BACKGROUND Complete resection of the primary tumor is critical for the survival of children with hepatoblastomas. This prospective clinical study aimed to clarify the outcome of a chemotherapy regimen comprising cisplatin and doxorubicin (PLADO) followed by definitive surgery conducted at the appropriate time in patients with intermediate-risk hepatoblastoma. METHODS This study included patients with nonmetastatic hepatoblastomas who met any of the following criteria: age, ≥3 years; PRETEXT IV disease; or the presence of one or more of these PRETEXT annotation factors: E1, E1a, E2, E2a, F1, N1, P2, P2a, V3, or V3a positive. The study protocol consisted of four preoperative and two postoperative courses of PLADO. The appropriate surgeries were conducted at optimized timings via real-time central surgical reviews. RESULTS The 3-year progression-free and overall survival of the 33 intermediate-risk patients included were 78.7% and 87.9%, respectively. Preoperative PLADO resulted in a partial response in 83.9% of the patients. Microscopic complete resection was ultimately obtained in 31 (94%) patients. Surgery, including liver transplantation (LTx), was performed without significant delay, and none of the patients who underwent resection required more than six preoperative courses. Two patients never had surgery due to tumor progression. CONCLUSIONS The outcome for patients with intermediate-risk hepatoblastoma was satisfactory. PLADO, combined with surgery (including LTx) conducted at the optimal time, appeared to cure most patients in this study.