Future Prospective

Abstract

As documented in some of the chapters, in the last 3 decades, remarkable success has been achieved in the cure of hepatoblastoma (HB); in the late seventies the 5-year overall survival of children affected by this rare neoplasm was 30%; now it has more than doubled (Perilongo et al. 2009). Thus, at the beginning of this century, it can be stated that multidisciplinary approaches including conventional systemic chemotherapy has allowed the cure of more than two-third of the children diagnosed with hepatoblastoma. Remarkable refinements in the diagnostic capabilities, mainly related to the introduction of magnetic resonance images in daily clinical practice, in the surgical approach, in a more extensive and rational, use of orthotopic liver transplantation, in the supportive measures, in the use of systemic chemotherapy, and in tailoring treatment according to more and more individualized risk profiles are the facts that must be accounted to explain these gratifying results. However, it is a common assumption that to make further progress, that is, to cure those children affected by tumors, which are not amenable to any kind of radical surgery (including orthotopic liver transplantation), which are metastatic, do not respond to chemotherapy, recur, or present with low alpha-fetoprotein, different avenues must be envisaged.