# Hepatocellular Carcinoma — GCMD Library living collection

Everything in the library about hepatocellular carcinoma — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 87 cited statements

## Episodes
### Surgical Management
- [Update Course 2023 - Updates in the use of ICG](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267) — video · 19:57 · [machine version](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267.md)

### Case-Based Learning
- [Clinical & Research Update: Pediatric Liver Tumors -  A Case-Based Discussion with Drs. Katherine Somers & Alex Bondoc](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848) — video · 69:23 · [machine version](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848.md)

### In-Depth Reviews
- [Hepatoblastoma: Update Course 2014](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648) — video · 24:43 · [machine version](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=0) PRETEXT and POSTTEXT staging systems for hepatoblastoma (Ep 1)
- [4:24](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=264) Management of PRETEXT II tumors and role of neoadjuvant chemotherapy (Ep 1)
- [11:31](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=691) Transplant versus extended resection: timing and outcomes (Ep 1)
- [14:59](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=899) Referral criteria and role of transplant centers in complex hepatoblastoma (Ep 1)
- [21:00](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1260) Biopsy approach in atypical presentations (Ep 1)
- [22:01](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1321) Management of pulmonary metastases and future research directions (Ep 1)
- [0:03](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=3) ICG for Sentinel Lymph Node Biopsy in Pediatric Sarcomas (Ep 2)
- [5:51](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=351) Technical Considerations and Laparoscopic Applications (Ep 2)
- [9:41](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=581) ICG Biology and FDA Status (Ep 2)
- [11:41](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=701) Hepatic Metastasis Detection Using Preoperative ICG (Ep 2)
- [15:15](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=915) Infrared Ureteral Stents and Future Fluorophores (Ep 2)
- [17:35](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=1055) Emerging Applications and Institutional Experience (Ep 2)
- [3:48](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=228) Case 1 Presentation: 2-Year-Old with Metastatic Hepatoblastoma (Ep 3)
- [11:40](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=700) Atypical Presentations and Induction Chemotherapy for Case 1 (Ep 3)
- [20:06](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1206) Surgical Planning and Technique for Case 1 (Ep 3)
- [27:57](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1677) Pathology and Adjuvant Therapy for Case 1 (Ep 3)
- [36:32](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2192) Case 2 Presentation: 9-Month-Old with Multifocal Disease and Renal Failure (Ep 3)
- [47:49](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2869) Management of Hepatoblastoma in End-Stage Renal Disease (Ep 3)
- [52:00](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3120) Combined Liver-Kidney Transplant Strategy (Ep 3)
- [61:41](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3701) Molecular Diagnostics and Future Directions (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "PRETEXT staging stands for pre-treatment extent of disease and is based on segmental liver anatomy, performed prior to chemotherapy." (guideline) [Ep 1 · 2:02](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=122)
- "PRETEXT staging has a tendency to overstage because it is based purely on imaging, and bulky tumors make it difficult to assess true vascular invasion versus mass effect." (clinical) [Ep 1 · 2:28](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=148)
- "POSTTEXT staging refers to extent of disease after neoadjuvant chemotherapy has been given." (guideline) [Ep 1 · 2:51](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=171)
- "Key staging annotations include involvement of the retrohepatic cava or hepatic veins, and the portal vein bifurcation." (guideline) [Ep 1 · 4:10](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=250)
- "COG recommendations state that PRETEXT I-II tumors with clear 1 cm margins and no vascular involvement can be resected locally without referral to specialized centers." (guideline) [Ep 1 · 7:41](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=461)
- "Most tumor volume shrinkage from chemotherapy occurs within the first two cycles." (clinical) [Ep 1 · 10:14](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=614)
- "After 2 cycles of chemotherapy, if the tumor has not shrunk to a resectable size, the patient should be evaluated for transplant." (guideline) [Ep 1 · 10:33](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=633)
- "As hepatoblastoma tumors shrink with chemotherapy, they do not shrink away from vascular supply significantly; size decreases but vascular margins do not substantially improve." (clinical) [Ep 1 · 11:06](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=666)
- "Survival after extensive or 'heroic' resections (tumor liver explants with back table resections and reimplants, portal vein reconstructions, hepatic vein reconstructions) is not as good as transplant survival." (clinical) [Ep 1 · 12:10](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=730)
- "There has been a move away from heroic resections in hepatoblastoma due to inferior survival compared to transplantation." (opinion) [Ep 1 · 12:40](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=760)
- "Patients who undergo rescue transplant after failed resection do far worse than patients who have a planned transplant upfront." (clinical) [Ep 1 · 14:09](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=849)
- "Current thinking is to refer patients to a transplant center early, even if two cycles of chemotherapy will be given first, to have pre-transplant evaluation completed and the patient integrated into the system." (guideline) [Ep 1 · 14:36](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=876)
- "Primary transplant patients do surprisingly well despite immunosuppression for cancer, particularly in liver tumors." (clinical) [Ep 1 · 15:11](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=911)
- "In the UK, all biliary atresia patients are referred upfront to a transplant center." (clinical) [Ep 1 · 16:02](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=962)
- "For non-transplant center surgeons performing hepatoblastoma resection, there must be 95% confidence of successful resection with adequate margins before proceeding; otherwise referral to a transplant center is indicated." (opinion) [Ep 1 · 17:36](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1056)
- "Anatomic resection with a good margin is appropriate for local management; disease near hepatic veins, crossing the liver, or involving the portal vein should be referred." (opinion) [Ep 1 · 18:11](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1091)
- "Liver transplant surgeons have extensive experience operating on the liver, which may benefit pediatric surgeons managing borderline-resectable hepatoblastoma cases." (opinion) [Ep 1 · 18:55](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1135)
- "Despite advanced imaging, the truth about resectability is determined at the time of operation." (clinical) [Ep 1 · 19:43](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1183)
- "In Europe, all liver tumors receive chemotherapy upfront before surgery to make the tumor smaller and potentially avoid transplantation." (clinical) [Ep 1 · 19:58](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1198)
- "Trisegmentectomy for cure is a reasonable approach to avoid lifelong immunosuppression from transplantation." (opinion) [Ep 1 · 20:19](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1219)
- "Central hepatectomies have been performed successfully for hepatoblastoma cure without requiring transplant, though it is a difficult operation." (clinical) [Ep 1 · 20:34](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1234)
- "For core needle biopsy of hepatoblastoma, approximately 10 passes are recommended, going through an area that includes normal parenchyma and tumor." (guideline) [Ep 1 · 21:25](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1285)
- "There are two camps regarding pulmonary metastases in hepatoblastoma: one advocates resecting metastases upfront before hepatectomy; the other suggests waiting until after hepatectomy because liver regeneration growth factors may stimulate previously unrecognized lung sites." (clinical) [Ep 1 · 22:11](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1331)
- "There is no good data on either side of the pulmonary metastases timing debate; all evidence is limited to a handful of patients." (clinical) [Ep 1 · 22:45](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1365)
- "Papers examining stage 4 hepatoblastoma with pulmonary metastases are limited to cohorts of less than 20 patients, making it difficult to draw good conclusions." (epidemiological) [Ep 1 · 23:22](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1402)
- "There may be reporting bias in hepatoblastoma transplant literature: successful cases (good chemo response, transplant, long-term survival) are reported, but failures may not be." (opinion) [Ep 1 · 23:38](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1418)
- "PLUTO (Pediatric Liver Unresectable Tumor Observatory) is an international group seeking to answer questions about unresectable hepatoblastoma that cannot be answered at individual or multi-center level within North America or Europe." (clinical) [Ep 1 · 24:02](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1442)
- "It will likely take several years before PLUTO can answer key questions about unresectable hepatoblastoma management." (opinion) [Ep 1 · 24:30](https://library.globalcastmd.com/watch/hepatoblastoma-update-course-2014-648?t=1470)
- "Rib fractures or vertebral fractures are fairly common as a presentation factor with hepatic tumors in young children, particularly hepatoblastoma." — Katherine Somers (clinical) [Ep 3 · 14:51](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=891)
- "Fractures in hepatoblastoma patients will heal as they go through their therapy, and kids tend to be rather unbothered by their fractures once cancer therapy is underway." — Katherine Somers (clinical) [Ep 3 · 15:29](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=929)
- "Precocious puberty in a Tanner stage one patient is a sign that should prompt consideration of underlying malignancy on the differential." — Katherine Somers (clinical) [Ep 3 · 15:43](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=943)
- "Weight loss or sarcopenia during active cancer therapy is associated with poor outcomes across all pediatric cancer diagnoses." — Katherine Somers (epidemiological) [Ep 3 · 19:39](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1179)
- "Advanced nutritional support is a key part of care for pediatric liver tumor patients to ready them for surgical interventions." — Katherine Somers (clinical) [Ep 3 · 19:52](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1192)
- "With a young child, pulmonary metastasis, and a large liver mass, hepatoblastoma is the diagnosis 99.9% of the time." — Alex Tobin (clinical) [Ep 3 · 22:03](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1323)
- "There is data in pediatrics about the approach of a tumor board as it pertains to the success and long-term outcomes of patients whose cases are presented at a tumor board style multidisciplinary conference." — Alex Bondoc (epidemiological) [Ep 3 · 23:04](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1384)
- "You get the maximal effect of tumor shrinkage after the first block or cycle of chemotherapy in intermediate risk patients; you typically won't get as much shrinkage after subsequent blocks." — Alex Bondoc (clinical) [Ep 3 · 24:34](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1474)
- "Indocyanine green (ICG) is highly sensitive but not specific for tumor detection; it can help find multifocal disease." — Alex Bondoc (clinical) [Ep 3 · 26:05](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1565)
- "In about 15% of lung resections for hepatoblastoma metastases, ICG fluorescence finds lesions not visible on high-resolution CT imaging." — Alex Bondoc (clinical) [Ep 3 · 26:21](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1581)
- "You can see tumor through vessel walls with indocyanine green." — Alex Bondoc (clinical) [Ep 3 · 26:46](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1606)
- "The FIT trial (AHEP 1531) mandated liver biopsy for diagnosis before starting treatment." — Ranga (Ranganathan) (guideline) [Ep 3 · 30:05](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1805)
- "Once chemotherapy begins and the tumor gets replaced by pools of blood and fibrous tissue, there's nothing for the chemotherapy to kill, and the size doesn't decrease much further beyond a certain point." — Ranga (Ranganathan) (clinical) [Ep 3 · 33:19](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=1999)
- "For patients with successful primary tumor resection, the first surgical goal is always primary tumor resection whenever possible." — Katherine Somers (clinical) [Ep 3 · 34:31](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2071)
- "After primary tumor resection, consolidation chemotherapy alternates carboplatin-doxorubicin cycles with staged lung metastasectomy procedures." — Katherine Somers (clinical) [Ep 3 · 34:49](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2089)
- "In patients with known vascular invasion and metastatic disease, continuing chemotherapy despite beautiful response helps weed out any remaining circulating cells that remain active." — Katherine Somers (clinical) [Ep 3 · 35:47](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2147)
- "Hematogenous metastases to the lungs are the primary metastatic site for hepatoblastoma." — Alex Bondoc (clinical) [Ep 3 · 36:56](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2216)
- "PRETEXT criteria define metastatic disease as more than 2 nodules greater than 3 millimeters in diameter or 1 nodule greater than 5 millimeters in diameter." — Alex Tobin (guideline) [Ep 3 · 38:46](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2326)
- "Even when one side of the chest shows no viable tumor after chemotherapy, the other side is still cleared surgically because that is the best pathway to long-term disease control and maintenance of remission." — Katherine Somers (clinical) [Ep 3 · 39:20](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2360)
- "ICG fluorescence correlates with the viability of lung metastases; non-fluorescent masses may represent dead tumor." — Alex Bondoc (clinical) [Ep 3 · 40:42](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2442)
- "Patients with hepatoblastoma are frequently born prematurely." — Alex Tobin (epidemiological) [Ep 3 · 45:00](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2700)
- "Known risk factors for developing hepatoblastoma include Beckwith-Wiedemann syndrome, hemihypertrophy syndromes, trisomy 18, autosomal recessive polycystic kidney disease, and extreme prematurity." — Katherine Somers (epidemiological) [Ep 3 · 48:44](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2924)
- "It's not just autosomal recessive polycystic kidney disease children who develop hepatoblastoma; there is increased incidence in end-stage renal disease early in life." — Katherine Somers (epidemiological) [Ep 3 · 49:18](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2958)
- "Cisplatin's primary toxicity is renal, and it can cause chronic kidney disease." — Katherine Somers (clinical) [Ep 3 · 49:39](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=2979)
- "Platinum-based chemotherapy can be delivered to patients on peritoneal dialysis using advanced pharmacokinetic and pharmacodynamic modeling systems without typical mandated hyperhydration." — Katherine Somers (clinical) [Ep 3 · 50:02](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3002)
- "Hepatoblastoma typically presents in the toddler range (first and second year of life), but predisposed patients can develop it as early as congenital or immediately post-delivery." — Katherine Somers (clinical) [Ep 3 · 50:59](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3059)
- "For known predisposition patients, screening protocol includes ultrasound and alpha-fetoprotein levels, taking into account that AFP has a very different range of normal values in the first months of life." — Katherine Somers (clinical) [Ep 3 · 51:20](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3080)
- "PRETEXT 4 multifocal disease mandates liver transplant as the surgical approach." — Alex Bondoc (clinical) [Ep 3 · 52:15](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3135)
- "In deceased donor liver transplant for hepatoblastoma, you cannot have extrahepatic disease because of the huge induction of immunosuppression required." — Alex Bondoc (clinical) [Ep 3 · 58:50](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3530)
- "In the United States, a child with hepatoblastoma automatically gets status 1B categorization on the deceased donor list, which is the second highest stratum for organ allocation." — Alex Bondoc (guideline) [Ep 3 · 59:46](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3586)
- "A patient with hepatoblastoma typically does not have underlying liver disease, unlike most liver transplant candidates." — Alex Bondoc (clinical) [Ep 3 · 60:10](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3610)
- "Vincristine-irinotecan is a less intensive regimen that can be used as maintenance therapy while waiting for organ offers during transplant listing." — Katherine Somers (clinical) [Ep 3 · 60:58](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3658)
- "Conventional hepatoblastoma is genomically quiet with very low mutation burden and invariably has either a point mutation or small deletion in exon 3 of the CTNNB1 gene." — Ranga (Ranganathan) (clinical) [Ep 3 · 62:23](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3743)
- "Hepatocellular neoplasm NOS shows more genomic instability with chromosomal gains and losses, characterized by CTNNB1 deletion, often with large deletions or complete exon 3 skipping (exon 2 joined to exon 4)." — Ranga (Ranganathan) (clinical) [Ep 3 · 62:41](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3761)
- "Beta-catenin immunohistochemistry is frequently very weak positive or even negative in hepatocellular neoplasm NOS, which is a clue to diagnosis along with pleomorphic appearance and macrotrabecular arrangement." — Ranga (Ranganathan) (clinical) [Ep 3 · 63:19](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3799)
- "Hepatocellular neoplasm NOS can be targeted with high-risk hepatoblastoma therapy to shrink tumors and make them amenable to surgery in most cases." — Ranga (Ranganathan) (clinical) [Ep 3 · 63:51](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3831)
- "Every child with a new cancer diagnosis meets with oncology genetic counseling team for complete genetic testing including germline testing if something is identified." — Katherine Somers (clinical) [Ep 3 · 64:50](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3890)
- "Radiomics can predict pure fetal histology hepatoblastoma with area under the receiver operating curve of about 0.85." — Alex Tobin (clinical) [Ep 3 · 66:36](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=3996)
- "Pure fetal histology hepatoblastoma patients are cured with resection alone and don't need chemotherapy." — Alex Tobin (clinical) [Ep 3 · 66:58](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=4018)
- "Artificial intelligence can segment hepatoblastoma tumors very accurately at the level of an expert." — Alex Tobin (clinical) [Ep 3 · 67:13](https://library.globalcastmd.com/watch/clinical-research-update-pediatric-liver-tumors-a-case-based-discussion-with-drs-katherine-somers-alex-bondoc-11848?t=4033)
- "ICG can be used as an adjunct to sentinel node identification in pediatric surgical oncology" — Seth Goldstein (clinical) [Ep 2 · 3:16](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=196)
- "Sentinel node biopsy in pediatric rhabdomyosarcoma is standard of care and dictates drug regimen and indicates radiation to lymph node basin if positive" — Seth Goldstein (guideline) [Ep 2 · 1:36](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=96)
- "ICG technique allows real-time intraoperative control of injection location (intratumoral vs. four quadrants, dermal vs. subdermal) by surgeons rather than radiologists" — Seth Goldstein (clinical) [Ep 2 · 4:00](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=240)
- "ICG fluorescence visualization occurs over 45-75 seconds after injection, allowing direct observation of lymphatic drainage to sentinel node" — Seth Goldstein (clinical) [Ep 2 · 5:20](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=320)
- "Near-infrared fluorescence penetrates approximately 1-2 centimeters through soft tissue" — Tom Isch (clinical) [Ep 2 · 7:23](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=443)
- "ICG enables laparoscopic sentinel node identification in paratesticular rhabdomyosarcoma, which is not feasible with radiotracer methods" — Seth Goldstein (clinical) [Ep 2 · 8:40](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=520)
- "In children under 10 years old with paratesticular rhabdomyosarcoma, sentinel node biopsy may be performed instead of full ipsilateral lymph node clearance" — Seth Goldstein (guideline) [Ep 2 · 8:40](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=520)
- "Indocyanine green was developed by Kodak company after World War II and has been FDA approved since the 1960s" — Seth Goldstein (clinical) [Ep 2 · 9:47](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=587)
- "ICG is approved for all adult and pediatric applications with no on-label or off-label concerns" — Seth Goldstein (guideline) [Ep 2 · 10:30](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=630)
- "ICG is exclusively cleared through the biliary system" — Seth Goldstein (clinical) [Ep 2 · 11:41](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=701)
- "For hepatic metastases in the chest, ICG administered 24 hours preoperatively will be retained only in liver tissue by the time of thoracotomy, enabling metastasis localization" — Seth Goldstein (clinical) [Ep 2 · 12:00](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=720)
- "ICG technique for hepatic metastases is successful for hepatoblastoma but has not been successful for Wilms tumor" — Tom Isch (clinical) [Ep 2 · 12:32](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=752)
- "Sarcomas other than hepatic primaries require much higher ICG dosage and are less specific" — Seth Goldstein (clinical) [Ep 2 · 12:39](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=759)
- "Wilms tumor metastases in the lungs are avid for ICG, though the primary kidney tumor is not" — Seth Goldstein (clinical) [Ep 2 · 13:34](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=814)
- "ICG fluorescence identifies additional pulmonary metastases beyond what visual inspection and palpation detect during thoracotomy" — Seth Goldstein (clinical) [Ep 2 · 14:00](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=840)
- "Infrared ureteral stents emit light that travels through centimeters of tissue and can be detected by standard fluorescence imaging systems" — Seth Goldstein (clinical) [Ep 2 · 16:20](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=980)
- "A renally-cleared fluorophore is under investigation that could enable ureteral identification without stent placement" — Seth Goldstein (clinical) [Ep 2 · 17:00](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=1020)
- "ICG can identify accessory cystic ducts during cholecystectomy by showing separate fluorescence of the accessory duct, main cystic duct, and common bile duct" — Tom Isch (clinical) [Ep 2 · 19:00](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=1140)
- "ICG is used for vascular mapping in partial nephrectomy for Wilms tumor" — Tom Isch (clinical) [Ep 2 · 18:45](https://library.globalcastmd.com/watch/update-course-2023-updates-in-the-use-of-icg-7267?t=1125)

## Changelog
- Sep 21: 3 items added automatically

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