The two main types of liver cancer in children are hepatoblastoma (HB) and hepatocellular carcinoma (HCC). Hepatoblastoma generally develops in children under the age of three and rarely spreads outside the liver. Hepatocellular carcinoma can affect children of any age and often spreads to other parts of the body. Treatment of HB and HCC often involves surgery, chemotherapy, or radiation therapy. If the cancer cannot be surgically removed, treatment may include a liver transplantation.
To describe patient outcomes after liver transplantation for inoperable liver cancer, researchers reviewed the medical records of 135 children with HB and 41 children with HCC. Children were under the age of 18 years and had been diagnosed with cancer between 1987 and 2004. The 135 children with HB received a total of 152 liver transplantations, and the 41 children with HCC received a total of 43 liver transplantations.
- Among the patients with HB, 79% survived for at least one year after transplantation, 69% survived for at least five years after transplantation, and 66% survived for at least 10 years after transplantation.
- Among the patients with HCC, 86% survived for at least one year after transplantation, 63% survived for at least five years after transplantation, and 58% survived for at least 10 years after transplantation.
- The most common cause of death in both groups was metastatic or recurrent cancer. This accounted for 54% of deaths among patients with HB and 86% of deaths among patients with HCC.
- Patients with a better medical condition before liver transplantation had better survival after liver transplantation.
The researchers conclude that liver transplantation for treatment of inoperable childhood liver cancer results in good long-term survival. They note that in combination with improved chemotherapy regimens, earlier evaluation for liver transplantation may further improve survival.
 Austin MT, Leys CM, Feurer ID et al. Liver Transplantation for Childhood Hepatic Malignancy: A Review of the United Network for Organ Sharing (UNOS) Database. Journal of Pediatric Surgery. 2006;41:182-186.