Introduction: Achievement of complete surgical resection is the mainstay of multimodal treatment for hepatoblastomas. Overall, outcomes have greatly improved because of advances in chemotherapy and innovations of surgical technologies, including the liver transplantation.
Materials and Methods: The aim of our study was to study results of  surgical treatment patients with hepatoblastoma in one single center in period 2005 to 2017 years by liver resection and liver transplantation and compare outcome between liver resection group and liver transplantation group. To achieve this goal we have retrospectively studied 2 groups of patients with hepatoblastoma : 52 patients who underwent liver resection and 8 patients who underwent transplantation of the liver from a living related donor . These patient groups were homogeneous for age, sex , neoadjuvant chemotherapy, the level of AFP, the functional state of the liver . However, in the transplantation group were more patients resistant to neoadjuvant chemotherapy (62 % and 20 % respectively).The patients were classified according to the pretreatment extent of disease (PRETEXT) grouping system. 3 patients (5%) were PRETEXT group I, 19 (31,6%) group II, 30 (50%) group III and 8 (13,4%) group IV. 12 patients PRETEXT I-II underwent primary surgery. 48 patients were treated with preoperative chemotherapy. 51 patients received postoperative chemotherapy. The standard perioperative treatment is 4 cycles of preoperative chemotherapy followed by surgical treatment and 2 postoperative cycles of chemotherapy («PLADO» or «superPLADO»). Patients with PRETEXT IV tumors, multifocal tumors and tumors invading major vessels of the liver underwent liver transplantation.
Results: The overall 1-,3- and 5-year survival rate for 52 patients after liver resection and for 8 patients after LDLT in the study was 90,4%, 82,7%, 71,1% and 100%, 87,5%, 75%, respectively. Recurrence-free 1-,3- and 5-year survival rate for 52 patients after liver resection and for 8 patients after LDLT in the study was 86,5%, 76,9%, 69,2% and 100%, 87,5%, 75%, respectively. Operative morbidity and mortality after liver resection and after LDLT were 17,3% and 12,5%, 9,6%, and 0%, respectively. 5 patients died after extended hepatectomies. After a median follow-up of  3.8 years (range 1.5-5.3 years), 42 (70%) of the patients were tumor-free in remission and 18 (30%) had died.
Conclusion: Resection and transplantation technology in combination with chemotherapy allows to obtain a good long-term outcome. We did not find any difference in the long-term results between resection and transplantation groups although in transplantation group patients liver tumor lesion was more extensive. Liver transplantation is a good treatment option for children with unresectable hepatoblastoma.