Risk factors of adverse surgical outcomes after liver resection for hepatoblastoma - a review of 30 years of experience [Oral presentation]

Abstract

<div><p><strong>Purpose: </strong>We reported the surgical outcomes in hepatoblastoma treated over 30 years and analyzed risk factors leading to adverse events.</p><p><strong>Methods: </strong>This was a retrospective study and children (age < 12 years) receiving liver resection for hepatoblastoma (excluding liver transplant) in two studied centres between 1995 to 2024 were reviewed. Demographic data, surgical complications and 5-year disease-free survival rate were reported. Risk factors for 30-day post-operative complications and 5-year tumor recurrence were evaluated by regression analysis. </p><p><strong>Results: </strong>This study included 68 patients with 50 (73.5%) of them had PRETEXT III disease. Nine patients (13.2%) had metastases and 7 (10.3%) experienced tumor rupture prior to surgery. The median age at surgery was 18 months (8 -56 months). The most frequent type of surgery was extended right hepatectomy (n = 40, 58.8%). Upfront resection was performed in 8 patients (11.8%). The 30-day post-operative complication rate was 17.6 % (n=12) and 6 patients required second operation. The median follow up was 12.4 years (range: 1 – 23.5 years) and 5-year disease free survival was 79.4% (n = 54). </p><p>Diving the study cohort into two study periods (1995 to 2009 vs 2010 to 2024), the complication rate and 5-year disease survival rate were 25.0% and 75.0% in the first period; 12.5% and 82.5% in the second period respectively. </p><p>Pre-operative tumor rupture [OR: 1.97 (1.11-2.32), p = 0.048] and operation over 6 hours were risk factors for 30-day post-operative complications [OR: 2.48 (1.91-3.12), p = 0.036]. Presence of distant metastasis was a risk factor for 5-year tumor recurrence [OR: 1.63 (1.05-1.92), p = 0.042]. </p><p><strong>Conclusion: </strong>An improvement trend in the surgical outcomes of hepatoblastoma treated in recent years was observed. Pre-operative tumor rupture and distant metastasis required special attention as they were risk factor for adverse outcomes. Prolonged operation should be avoided to minimize surgical complications. </p></div>