"Update on pediatric primary liver tumors"

Progress in the study of therapeutic strategies for hepatoblastoma in children

Hepatoblastoma (HB) is the most common primary malignant liver tumor in children, representing approximately 50% to 60% of pediatric liver cancers. It predominantly affects children under the age of 3 years, with a slightly higher incidence in boys compared to girls. The main pathological subtypes of HB are epithelial and mixed types. The etiology and pathogenesis are unclear and may be related to factors such as genetics and gene mutations. The diagnosis primarily relies on imaging examinations (including abdominal ultrasound, computed tomography, and magnetic resonance imaging) and serum alpha-fetoprotein testing. Treatment approaches include surgical resection, chemotherapy, and liver transplantation. Surgical resection is currently the only curative option, especially effective for early-stage localized tumors; chemotherapy can be used to shrink tumors before surgery or to manage their progression; liver transplantation is recommended for cases that cannot be surgically removed or for instances where the disease recurs after surgery. Recent advancements have encouraged a multidisciplinary approach to treatment, with ongoing research into new chemotherapeutic and targeted agents. Despite these developments, challenges remain, such as the need for more precise and individualized therapies, chemotherapy resistance that can lead to poor outcomes in some patients, and a shortage of organ donors, along with the risk of immune rejection after transplantation. A thorough synthesis of current therapeutic strategies will establish an evidence-based foundation to enhance the management of HB in children, ultimately improving prognosis and quality of life.