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Clinical Efficacy and Prognosis Factors for Advanced Hepatoblastoma in Children: A 6-year Retrospective Study

  • Zhang, Yi (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Zhang, Wei-Ling (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Huang, Dong-Sheng (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Hong, Liang (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Wang, Yi-Zhuo (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Zhu, Xia (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Hu, Hui-Min (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Zhang, Pin-Wei (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Yi, You (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University) ;
  • Han, Tao (Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University)
  • Published : 2013.08.30

Abstract

Objective: This study aimed to investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma (HB) and the factors affecting prognosis. Methods: A total of 35 children underwent multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. The patients were followed up every month. Results: Serum AFP levels in 33 out of 35 patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the values of serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the 35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases with locally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventional treatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33 patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission (PR), 1 became disease progressive (DP), and 10 died. The remission and overall survival rates were 66.7% (22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than the epithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P < 0.001). Conclusion: Multimodality treatment can effectively improve remission rate and prolong the survival of children with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors, HB pathological classification, and staging are highly useful in predicting prognosis.

Keywords

Hepatoblastoma;stem cell transplantation;advanced stage;chemotherapy;children

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