Introduction : This study reviewed the clinical outcomes in the surgical management of hepatoblastoma over the past 30 years.

Methods : Pediatric patients with hepatoblastoma who underwent surgery (1985-2015) were reviewed (n=45). The outcomes of operation at different eras (I: 1985 to 1994; II: 1995 to 2003; III: 2004 to 2015) were compared.

Results : The most frequent type of liver resection was extended right hepatectomy (n = 10, 22.2%). The overall operative morbidity and mortality rates were 22.2% (n=10) and 0%. The median follow up was 157 months. The overall 5-year disease free survival was 77.8% (n = 35). Comparing the three study eras (I: n = 8; II: n = 15; III: n = 22), there was no significant difference in the pre-op disease status. Patient operated in era III had the shortest operative duration (I: 423+/-132 vs II: 368 +/- 103 vs III: 296 +/- 84 minutes, p = 0.03) as well as the least blood loss (I: 680+/180 vs II: 452 +/- 84 vs III: 250 +/-86 minutes, p = 0.02). The incidence of major surgical complications was highest in era II (I: 25.0% vs II: 26.6% vs III: 18.2%, p= 0.73). The 5-year disease free survival appeared to be the best in era III (I: 75.0% vs II: 73.3% vs III: 81.8%, p= 0.61)

Conclusions : With the advancement in perioperative care and surgical techniques, the operative outcome of hepatoblastoma has significantly improved in recent years.