Retrospective analysis of pediatric hepatoblastoma with tumor rupture: experience from a single center

Background Hepatoblastoma (HB) tumor rupture is currently considered as a high-risk factor in some risk-stratification systems. This study aimed to investigate the value of HB tumor rupture in predicting the poor prognosis of child patients. Methods The clinical data from children with high-risk HB or HB tumor rupture at our institution from October 2008 to October 2017 were retrospectively reviewed and analyzed. Results Altogether 34 children with high-risk HB or HB tumor rupture were retrospected, including 25 in the high-risk group and 9 in tumor rupture group. The 3-year overall survival (OS) rate in tumor rupture group was significantly higher than that in high-risk group (100% vs 60%, p=0.035). In tumor rupture group, 7 (77.8%) out of 9 patients had the hemoglobin level ≤ 8 g/L and 3 (33.3%) had that ≤ 6 g/L at the time of diagnosis. Peritoneal perfusion with normal saline and interleukin-2 was implemented for each patient until the free fluid was under normal level. At the end of the treatment, 7 (77.8%) of 9 patients achieved complete response (CR). No patient died at the last follow-up. Conclusions Tumor rupture is not predictive of poor prognosis with the risk of peritoneal dissemination/relapse.

Feasibility of Ultrasound-Guided Peritoneal Perfusion with Ozone in the Treatment of Chronic Pelvic Pain: A Bicenter Retrospective Analysis

Background: Numerous therapies have been developed for the treatment of chronic pelvic pain (CPP). Oxygen-ozone therapy is a new method for the treatment of CPP. Objectives: This article evaluated the feasibility of ultrasound-guided peritoneal perfusion with ozone in patients with CPP. Study Design: This is a bicenter retrospective study. Setting: The study was conducted at 2 pain centers of a university hospital. Methods: The medical records of patients with CPP (n = 60) from March 2016 until October 2018 were collected and reviewed. Group A contained 19 patients who were treated with a 1500 mcg dose of ozonated water (10 mcg/mL concentration and 150 mL volume), group B contained 23 patients using the same dose of ozonated water but a 15 mcg/mL concentration and 100 mL volume. Group C included 18 patients using a similar ozone dose but delivered in an oxygen-ozone mixture (15 mcg/mL concentration and 100 mL volume oxygen-ozone mixture). Visual Analog Scale (VAS) scores for pain of the 3 groups were compared at pretreatment, posttreatment, 1, 3, and 6 months posttreatment. The injection pain was evaluated using a 4-point verbal rating scale. Quality of life (QoL), anxiety, and depression were assessed at pretreatment and at 6 months posttreatment. Results: The VAS scores of the 3 groups decreased over time following treatment. Group A showed much higher pain scores compared with groups B and C at 1, 3, and 6 months posttreatment. However, the injection pain for groups B and C was higher than group A, but there was no difference seen between group B and C. At 6 months posttreatment, the QoL for all patients improved compared with pretreatment, whereas the anxiety and depression did not demonstrate differences. Limitations: The main limitations of this study are the retrospective study design, limited case number, and short follow-up period. Conclusions: Ultrasound-guided peritoneal perfusion with ozone is a feasible therapy for patients with CPP. Key words: Chronic pelvic pain, ozone, peritoneal perfusion