Modified hepatectomy for patients with PRETEXT III hepatoblastoma: Balancing complete curability with preservation of adequate remaining liver function

Abstract

In children with PRETEXT III hepatoblastoma, trisegmentectomy is considered for complete anatomic resection, but it may result in posthepatectomy liver failure. Herein, we present three cases of patients on whom hemihepatectomy + subsegmentectomy was performed to obtain radicality and to preserve remnant liver volume. All patients achieved complete microscopic resection and a recurrence-free survival of more than 5 years. There was no significant difference in the surgery duration or blood loss between these three patients and pediatric patients with hepatoblastoma who underwent hemihepatectomy. There was also no significant difference in the duration until postoperative chemotherapy. This procedure may allow both complete anatomical resection of the tumor and preservation of residual liver volume equivalent to hemihepatectomy.