{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:04:36Z","timestamp":1788447876617,"version":"build-2803163510"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":284,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T00:00:00Z","timestamp":1588809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T00:00:00Z","timestamp":1588809600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Outcomes of high-risk hepatoblastoma have been dismal, especially in resource-challenged countries where access to chemotherapy and paediatric liver transplantation is limited for the underprivileged. This study aimed to assess the results of treatment of high-risk hepatoblastoma in a tertiary centre, including patients who had non-transplant surgical procedures in the form of extended resection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A review of patients with high-risk hepatoblastoma treated between January 2012 and May 2018 was carried out. Perioperative data and long-term outcomes were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 52 children with hepatoblastoma, 22 were considered to have high-risk hepatoblastoma (8 girls and 14 boys). The mean(s.d.) age at diagnosis was 35(20)\u00a0months. Of these 22 children, five died without surgery. Of the remaining 17 who underwent surgery, six had a resection (4 right and 2 left trisectionectomies) and 11 underwent living-donor liver transplantation. Median follow-up was 48 (range 12\u201390)\u00a0months. Thirteen of the 17 children were alive at last follow-up and four developed disseminated disease (3 had undergone liver transplantation and 1 liver resection). The overall survival rate at 1, 3 and 5 years was 77, 64 and 62 per cent for the whole cohort with high-risk hepatoblastoma. In children who had surgery, 1-, 3- and 5-year survival rates were 91, 82 and 73 per cent for transplantation and 100, 83 and 83 per cent for resection. There was no difference in survival between the two surgical groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Excellent results in the treatment of high-risk hepatoblastoma are possible, even in resource-challenged countries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs5.50297","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T18:15:05Z","timestamp":1588875305000},"page":"630-636","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes for high-risk hepatoblastoma in a resource-challenged setting"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-8892","authenticated-orcid":false,"given":"A","family":"Rammohan","sequence":"first","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Sree Balaji Medical College Hospital, Bharat Institute of Higher Education and Research , Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Rela","sequence":"additional","affiliation":[{"name":"Ray of Light Foundation, Kanchi Kamakoti Children's Health Institute Laboratory and Diagnostic Services (CHILDS) Trust Hospital, CHILDS Trust Medical Research Foundation , Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G V","family":"Kumar","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Sree Balaji Medical College Hospital, Bharat Institute of Higher Education and Research , Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J X","family":"Scott","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Sree Balaji Medical College Hospital, Bharat Institute of Higher Education and Research , Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Shanmugam","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Sree Balaji Medical College Hospital, Bharat Institute of Higher Education and Research , Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M S","family":"Reddy","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Sree Balaji Medical College Hospital, Bharat Institute of Higher Education and Research , Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Sree Balaji Medical College Hospital, Bharat Institute of Higher Education and Research , Chennai, India"},{"name":"Ray of Light Foundation, Kanchi Kamakoti Children's Health Institute Laboratory and Diagnostic Services (CHILDS) Trust Hospital, CHILDS Trust Medical Research Foundation , Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,7]]},"reference":[{"key":"2023020206424048900_bjs550297-bib-0001","doi-asserted-by":"crossref","first-page":"201","DOI":"10.4103\/0971-9261.142001","article-title":"The treatment of hepatoblastoma: its evolution and the current status as per the SIOPEL trials","volume":"19","author":"Aronson","year":"2014","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"2023020206424048900_bjs550297-bib-0002","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/S1470-2045(16)30598-8","article-title":"Risk-stratified staging in paediatric hepatoblastoma: a unified analysis from the Children's Hepatic tumors International Collaboration","volume":"18","author":"Meyers","year":"2017","journal-title":"Lancet 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