International Journal of Clinical Oncology

, Volume 18, Issue 6, pp 943–945 | Cite as

Current therapeutic strategies for childhood hepatic malignant tumors

  • Eiso HiyamaEmail author
Introduction to Review Articles


The two main malignant hepatic tumors in children are hepatoblastomas (HBLs) and hepatocellular carcinomas (HCCs). The past two decades have brought significant improvement to the outcomes of children diagnosed with malignant hepatic tumors, especially HBL, due to improvements in diagnosis and treatment. Histological diagnosis is essential for differential diagnosis of these tumors. In surgery, liver resection has become a safe and secure technique because of progress in anatomical knowledge and surgical dissection; also liver transplantation has become widely used for unresectable tumors. Moreover, the introduction of effective chemotherapeutic regimens has significantly improved the survival of children with HBL due to an increase in the number of patients ultimately undergoing tumor resection, and a reduction in the incidence of post-surgical recurrence. These improvements are the result of multicenter cooperative trials conducted by the Japanese Study Group for Pediatric Liver Tumor, the Children’s Oncology Group, and the International Childhood Liver Tumor Strategy Group, including work of the German Association of Pediatric Hematology and Oncology. This paper summarizes the results of these studies and calls on the current international collaboration study called the Children’s Hepatic Tumors International Collaboration Project to establish global clinical research on childhood hepatic malignant tumors.


Hepatoblastoma Hepatocellular carcinoma Childhood International collaboration Clinical trials Database 



Supported by: Grant-in-Aid for Scientific Research (A) from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) (No. 3256006 and No. 24249084) and Research Grant from The Ministry of Health Labour and Welfare (MHLW) (H24-GANRINSYOU-IPPAN-013) of Japan.

Conflict of interest

The author declares that he has no conflict of interest.


  1. 1.
    Litten JB, Tomlinson GE (2008) Liver tumors in children. Oncologist 13:812–820PubMedCrossRefGoogle Scholar
  2. 2.
    Finegold MJ, Egler RA, Goss JA et al (2008) Liver tumors: pediatric population. Liver Transpl 14:1545–1556PubMedCrossRefGoogle Scholar
  3. 3.
    Darbari A, Sabin KM, Shapiro CN et al (2003) Epidemiology of primary hepatic malignancies in U.S. children. Hepatology 38:560–566PubMedCrossRefGoogle Scholar
  4. 4.
    Le Bail B (2012) Pathology: a pictorial review. A selected atlas of paediatric liver pathology. Clin Res Hepatol Gastroenterol 36:248–252PubMedCrossRefGoogle Scholar
  5. 5.
    Ortega JA, Douglass EC, Feusner JH et al (2000) Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the Children’s Cancer Group and the Pediatric Oncology Group. J Clin Oncol 18:2665–2675PubMedGoogle Scholar
  6. 6.
    Pritchard J, Brown J, Shafford E et al (2000) Cisplatin, doxorubicin, and delayed surgery for childhood hepatoblastoma: a successful approach—results of the first prospective study of the International Society of Pediatric Oncology. J Clin Oncol 18:3819–3828PubMedGoogle Scholar
  7. 7.
    Perilongo G, Maibach R, Shafford E et al (2009) Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma. N Engl J Med 361:1662–1670PubMedCrossRefGoogle Scholar
  8. 8.
    Meyers RL, Rowland JR, Krailo M et al (2009) Predictive power of pretreatment prognostic factors in children with hepatoblastoma: a report from the Children’s Oncology Group. Pediatr Blood Cancer 53:1016–1022PubMedCrossRefGoogle Scholar
  9. 9.
    Dicken BJ, Bigam DL, Lees GM (2004) Association between surgical margins and long-term outcome in advanced hepatoblastoma. J Pediatr Surg 39:721–725PubMedCrossRefGoogle Scholar
  10. 10.
    Hishiki T, Matsunaga T, Sasaki F et al (2011) Outcome of hepatoblastomas treated using the Japanese Study Group for Pediatric Liver Tumor (JPLT) protocol-2: report from the JPLT. Pediatr Surg Int 27:1–8PubMedCrossRefGoogle Scholar
  11. 11.
    Zsiros J, Brugieres L, Brock P et al (2013) Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): a prospective, single-arm, feasibility study. Lancet Oncol 14:834–842PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Lopez-Terrada D, Zimmermann A (2012) Current issues and controversies in the classification of pediatric hepatocellular tumors. Pediatr Blood Cancer 59:780–784PubMedCrossRefGoogle Scholar
  13. 13.
    Malogolowkin MH, Katzenstein HM, Meyers RL et al (2011) Complete surgical resection is curative for children with hepatoblastoma with pure fetal histology: a report from the Children’s Oncology Group. J Clin Oncol 29:3301–3306PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Lopez-Terrada D, Alaggio R, De Dávila MT et al (2013) Towards an International Pediatric Liver Tumor Consensus Classification: Proceedings of the Los Angeles COG International Liver Tumors Symposium. Mod Pathol. doi: 10.1038/modpathol.2013.80
  15. 15.
    Sasaki F, Matsunaga T, Iwafuchi M et al (2002) Outcome of hepatoblastoma treated with the JPLT-1 (Japanese Study Group for Pediatric Liver Tumor) Protocol-1: a report from the Japanese Study Group for Pediatric Liver Tumor. J Pediatr Surg 37:851–856PubMedCrossRefGoogle Scholar
  16. 16.
    Perilongo G, Shafford E, Maibach R et al (2004) Risk-adapted treatment for childhood hepatoblastoma. final report of the second study of the International Society of Paediatric Oncology–SIOPEL 2. Eur J Cancer 40:411–421PubMedCrossRefGoogle Scholar
  17. 17.
    Fuchs J, Rydzynski J, Von Schweinitz D et al (2002) Pretreatment prognostic factors and treatment results in children with hepatoblastoma: a report from the German Cooperative Pediatric Liver Tumor Study HB 94. Cancer 95:172–182PubMedCrossRefGoogle Scholar
  18. 18.
    Haberle B, Bode U, von Schweinitz D (2003) Differentiated treatment protocols for high- and standard-risk hepatoblastoma–an interim report of the German Liver Tumor Study HB99. Klin Padiatr 215:159–165PubMedCrossRefGoogle Scholar
  19. 19.
    Katzenstein HM, Rigsby C, Shaw PH et al (2002) Novel therapeutic approaches in the treatment of children with hepatoblastoma. J Pediatr Hematol Oncol 24:751–755PubMedCrossRefGoogle Scholar
  20. 20.
    Katzenstein HM, Chang KW, Krailo M et al (2009) Amifostine does not prevent platinum-induced hearing loss associated with the treatment of children with hepatoblastoma: a report of the Intergroup Hepatoblastoma Study P9645 as a part of the Children’s Oncology Group. Cancer 115:5828–5835PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    McDermott U, Settleman J (2009) Personalized cancer therapy with selective kinase inhibitors: an emerging paradigm in medical oncology. J Clin Oncol 27:5650–5659PubMedCrossRefGoogle Scholar
  22. 22.
    Walterhouse D, Watson A (2007) Optimal management strategies for rhabdomyosarcoma in children. Paediatr Drugs 9:391–400PubMedCrossRefGoogle Scholar
  23. 23.
    Gustafson WC, Matthay KK (2011) Progress towards personalized therapeutics: biologic- and risk-directed therapy for neuroblastoma. Expert Rev Neurother 11:1411–1423PubMedCrossRefGoogle Scholar

Copyright information

© Japan Society of Clinical Oncology 2013

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryHiroshima University HospitalHiroshimaJapan
  2. 2.Natural Science Center for Basic Research Development (N-BARD)Hiroshima UniversityHiroshimaJapan

Personalised recommendations