多灶性肝母细胞瘤手术切除的单中心研究OA北大核心CSTPCD

Objective To explore the feasibility and effectiveness of hepatectomy for multifocal hepato-blastoma(HB).Methods A retrospective analysis was conducted for 21 hospital cases of multifocal HB pa-tients from April 2014 to December 2022.Clinical characteristics,surgical procedures and long-term outcomes were collected and compared with 58 cases of unifocal hepatoblastoma patients with intermediate/high-risk group during the same period.Results Among 21 children with multifocal HB,there were 2 tumor foci(n=1 1),3 tumor foci(n=4)and 5 tumor foci(n=1).Five cases had more than five intrahepatic tumor foci and a definite count was impossible.Tumor resection was anatomical(n=9),irregular(n=11)and combined liver dissection and portal vein ligation for staged hepatectomy(ALPPS,n=1).R0 resection(n=20)and R1 re-section(n=1)were performed without serious postoperative complications.After receiving multidisciplinary comprehensive treatment of surgery plus chemotherapy,median follow-up time for multifocal HB was 57 months.The outcomes were disease-free survival(n=18)and death(n=3).The 3-year event free survival(EFS),3-year overall survival(OS)and cumulative incidence of local progression(CILP)in children with multifocal HB were 57.58％,82.00％and 38.00％respectively.The above parameters of single focus intermittent/high-risk HB admitted during the same period were 91.84％,74.96％and 20.04％respectively.No significant sta-tistical difference existed between two datasets.Conclusions For multifocal HB,standardized surgical resec-tion plus perioperative chemotherapy may achieve satisfactory outcomes.It provides an effective treatment for multifocal HB children.