Page 59 - Read Online

Weeda et al. Hepatoma Res 2021;7:43 Hepatoma Research
DOI: 10.20517/2394-5079.2021.10

Perspective Open Access

The future of pediatric hepatocellular carcinoma: a

combination of surgical, locoregional, and targeted
therapy

1
Víola B. Weeda , Maciej Murawski 2
1
Department of Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam 1105AZ, the Netherlands.
2
Department of Pediatric Surgery and Urology, Medical University of Gdansk, Gdansk 80-210, Poland.
Correspondence to: Dr. Víola B. Weeda, Department of Surgery, Academic Medical Centre, University of Amsterdam,
Meibergdreef 9 1105AZ, Amsterdam 1105AZ, the Netherlands. E-mail: v.b.weeda@amsterdamumc.nl
How to cite this article: Weeda VB, Murawski M. The future of pediatric hepatocellular carcinoma: a combination of surgical,
locoregional, and targeted therapy. Hepatoma Res 2021;7:43. https://dx.doi.org/10.20517/2394-5079.2021.10

Received: 28 Jan 2021 First Decision: 22 Mar 2021 Revised: 30 Mar 2020 Accepted: 1 Apr 2021 Published: 11 Jun 2021
Academic Editors: Richard S Finn, Guang-Wen Cao Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Despite hepatocellular carcinoma’s position as the second most common pediatric liver tumor, it is a rare tumor in
children warranting international collaboration to improve outcomes. Few cases diagnosed in earlier stages, when
confined to the liver and responding to systemic treatment or with resectable metastases, may be cured by
complete resection and/or orthotopic transplantation. Complete resection is the only chance for cure; therefore, all
attempts should be made to make these options available. Despite modest progress in locoregional treatments,
these serve in most cases as palliative treatment or as a bridge to definitive treatment at best. Currently used
systemic treatments have response rates below 50%. Five-year survival in advanced stages is below 30%. The
international Paediatric Hepatic International Tumour Trial trial is evaluating novel systemic treatments in pediatric
hepatocellular carcinoma. Patients suffering from these tumors likely benefit from targeted treatment based on
molecular aberrations corresponding with tumor subtype.

Keywords: Hepatocellular carcinoma, pediatric, liver tumor, liver transplantation, surgery, locoregional treatment,
targeted treatment

INTRODUCTION
Despite its low incidence of approximately one per million children, hepatocellular carcinoma (HCC) is the

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.hrjournal.net