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Liver Tumors in Children

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The Surgery of Childhood Tumors

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Abstract

Improvements in the outcome of pediatric liver tumors over the past four decades have come from advances in chemotherapy radiographic imaging, surgical technique, and perioperative management. Increasingly sophisticated surgical techniques have been based on a more accurate understanding of the segmental anatomy of the liver and an increasing breadth of experience in complex liver resection. Meticulous review of contrast enhanced CT/MR imaging facilitates PRETEXT and POST-TEXT grouping to determine optimal timing and desired extent of liver resection. Excellent knowledge of liver anatomy is essential and the dissection must ensure protection of the vascular inflow and outflow to the remaining liver at all times. Referral to a liver specialty center in advanced cases may facilitate resectability and timely transplantation when necessary. Potential surgical complications include bleeding, vascular injury, cardiac arrest, liver failure, and bile leak. The risk of complications can be minimized with preoperative planning, appropriate referral, and precise surgical technique.

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Abbreviations

AFP:

Alpha Fetoprotein

AMKL:

Acute Megakaryoblastic Leukemia

CHIC:

Children’s Hepatic tumor International Collaboration

COG:

Children’s Oncology Group

ENCCA:

European Network for Cancer Research in Children and Adolescents

FL-HCC:

Fibrolamellar hepatocellular carcinoma

FNH:

Focal nodular hyperplasia

GCTs:

Teratoma (germ cell tumors)

GPOH:

German Pediatric Oncology Hematology Study Group

HACE:

Hepatic Arterial chemo-Embolization

HB:

Hepatoblastoma

HCC:

Hepatocellular Carcinoma

HC-NOS:

Hepatocellular Neoplasm-Not otherwise specified

HLH:

Hemophagocytic Lymphohistiocytosis

IMT:

Inflammatory myofibroblastic tumor

JPLT:

Japanese Pediatric Liver Tumors Study Group

LCH:

Langerhahn’s Cell Histiocytosis

LRN:

Large regenerative nodules

NOS:

Heptocellular tumor Not otherwise specified

NRH:

Nodular regenerative hyperplasia

PEI:

Percutaneous ethanol injection

PLUTO:

Pediatric Liver Unresectable Tumor Observatory

POST-TEXT:

POST-Treatment EXTent of tumor

PRETEXT:

PRE-Treatment EXTent of tumor

RFA:

Radiofrequency ablation

SIOPEL:

Liver Tumor Study group of the Societe International Oncologie Pediatriqe

SPLIT:

Study of Pediatric Liver Transplantation

TACE:

Trans-Arterial chemoembolization

TCLT:

Transitional cell liver tumor

TPN:

Total Parenteral Nutrition

USL:

Undifferentiated sarcoma of the liver

VLBW:

Very Low Birth Weight

VOD:

Hepatic veno-occlusive disease

Chemotherapy abbreviations see legend for Table 16.9

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Authors and Affiliations

  1. Pediatric Surgery, Primary Children’s Medical Center, University of Utah, 100 Mario Capecchi Dr., Suite 2600, Salt Lake City, UT, 84103, USA

    Rebecka L. Meyers MD

  2. Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, Gdansk, Poland

    Piotr Czauderna MD, PhD, FEBPS

  3. Department of Pediatric Surgery, Children’s Hospital, University of Munich, Munich, Germany

    Beate Häberle MD

  4. Pediatric Surgery, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan

    Eiso Hiyama MD, PhD

Authors
  1. Rebecka L. Meyers MD
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  2. Piotr Czauderna MD, PhD, FEBPS
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  3. Beate Häberle MD
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  4. Eiso Hiyama MD, PhD
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Correspondence to Rebecka L. Meyers MD .

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  1. Surgical Paediatrics, University of Glasgow, Glasgow, United Kingdom

    Robert Carachi

  2. Indianapolis, Indiana, USA

    Jay L. Grosfeld

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Meyers, R.L., Czauderna, P., Häberle, B., Hiyama, E. (2016). Liver Tumors in Children. In: Carachi, R., Grosfeld, J. (eds) The Surgery of Childhood Tumors. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48590-3_16

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