustiniani 3, Padova, 35128, Italy

    Giorgio Perilongo

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© 2011 Springer Berlin Heidelberg

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Czauderna, P., von Schweinitz, D. (2011). Surgical Treatment. In: Zimmermann, A., Perilongo, G. (eds) Pediatric Liver Tumors. Pediatric Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-14504-9_10

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  • DOI: https://doi.org/10.1007/978-3-642-14504-9_10

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