Background : Hepatoblastomas (HB) are rare pediatric neoplasms, comprising 1% of pediatric malignancies. Till 1970s, surgery was the primary modality of treatment of HB. 60% of the patients present in an unresectable stage. Surgical resection after neoadjuvant chemotherapy (NCh) could be done in 87% of the cases whereas historically only 30% of the cases were operable upfront. Orthotopic Liver transplant is an effective treatment for unresectable HB with survival rates of 82%.

Methods : Eleven children were operating between 2010 and 2023s in our department. The clinical presentations, chemotherapy tolerance and response, surgical procedure undertaken, complications and 5-years survival rate were analysed. All the patients had elevated AFP levels and pathological confirmation was done. Median age of the population was 12 months (6-18months).

Results : Nine patients were treated with NCh incorporating cisplatin and adriamycin. Patients were routinely reassessed after three cycles for surgical resection. If the tumor was found to be inoperable, patient was given one more cycle of chemotherapy. Postoperatively, two to three cycles of chemotherapy were given to a total of six cycle. Chemo- therapy was well tolerated without morbidity or mortality. Primary surgery was done in tow patients. Major hepatic resection was performing in 8 children. Morbidity rate was 7,1% (1 patients with low debit biliary fistula). 5 years survival was 86%.

Conclusions : Treatment of HB with multidisciplinary approach was well tolerated. Surgical morbidity was also less if resection was performed after neoadjuvant chemotherapy. Combined modality treatment is now the standard of care in HB. Surgery remains the cornerstone of management and complete resection is crucial for cure .