WOFAPS 2025 8th World Congress of Pediatric Surgery

Muhammad Saleem ¹, Nabila Talat ², Jamaal Butt ², umer saleem ³, Hassan Mahmud ², Azka Saleem ², Muhammad Zubair Shoukat ²

¹ Akhtar Saeed Medical & Dental College, Lahore
² University of child health sciences, The Childrens Hospital, Lahore
³ services institute of medical sciences lahore

Purpose
Liver tumors are the third most common intra-abdominal malignancy in children. Approximately two-thirds of liver tumors in children are malignant, Complete surgical excision remains the cornerstone of curative treatment. The purpose of this study is to present our institutional experience in the diagnosis, surgical management, and outcome of pediatric liver tumors over a period of 16 years.

Method
A retrospective study of 104 children who underwent surgical intervention for liver masses between 2007 and 2024.. Data were reviewed regarding demographics, clinical presentation, diagnostic workup, tumor histopathology, surgical procedures, postoperative complications, and final outcomes. Malignant cases were treated with neoadjuvant chemotherapy followed by surgical resection.

Results
The mean age at diagnosis was 40.09 ± 39.0 months. Male-to-female ratio was 1.66:1. Right hypochondrial mass (63.5%) and abdominal pain (21.2%) were the most common presenting symptoms. Malignant tumors comprised 81.9% of cases, with hepatoblastoma accounting for 64.4%. Benign tumors included mesenchymal hamartoma (12.5%) and biliary cystadenoma (4.8%). Right lobectomy was the most performed surgery (42.3%) with resection of involved segments 5, 6, 7 and 8 in 39.4% followed by Left lateral segmentectomy (14.4%). Chemotherapy (pre and post) was administered in 44.2% of malignant cases. Postoperative complications occurred in 23%, including recurrence (9.6%) and liver failure (2.9%). Overall, 58.7% of patients were discharged alive, 15.4% died, and 17.3% were lost to follow-up.

Conclusion
Complete surgical excision significantly improves survival in pediatric liver tumors. Early referral, timely diagnosis, coordinated multidisciplinary care, and safe hepatic resection are critical for favorable outcomes. Despite being in a resource-limited setting, our survival outcomes remain comparable to international standards.