儿童肝母细胞瘤20例

The Experience in the Treatment for Hepatoblastoma.

目的总结本中心肝母细胞瘤患儿的治疗经验，探讨提高肝母细胞瘤患儿疗效的治疗方法。方法回顾性分析本中心收治的22例肝母细胞瘤患儿临床资料，将所得结果与欧洲资料进行比较。结果1998年8月至2008年10月，本中心共收治肝母细胞瘤患儿22例，总体生存率为70％，与欧洲的76．8％相比，差异无统计学意义（P〉0．05）。Ⅰ期、Ⅱ期、Ⅲ期患儿生存率分别为100％、85．7％和71．4％，与欧洲的96．3％、100．0％和76．0％比较，差异无统计学意义（P〉0．05）。而Ⅳ期生存率为0，显著低于欧洲的35．7％（P〈0．05）。Ⅰ、Ⅱ、Ⅲ期生存率均显著高于Ⅳ期（P〈0．05）。而Ⅰ、Ⅱ、Ⅲ期之间生存率比较，差异无统计学意义（P〉0．05）。本中心肝母细胞瘤完整切除率为78．9％，与欧洲的86％相比，差异无统计学意义（P〉0．05）。术前行全身化疗的患儿肿瘤完整切除率为70％，而术前未行化疗者肿瘤完整切除率为88．9％，两者比较，差异无统计学意义（P〉0．05）。结论本中心肝母细胞瘤的治疗效果及预后与欧洲相当，多学科协作的治疗模式能取得良好的临床效果。

Objective To analyze the treatment effect and prognosis of hepatoblastoma of our center retrospectively and tocompare them with the European data. Methods The clinical data of our center was collected. 22 cases of hepatoblastoma were retrospectively studied and the results were compared with the European data. Results The overall survival rate of hepatoblastoma of our center is 70%, similar to 76.8% of Europe （P 〉 0.05）. The survival rates of children with stage Ⅰ , Ⅱ and m are 100%, 85.7% and 71.4% respectively, similar to 96.3%, 100.0% and 76.0% of Europe （P 〉 0.05）. The survival rate of children with stage Ⅳ is 0%, significantly lower than 35.7% of Europe（P 〈 0.05 ）. The survival rates of children with stage Ⅰ, Ⅱ and Ⅲ are significantly higher than that of stage Ⅳ （P 〈 0.05）. The differences between the survival rates of stage Ⅰ , Ⅱ and Ⅲ are of no significance （P 〉 0.05）. There is no difference between the removal rate of hepatoblastoma in our centre （78.9%） and in Europe （86%） （P 〉 0.05）. The removal rates of tumor for children treated with or without pre-operative chemotherapy are 70% and 88.9% respectively. There is no difference between them （P 〉 0.05）. Conclusions The treatment effect and prognosis of hepatoblastoma in our centre is similar to those of Europe. Muhidisciplinary team treatment is an effective model for diagnosis and treatment for hepatoblastoma.