Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6437
Peer-review started: November 11, 2021
First decision: March 3, 2022
Revised: March 23, 2022
Accepted: May 16, 2022
Article in press: May 16, 2022
Published online: July 6, 2022
Undifferentiated embryonal sarcoma of the liver (UESL) is a rare and aggressive mesenchymal tumor in children.Modern multimodal treatment and supportive therapy have improved survival. Complete tumor excision plays the central role in the treatment of UESL.
The prognosis is poor when complete excision of tumor with UESL cannot be achieved. It is imperative to explore new choices for successful operation of UESL in children.
This report aimed to evaluate the efficacy of neoadjuvant therapy (NAT) for UESL and explore a new choice for successful operation of UESL in children.
Six patients who were newly diagnosed and unresectable with UESL received NAT and surgery at our center between January 2004 and December 2019 were retrospectively analyzed. The NAT included preoperative transcatheter arterial chemoembolization (TACE) and systemic chemotherapy. Surgical and survival data would be recorded and analyzed.
The tumor volumes decreased by 18.2%–68.7%, with a mean value of 36% after 1 cycle of NAT (t = 3.524, P = 0.017). Massive tumor necrosis was seen in the pathological examination of the specimen: > 90% necrosis in two, > 50% necrosis in three, and 25% necrosis in 1, with an average percentage of 71.8%. Complete tumor resection was successfully performed in all patients. Preoperative NAT may help complete removal of unresectable UESLs. However, there was no control group due to the small number of cases.
The present study indicated that the use of NAT effectively reduced tumor volume, cleared tumor margin, and caused massive tumor necrosis. It may provide a promising choice for successful operation of UESL in children.
Further investigations with a larger cohort and prospective study are needed to compare the efficacy of TACE, systemic chemotherapy and NAT for UESL.