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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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 REVIEW ARTICLE
Year : 2014  |  Volume : 19  |  Issue : 4  |  Page : 201-207

The treatment of hepatoblastoma: Its evolution and the current status as per the SIOPEL trials


1 Department of Surgery, Division of Pediatric Surgery, Queen Elisabeth Central Hospital, University of Malawi, Blantyre, Malawi
2 Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, Gdansk, Poland
3 Departement of statistics, International Breast Cancer Study Group (IBCSG) Coordinating Center, Berne, Switzerland
4 Department of Paediatrics, Division of Paediatrics, University Hospital of Padua, Italy
5 Department of Paediatric Oncology, Birmingham Children's Hospital, Birmingham, United Kingdom

Correspondence Address:
Daniel C Aronson
MD, PhD, Department of Surgery, Division of Pediatric Surgery, Queen Elisabeth Central Hospital, College of Medicine, University of Malawi, Private Bag 414, Chichiri, Blantyre
Malawi
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9261.142001

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Aim of the Review: To describe the significant improvement in the diagnosis, treatment and outcome of children diagnosed with hepatoblastoma (HB) that has occurred in the past four decades. Recent findings are mainly focused on lessons learned from the experiences of the Childhood Liver Tumors Strategy Group (SIOPEL). Important milestones were the risk stratification of HB that allowed to tailor down therapy for standard-risk HB and intensify treatment for high-risk HB. The multi-institutional international cooperative SIOPEL trials are reviewed and current treatment guidelines are given. Intensified cooperation between the SIOPEL and the Children's Oncology Group (COG) and the national study groups from Germany (GPOH) and Japan (JPLT) led to the acceptance and use of one staging system (PRETEXT) and the formation of a single robust database containing data of 1605 HB patients. This will allow analysis with enough statistical power of treatment directing factors that will form one of the bases of the next-generation clinical trial that is currently designed by all four collaborating study groups. Summary: Successive SIOPEL trials and increasing international collaboration have improved survival rates of patients with HB through risk stratification, advances in chemotherapy and increased complete resection rates including liver transplantation as a surgical option.






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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

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