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Hiyama et al. Hepatoma Res 2021;7:44 Hepatoma Research
DOI: 10.20517/2394-5079.2021.21

Original Article Open Access

The prognostic evaluation of marginal positive

resection in hepatoblastoma: Japanese experience

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Eiso Hiyama , Tomoro Hishiki , Kenichiro Watanabe , Kohmei Ida , Michihiro Yano , Sho Kurihara ,
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Masato Kojima , Isamu Saeki , Takeshi Inoue , Yukichi Tanaka 8
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Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan.
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Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima 734-8551, Japan.
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Department of Pediatric Surgery, Chiba University, Graduate School of Medicine, Chiba 260-8677, Japan.
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Department of Hematology and Oncology Shizuoka Children’s Hospital, Shizuoka 420-8660, Japan.
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Department of Pediatrics, Teikyo University Hospital Mizonokuchi, Kawasaki 213-8507, Japan.
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Department of Pediatrics, Akita University Hospital, Akita 010-8543, Japan.
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Department of Pathology, Osaka City General Hospital, Osaka 534-0021, Japan.
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Clinical Research Institute and Department of Pathology, Kanagawa Children’ Medical Center, Yokohama 232-8555, Japan.
Correspondence to: Prof. Eiso Hiyama, Department of Pediatric Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-
ku, Hiroshima 734-8551, Japan. E-mail: eiso@hiroshima-u.ac.jp
How to cite this article: Hiyama E, Hishiki T, Watanabe K, Ida K, Yano M, Kurihara S, Kojima M, Saeki I, Inoue T, Tanaka Y. The
prognostic evaluation of marginal positive resection in hepatoblastoma: Japanese experience. Hepatoma Res 2021;7:44.
https://dx.doi.org/10.20517/2394-5079.2021.21
Received: 16 Feb 2021 First Decision: 12 Apr 2021 Revised: 13 May 2021 Accepted: 26 May 2021 First online: 28 May 2021
Academic Editors: Guang-Wen Cao, Piotr Czauderna, Daniel C. Aronson Copy Editor: Yue-Yue Zhang Production Editor: Yue-
Yue Zhang
Abstract
Aim: In the Japanese study group for Pediatric Liver Tumor (JPLT) studies, the survival of patients with
hepatoblastoma (HB) was improved by cisplatin/pirarubicin-based chemotherapy with combined surgical
resection. We aimed to clarify whether marginal positive resection is correlated with the prognosis of HB patients
from the JPLT-2 study (1999-2012).
Methods: Of the 361 JPLT-2 patients, we excluded 4 who died before surgery, 14 inoperable following preoperative
chemotherapy, and 6 macroscopically positive resections and analyzed local recurrence and survival rates in 337
patients who underwent primary resection including liver transplantation.

Results: The five-year event-free survival (EFS) and overall survival (OS) rates were 76.0% and 87.7% in patients
(n = 312) with complete resection of their primary tumors and 59.1% and 83.0% in those (n = 25) with
microscopically margin-positive resection (microMPR), respectively. Among patients without distant metastasis,
the five-year EFS and OS rates were 81.4% and 90.8% in those (n = 263) with complete resection vs. 62.5% and

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