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Retrospective Analysis of Childhood Hepatoblastoma in a Single Centre in China
1Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
This study evaluated a hepatoblastoma treatment protocol, finding survival rates comparable to developed nations. Early AFP recovery after chemotherapy is a key indicator of better outcomes in children.
Area of Science:
- Pediatric Oncology
- Hepatoblastoma Research
- Multidisciplinary Cancer Care
Background:
- Hepatoblastoma is a rare liver cancer in children.
- Multidisciplinary models are crucial for optimizing treatment protocols.
- Investigating treatment efficacy and prognostic factors is essential for improving patient outcomes.
Purpose of the Study:
- To assess the efficacy of a specific treatment protocol for pediatric hepatoblastoma.
- To identify prognostic factors influencing treatment outcomes in hepatoblastoma patients.
- To evaluate the multidisciplinary approach in managing pediatric liver cancer.
Main Methods:
- Retrospective analysis of 104 pediatric hepatoblastoma patients (<18 years).
- Data collected included clinical features, chemotherapy, surgical treatment, and outcomes.
- Patients treated at Shanghai Children's Medical Center from August 2011 to October 2017.
Main Results:
- Achieved a 5-year overall survival rate of 86.3% and event-free survival (EFS) of 81.8%.
- High-risk patients showed significantly lower EFS (75.7%) and overall survival (80.5%) compared to standard-risk (96.8% EFS, 100% OS).
- Factors like younger age, higher alpha-fetoprotein (AFP) levels, absence of metastases, and prompt postoperative AFP recovery were associated with better survival.
Conclusions:
- The treatment protocol demonstrated overall survival and EFS rates comparable to those in developed countries.
- Normal postoperative alpha-fetoprotein (AFP) levels after three chemotherapy cycles are a significant prognostic indicator.
- Multidisciplinary care contributes to effective management of pediatric hepatoblastoma.
Aims:
To investigate the protocol efficacy and prognostic factors for paediatric hepatoblastoma in a multidisciplinary model in our centre.
Materials And Methods:
Consecutive hepatoblastoma patients (<18 years old) treated at Shanghai Children's Medical Center in China from August 2011 to October 2017 were analysed retrospectively for clinical features, chemotherapy courses, surgical treatment and outcomes.
Results:
One hundred and four cases of paediatric hepatoblastoma (64 males, 40 females; median age at diagnosis 1.64 years) had a median follow-up of 30.68 months (range 8.3-73.3 months). First complete remission was achieved in 95 cases, 85 of which achieved continuous complete remission. Another three cases were lost to follow-up after a median of 24.73 months in complete remission. Seven cases relapsed later, with two achieving a second complete remission and four deaths. Nine cases did not achieve complete remission and five of them died. In general, the 5-year overall survival rate and 5-year event-free survival (EFS) rate were 86.3 ± 5.0% and 81.8 ± 4.3%, respectively. Thirty-two cases were classified as standard risk and 72 as high risk with 5-year EFS of 96.8 ± 3.2% and 75.7 ± 5.7% (P = 0.029) and 5-year overall survival of 100% and 80.5 ± 7.0%, respectively. The mean platelet count (P = 0.0036), lactate dehydrogenase (P = 0.0443) and ferritin level (P = 0.0006) at diagnosis were much higher in the high-risk group than in the standard-risk group. Univariate analysis showed that patients <5 years of age (P = 0.018), with higher α-fetoprotein (AFP) level (>100 ng/ml, P = 0.008), without metastases at diagnosis (P = 0.001) and postoperative AFP recovery after no more than three chemocycles (P = 0.014) had better overall survival. In addition, the above factors, except metastases at diagnosis and risk group, were associated with prognosis in the multivariate analysis.
Conclusions:
The result of this protocol had similar overall survival and EFS rates compared with those in developed countries. Normal postoperative AFP levels after three chemocycles has prognostic value.
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