{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:18:08Z","timestamp":1787015888273,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T00:00:00Z","timestamp":1533772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2018,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Primary liver transplantation is recommended for central post\u2010treatment extent of disease (\n POST<\/jats:styled-content>\n \u2010\n TEXT<\/jats:styled-content>\n )\n III<\/jats:styled-content>\n and\n IV<\/jats:styled-content>\n hepatoblastoma. The aim of this study was to prospectively assess the safety and oncological efficacy of aggressive non\u2010transplant extended hepatic resection in these patients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A prospective study involved 18 children with central pretreatment extent of disease (\n PRETEXT<\/jats:styled-content>\n )\n III<\/jats:styled-content>\n and\n IV<\/jats:styled-content>\n : three had primary liver transplantation whereas 15 underwent hepatic resection after neoadjuvant chemotherapy.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Median tumor volume was 317\n mL<\/jats:styled-content>\n (range, 135\u2013546\n mL<\/jats:styled-content>\n ). After four cycles of chemotherapy,\n POST<\/jats:styled-content>\n \u2010\n TEXT<\/jats:styled-content>\n stage was\n III<\/jats:styled-content>\n in 12 patients and\n IV<\/jats:styled-content>\n in three patients. There was no perioperative mortality. Postoperative complications consisted of two bile leaks, one temporary decompensation and one sub\u2010phrenic collection requiring drainage. One and 3\u00a0year disease\u2010free survival was 93.3% and 73.3% respectively. The 3\u00a0year overall survival was 86.6%. Four patients developed recurrence, of whom two died. Early recurrence in 1\u00a0year occurred in one patient. All recurrences were distant metastases.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Extended major hepatic resection for selected cases of\n POST<\/jats:styled-content>\n \u2010\n TEXT III<\/jats:styled-content>\n and\n IV<\/jats:styled-content>\n hepatoblastoma is a technically challenging but feasible approach with acceptable morbidity and mortality rates. Oncological outcomes are similar to liver transplantation without the long\u2010term commitment of immunosuppression or donor risk and morbidity, but a potential donor should always be organized on standby.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ped.13634","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T15:19:07Z","timestamp":1529075947000},"page":"862-868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Avoiding liver transplantation in post\u2010treatment extent of disease\n III<\/scp>\n and\n IV<\/scp>\n hepatoblastoma"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4903-5223","authenticated-orcid":false,"given":"Ahmed","family":"El\u2010Gendi","sequence":"first","affiliation":[{"name":"Department of Surgery Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shady","family":"Fadel","sequence":"additional","affiliation":[{"name":"Department of Medical and Radiation Oncology Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"El\u2010Shafei","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Shawky","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,9]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"516","article-title":"Hepatoblastoma and birth weight: Too little, too big, or just right?","volume":"130","author":"Ross JA","year":"1997","journal-title":"J. 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