[Risks factors for pediatric malignant liver tumors].

Area of Science:

• Pediatric Oncology
• Hepatology
• Epidemiology

Background:

• Pediatric Hepatic Malignancies (PHMs) represent a small fraction of childhood cancers, primarily hepatoblastoma (HB) and hepatocellular carcinoma (HCC).
• These cancers arise from a complex interplay between inherited predispositions and external exposures.
• Identifying these risk factors is crucial for understanding disease etiology and developing preventive strategies.

Purpose of the Study:

• To systematically review the primary constitutional and environmental risk factors associated with Pediatric Hepatic Malignancies (PHMs).
• To synthesize current evidence on the epidemiology and etiology of childhood liver cancers.

Main Methods:

• A comprehensive systematic literature review was conducted.
• Databases searched included Medline, Embase, Cancerlit, Lilacs, and SciElo.
• The review covered literature from the last 25 years using keywords related to liver cancer etiology, risk factors, and epidemiology in children.

Main Results:

• PHMs constitute 1% of pediatric malignancies, with HB and HCC being the most prevalent types.
• Key constitutional risk factors include Beckwith-Wiedemann syndrome, isolated hemihyperplasia, and genetic metabolic disorders.
• Significant environmental risk factors identified are viral infections (HBV, HCV), aflatoxin exposure, radiation, alcohol, and certain occupational exposures.

Conclusions:

• Early detection of HB is facilitated by screening in high-risk genetic syndromes like Beckwith-Wiedemann and isolated hemihyperplasia.
• Universal Hepatitis B Virus (HBV) vaccination is a critical preventive measure for a substantial portion of PHMs.
• Reducing exposure to environmental toxins, alcohol, and tobacco during prenatal and early childhood stages is essential for PHM prevention.