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Kirurgisk behandling af levertumorer hos børn

Overlæge Allan Rasmussen, overlæge Nina Kvist, professor Preben Kirkegaard & overlæge Cathrine Rechnitzer Rigshospitalet, Abdominalcentret, Kirurgisk Gastroenterologisk Klinik C, og Juliane Marie Centret, Pædiatrisk Klinik II
Ugeskr Læger 2008;170(16):1366-1369
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Summary Surgical treatment of children with hepatic tumours Ugeskr Læger 2008;170(16):1366-1369 Introduction: In this paper we review the results of surgical treatment of children with hepatic tumours. Materials and methods: The study comprises 33 children who have undergone lever resection or liver transplantation since 1990. 26 patients had hepatoblastoma, 3 had hepatocellular carcinoma, 2 had rhabdomyosarcoma, 1 had a mesenchymal tumour, and 1 had a giant haemangioma. Results: Because of the number of patients, we only analyzed the results of the treatment in the hepatoblastoma group. The survival was the same after resection (77.3%) and liver transplantation (75%). There was no difference in survival dependant on the type of resection, and there was no impact of the extension of tumour growth at the time of diagnosis. Conclusion: The combination of neoadjuvant chemotherapy followed by liver resection or liver transplantation is the treatment of choice in all children with hepatoblastoma. The results have improved dramatically over the last decades. The results in Denmark compare well with international results. Since 2000, very effective chemotherapy has downstaged all referred patients, so subsequent liver resection have been possible.
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