Related Experiment Video
Updated: Mar 24, 2026
Author Spotlight: Investigating Liver Cancer Pathogenesis Using Patient-Derived Organoids
Published on: August 18, 2023
Multidisciplinary effort in treating children with hepatoblastoma in China
Xiao-Jun Yuan1, Huan-Min Wang2, Hui Jiang3
1Department of Pediatric Hematology/Oncology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Insights
The Wuhan Protocol for hepatoblastoma treatment shows promising survival rates, comparable to developed nations. Further optimization is needed for surgical standardization and risk-based chemotherapy in pediatric cancer care.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Surgery
- Clinical Protocol Development
Background:
- Hepatoblastoma is a rare liver cancer primarily affecting children.
- Standardized treatment protocols are crucial for improving outcomes in pediatric cancers.
- The Chinese Children's Cancer Group developed the Wuhan Protocol to address hepatoblastoma treatment.
Purpose of the Study:
- To report the first nationwide hepatoblastoma treatment protocol in China (Wuhan Protocol).
- To present the final analysis of patient outcomes under this protocol.
- To evaluate the effectiveness of a multidisciplinary approach to hepatoblastoma treatment.
Main Methods:
- Retrospective analysis of 153 hepatoblastoma patients treated from 2006-2013.
- Involved 13 hospitals across China, adhering to the Wuhan Protocol.
- Utilized univariate and multivariate analyses to identify prognostic factors.
Main Results:
- Achieved 6-year overall survival (OS) of 83.3% and event-free survival (EFS) of 71.0%.
- Favorable prognostic factors included female sex, age under 5, complete resection, no metastases, and delayed surgery.
- Adverse factors included male sex, age 5+, PRETEXT III/IV, and incomplete resection.
Conclusions:
- The Wuhan Protocol demonstrates comparable OS and EFS rates to international standards.
- The protocol requires further refinement in surgical standardization (including liver transplantation) and risk-based chemotherapy.
- Multidisciplinary collaboration is key to successful hepatoblastoma management.
Abstract:
The purpose of this study is to report the first nationwide protocol (Wuhan Protocol) developed by Chinese Children's Cancer Group and the results of multidisciplinary effort in treating hepatoblastoma. In this study, we reported the final analysis, which includes 153 hepatoblastoma patients in 13 hospitals from January 2006 to December 2013. The 6-year overall survival and event-free survival rates were 83.3 ± 3.1% and 71.0 ± 3.7%, respectively, in this cohort. The univariate analysis revealed that female (P = 0.027), under 5 years of age (P = 0.039), complete surgical resection (P = 0.000), no metastases (P = 0.000), and delayed surgery following neoadjuvant chemotherapy (P = 0.000) had better prognosis. In multivariate analysis, male, 5 years of age or above, stage PRETEXT III or IV, and incomplete surgical resection were among the some adverse factors contributing to poor prognosis. The preliminary results from this study showed that patients who underwent treatment following Wuhan Protocol had similar OS and EFS rates compared to those in developed countries. However, the protocol remains to be further optimized in standardizing surgical resection (including liver transplantation), refining risk stratification and risk-based chemotherapy.
