{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:08:55Z","timestamp":1760148535184,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Hepatoblastoma is the most common malignant liver tumor of childhood, with liver transplant and extended resection used as surgical treatments for locally advanced tumors. Although each approach has well-described post-operative complications, quality-of-life outcomes have not been described following the two interventions. Long-term pediatric survivors of hepatoblastoma who underwent conventional liver resection or liver transplantation at a single institution from January 2000\u2013December 2013 were recruited to complete quality-of-life surveys. Survey responses for the Pediatric Quality of Life Generic Core 4.0 (PedsQL, n = 30 patient and n = 31 parent surveys) and Pediatric Quality of Life Cancer Module 3.0 (PedsQL-Cancer, n = 29 patient and n = 31 parent surveys) were collected from patients and parents. The mean total patient-reported PedsQL score was 73.7, and the parent-reported score was 73.9. There were no significant differences in scores on the PedsQL between patients who underwent resection compared to those who underwent transplantation (p &gt; 0.05 for all comparisons). On the PedsQL-Cancer module, procedural anxiety scores were significantly lower for patients who underwent resection as compared to transplant (M = 33.47 points less, CI [\u221260.41, \u22126.53], p-value 0.017). This cross-sectional study demonstrates that quality of life outcomes are overall similar among patients receiving transplants and resections. Patients who received a resection reported worse procedural anxiety.<\/jats:p>","DOI":"10.3390\/children10050890","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T02:37:51Z","timestamp":1684204671000},"page":"890","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Quality of Life Outcomes for Patients Who Underwent Conventional Resection and Liver Transplantation for Locally Advanced Hepatoblastoma"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7914-0425","authenticated-orcid":false,"given":"Zishaan","family":"Farooqui","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Cincinnati College of Medicine, CARE\/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA"},{"name":"Division of Pediatric General and Thoracic Surgery, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cincinnati College of Medicine, CARE\/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA"},{"name":"Division of Pediatric General and Thoracic Surgery, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5567-262X","authenticated-orcid":false,"given":"Emily","family":"Schepers","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cincinnati College of Medicine, CARE\/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA"},{"name":"Division of Pediatric General and Thoracic Surgery, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie","family":"Brewer","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Hartman","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cincinnati College of Medicine, CARE\/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA"},{"name":"Division of Pediatric General and Thoracic Surgery, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9802-5948","authenticated-orcid":false,"given":"Alexander","family":"Bondoc","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahna","family":"Pai","sequence":"additional","affiliation":[{"name":"Behavioral Medicine & Clinical Psychology, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Geller","sequence":"additional","affiliation":[{"name":"Division of Oncology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory M.","family":"Tiao","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery, Cincinnati Children\u2019s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.21037\/tgh.2016.04.01","article-title":"Pediatric liver transplantation for hepatoblastoma","volume":"1","author":"Meyers","year":"2016","journal-title":"Transl. Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1053\/jhep.2003.50375","article-title":"Epidemiology of primary hepatic malignancies in U.S. children","volume":"38","author":"Darbari","year":"2003","journal-title":"Hepatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1093\/aje\/kwj104","article-title":"Maternal and infant birth characteristics and hepatoblastoma","volume":"163","author":"McLaughlin","year":"2006","journal-title":"Am. J. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1002\/cncr.23169","article-title":"Trends in childhood cancer incidence in the U.S. (1992\u20132004)","volume":"112","author":"Linabery","year":"2008","journal-title":"Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.surg.2012.11.006","article-title":"Analysis of national and single-center incidence and survival after liver transplantation for hepatoblastoma: New trends and future opportunities","volume":"153","author":"Cruz","year":"2013","journal-title":"Surgery"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.5152\/tjg.2022.21827","article-title":"Multidisciplinary Management of Pediatric Hepatoblastoma: A 20-Year Single-Center Experience","volume":"33","author":"Sivrice","year":"2022","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/MOP.0000000000000042","article-title":"Hepatoblastoma state of the art: Pre-treatment extent of disease, surgical resection guidelines and the role of liver transplantation","volume":"26","author":"Meyers","year":"2014","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.jpedsurg.2006.12.065","article-title":"Outcomes of primary liver cancer in children: An appraisal of experience","volume":"42","author":"Pham","year":"2007","journal-title":"J. Pediatr. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1002\/cncr.10282","article-title":"Surgical view of the treatment of patients with hepatoblastoma: Results from the first prospective trial of the International Society of Pediatric Oncology Liver Tumor Study Group","volume":"94","author":"Schnater","year":"2002","journal-title":"Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2174\/138920107780487456","article-title":"Drug resistance in hepatoblastoma","volume":"8","author":"Warmann","year":"2007","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.ctrv.2010.02.013","article-title":"Progress in the surgical treatment of malignant liver tumors in children","volume":"36","author":"Otte","year":"2010","journal-title":"Cancer Treat. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/petr.12144","article-title":"Surgical treatment of primary liver tumors in children: Outcomes analysis of resection and transplantation in the SEER database","volume":"17","author":"McAteer","year":"2013","journal-title":"Pediatr. Transplant."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1001\/jamasurg.2015.1847","article-title":"Effect of Liver Transplant on Long-term Disease-Free Survival in Children With Hepatoblastoma and Hepatocellular Cancer","volume":"150","author":"Pham","year":"2015","journal-title":"JAMA Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2147\/HMER.S89997","article-title":"Unresectable hepatoblastoma: Current perspectives","volume":"9","author":"Meyers","year":"2017","journal-title":"Hepat. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e938","DOI":"10.1542\/peds.2009-1597","article-title":"Auditory late effects of childhood cancer therapy: A report from the Children\u2019s Oncology Group","volume":"125","author":"Grewal","year":"2010","journal-title":"Pediatrics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1002\/cncr.10428","article-title":"The PedsQL in pediatric cancer: Reliability and validity of the Pediatric Quality of Life Inventory Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module","volume":"94","author":"Varni","year":"2002","journal-title":"Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1097\/00005650-200108000-00006","article-title":"PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations","volume":"39","author":"Varni","year":"2001","journal-title":"Med. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/lt.24696","article-title":"Health-related quality of life after pediatric liver transplantation: A systematic review","volume":"23","author":"Parmar","year":"2017","journal-title":"Liver Transpl."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.jpeds.2011.10.038","article-title":"Health status of children alive 10 years after pediatric liver transplantation performed in the US and Canada: Report of the studies of pediatric liver transplantation experience","volume":"160","author":"Ng","year":"2012","journal-title":"J. Pediatr."},{"key":"ref_20","first-page":"1677","article-title":"Pediatric health-related quality of life: Feasibility, reliability and validity of the PedsQL transplant module","volume":"10","author":"Zielinski","year":"2010","journal-title":"Am. J. Transplant."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1111\/j.1600-6143.2010.03363.x","article-title":"Cognitive and academic outcomes after pediatric liver transplantation: Functional Outcomes Group (FOG) results","volume":"11","author":"Sorensen","year":"2011","journal-title":"Am. J. Transplant."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1002\/lt.23855","article-title":"Health-related quality of life: Two decades after liver transplantation","volume":"20","author":"Sullivan","year":"2014","journal-title":"Liver Transpl."},{"key":"ref_23","first-page":"562","article-title":"Paediatric liver transplantation--a review based on 20 years of personal experience","volume":"17","author":"Otte","year":"2004","journal-title":"Transpl. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e29398","DOI":"10.1002\/pbc.29398","article-title":"Long-term health-related quality of life in young childhood cancer survivors and their parents","volume":"68","author":"Fardell","year":"2021","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1007\/s11136-015-0961-3","article-title":"Health-related quality of life in young survivors of childhood cancer","volume":"24","author":"Wengenroth","year":"2015","journal-title":"Qual. Life Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1097\/MOT.0000000000000167","article-title":"Liver transplant and quality of life in the pediatric population: A review update (2013-2014)","volume":"20","author":"Alpert","year":"2015","journal-title":"Curr. Opin. Organ. Transplant."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1002\/lt.20294","article-title":"A critical review of the health-related quality of life of children and adolescents after liver transplantation","volume":"11","author":"Taylor","year":"2005","journal-title":"Liver Transpl."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1053\/jlts.2003.50012","article-title":"Health-related quality of life in pediatric liver transplant recipients: A single-center study","volume":"9","author":"Bucuvalas","year":"2003","journal-title":"Liver Transpl."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Dembowska-Bagi\u0144ska, B., Wi\u0119ckowska, J., Bro\u017cyna, A., \u015awi\u0119szkowska, E., Ismail, H., Broniszczak-Czyszek, D., Stefanowicz, M., Grajkowska, W., and Kalici\u0144ski, P. (2019). Health Status in Long-Term Survivors of Hepatoblastoma. Cancers, 11.","DOI":"10.3390\/cancers11111777"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3727\/105221616X693639","article-title":"Novel Advances in Understanding of Molecular Pathogenesis of Hepatoblastoma: A Wnt\/\u03b2-Catenin Perspective","volume":"17","author":"Bell","year":"2017","journal-title":"Gene Expr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1002\/pbc.26149","article-title":"Pediatric quality of life in long-term survivors of childhood cancer treated with anthracyclines","volume":"63","author":"Ryerson","year":"2016","journal-title":"Pediatr. Blood Cancer"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/5\/890\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:35:44Z","timestamp":1760124944000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/5\/890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,16]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["children10050890"],"URL":"https:\/\/doi.org\/10.3390\/children10050890","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2023,5,16]]}}}