PEDIATRIC LIVER TUMORS: DIFFERENT MODALITIES OF CURE

Introduction Primary malignant neoplasms of the liver are responsible for a small proportion of solid tumors that occur in the pediatric population. Hepatoblastoma is the most common malignant liver tumor. Most cases appear in the first two years of life. Patients are usually diagnosed at an advanced stage of the disease, requiring a multimodal strategy of chemotherapy and surgery. Hepatocellular carcinoma is less common, its incidence peaks during two life periods: between 0 and 4 years and between 10 and 14 years. Predisposing conditions include: cirrhosis secondary to metabolic liver disease, viral hepatitis, biliary atresia. Most cases are considered unresectable at diagnosis, do not respond as well to chemotherapy as hepatoblastoma. The aim of this review is to evaluate liver transplantation in pediatric patients with liver cancer. Methodology: This is a literature review study, with a qualitative approach. A search was carried out in the PubMed databases with the descriptors “liver transplant” and “pediatric”. Results: we chose 12 scientific productions for analysis according to the objective. It has been seen that one tenth of pediatric liver transplants are performed for primary liver malignancies, especially hepatoblastoma. Neoadjuvant and adjuvant chemotherapy were effective against hepatoblastoma, but if it remains, surgical intervention is required, through resection or organ transplantation. Serious surgical complications were more frequent after transplantation. However, this provides excellent oncological results with less recurrence than resection. Transplantation in hepatocellular carcinoma is less common, but the only curative treatment options are complete surgical resection and transplantation. Newly developed alternative therapeutic strategies including chemoembolization, intra-arterial chemotherapy, and intraoperative cryotherapy, as well as drug treatment, should be debated. Conclusion: Histology and tumor staging are necessary to assess the transplant response. Significant trends include an increased incidence of the procedure for hepatoblastoma, in addition to a significant improvement in hepatocellular carcinoma survival. However, the low availability of the organ limits further studies.