Hepatoblastoma (Childhood Liver Cancer) - Diagnosis & Treatment

How is hepatoblastoma diagnosed?

Apart from performing a physical examination and asking about your child's medical history, the doctor will recommend additional tests in order to confirm if your child has hepatoblastoma:

• Blood tests to evaluate liver function
• Alpha-fetoprotein (AFP) test, a tumour marker test which checks for elevated levels of AFP in the blood. This test is used not only for diagnostic purposes, but also to monitor the child's response to treatment.
• Vascular ultrasound, which allows the doctor to examine the blood vessels entering and leaving the liver
• Computerised tomography (CT) scan, which can help detect any tumour in the liver and its spread to other organs
• Magnetic resonance imaging (MRI) scan, which can help detect if the cancer has spread to blood vessels located near the liver
• PET-CT scan to see if the tumour has spread
• Biopsy to remove suspected liver tissue to check for cancerous cells

How is hepatoblastoma treated?

Treatment for hepatoblastoma typically involves a combination of surgery and chemotherapy. The paediatric surgical and oncology specialists will discuss with you possible options and customise an appropriate treatment plan based on your child's age, the size and location of the tumour, and the extent of spread.

Surgery

• Partial or total hepatectomy (removal of a part of or all of the liver). The aim of this surgery is to remove as much of the cancerous tumour as possible.
• Liver transplantation. A liver transplant may be needed after total hepatectomy, or in cases where the tumour is contained within the liver but unable to be removed by surgery.

Non-surgical treatment

• Chemotherapy. Chemotherapy destroys cancer cells using medicine given either orally, intravenously, or via intramuscular injections. It is needed before surgery, in order to shrink the tumour and make it easier to remove, and after surgery, in order to kill any remaining cancerous cells and reduce the risk of cancer recurrence.

Recovery from hepatoblastoma

In the past couple of decades, the survival rate for children with hepatoblastoma has also improved greatly. Children who undergo complete resection (removal) of tumours have an over 85% probability of survival. Those with metastatic cancer that responds to chemotherapy have a survival rate of about 60%.

Regular follow-ups are needed after treatment to ensure that the cancer does not come back.