Treatment of hepatoblastoma

In the early ‘80s the 5-overall-survival (OS) of children affected by HB was estimated to be on the 30% range. From the late ‘80s with the introduction of Cisplatin (CDDP) based CT regimen a dramatic change in the prognosis of these young patients was started to be documented. The first reports on the effect of this drug on HB regarded relapsing or resistant HB to the conventional CT of those years, represented by the combination of cyclophosphamide, vincristine (VCR) and 5fluouracile (5-FU). Those first experiences reported significantly tumour volume reduction in response to CDDP exposure. Counting on the fat that approximately only 30% of the HB at diagnosis is respectable and based on those preliminary data, clinical investigators started to move CDDP-based treatment, up-front, meaning soon after diagnosis. The effect of CDDP in “making the tumour smaller” and resectable was further confirmed. It was also a common surgeons’ feeling that the tumour after CDDP exposure was more compact, less bloody and more demarcated from the adjacent healthy liver parenchyma.