AMC improves pediatric liver cancer survival rate

Asan Medical Center said it has improved the survival rate of pediatric liver cancer patients from 60 percent to more than 90 percent by employing various surgical techniques.

Professor Koh Kyung-nam of the Department of Pediatric Oncology and Hematology at Asan Medical Center diagnoses a pediatric patient with hepatoblastoma.

Pediatric hepatoblastoma is a malignant tumor of the liver in children, accounting for more than 95 percent of liver cancers in children under the age of five. “Although hospitals use chemotherapy to shrink the tumor and perform surgery for complete resection, it is difficult to surgically remove all tumors, and the prognosis is poor if the tumors have already spread to other organs.”

To increase the survival rate of these patients, the AMC team has divided the intensity of chemotherapy for pediatric hepatoblastoma patients and introduced an imaging technology that uses fluorescent dyes to confirm tumor size.

The researchers increased the survival rate of pediatric hepatoblastoma patients to more than 90 percent. Professors Im Ho-joon, Koh Kyung-nam, Kim Hye-ri of the Department of Pediatric Oncology and Hematology, and Kim Dae-yeon and Namgoong Jung-man of the Department of Pediatric Surgery led the study.

It could also minimize side effects by administering weak chemotherapy to pediatric liver cancer patients, which can be operated on easily, and intensive chemotherapy to patients with multiple tumors or metastases, so they can undergo surgery.

They also injected the indocyanine green, a fluorescent substance that colors normal hepatocytes, liver cancer and hepatoblast carcinoma cells green, into patients’ bodies and used imaging technology with a near-infrared camera.

They used the method because normal hepatocytes secrete indocyanine green through the bile ducts. Yet hepatocellular carcinoma and hepatoblast carcinoma cells do not secrete indocyanine green, and the fluorescence signal persists even after two days.

“This fluorescence imaging system distinguishes between the surface of the liver and tumors near the resection, and can detect even small tumors on the surface of the liver that are not detected by computed tomography (CT) or magnetic resonance imaging (MRI), allowing many more possible.” accurate and safe liver resection and liver transplantation,” the team said.

“I think the improvement in the survival rate of pediatric liver cancer patients is the result of considering and implementing the optimal treatment approach based on each patient’s condition,” said Professor Koh. “We also believe that close collaboration between the Pediatric Oncology and Hematology Department and the Pediatric Surgery Department has greatly contributed to improving treatment outcomes.”

Professor Namgoong also said: “The pediatric solid cancer team is working with the pediatrics department to treat patients with various solid cancers, such as neuroblastoma and sarcoma, and hepatoblastoma.”

In the case of hepatoblastoma, unless a liver transplant is unavoidable, the team avoids liver transplantation as much as possible and used multistage liver resection to reduce the burden on patients afraid of transplantation, the professor added.

Cancer Medicine has published the study.

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