[Assessment of treatment results in children with malignant liver tumours in own experience].

Aim: The assessment of malignant liver tumours in children treated in our centre between years 1985-2004 has been made in order to analyze the prognostic factors and improvement in survival rate.

Material And Methods: 17 patients with malignant liver tumours were followed-up. There were 10 (58,8%) patients with hepatoblastomas, 5 (29,4%) hepatocarcinomas, 1 (5,9%) undifferentiated embryonal sarcoma and 1 (5,9%) rhabdomyosarcoma. Primary metastatic disease was recognized in 3 cases as: hepatic vascular involvement, lungs, femoral bone and lymph nodes of liver hilus metastases. All patients underwent preoperative chemotherapy. Tumour resection was attempted in 13 (76,5%) cases; it was complete within adequate resection margins in 11 (64 7%). In 3 cases biliary fistulas occurred after surgery. Secondary metastases appeared in lungs, lymph nodes of liver hilus and central nervous system in 4 cases.

Results: Twelve patients are alive with median follow-up 34,0 mths, five died with median survival time 16,0 mths. Total excision of liver tumour had no statistical significance in lifetime prolongation (p =0,12). Survival rate was statistically longer in patients without metastatic disease (p=0,028).

Conclusions: Complete surgical excision had no statistical significance in increasing survival time in liver tumour patients. Metastatic disease had statistical significance in shortening overall survival of patients with liver tumours. Unsatisfactory results in hepatocarcinoma treatment in children dramatically demonstrate the need for new treatment approaches.