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Tang MJ, Ma XL, He XL, Pan WH, Zhang XH, Jiang SY, Gao J, Li F, Yao W, Gu S, Zhang WL, Zhao Q, Huang SH, Fang YJ, Liu W, Niu HZ, Wang CM, Sun LR, Gao H, Dai YP, Huang SG, Zhong ZY, Wang XG, Li ZR, Yang LC, Wu YM, Wang HM, Sun X, Yuan XJ. A multicenter prospective study on the management of hepatoblastoma in children: a report from the Chinese Children's Cancer Group. World J Pediatr 2023:10.1007/s12519-023-00750-6. [PMID: 37770810 DOI: 10.1007/s12519-023-00750-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/17/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND This study aimed to identify survival risk factors in Chinese children with hepatoblastoma (HB) and assess the effectiveness of the new treatment protocol proposed by the Chinese Children's Cancer Group (CCCG) in 2016. METHODS A multicenter, prospective study that included 399 patients with HB from January 2015 to June 2020 was conducted. Patient demographics, treatment protocols, and other related information were collected. Cox regression models and Kaplan-Meier curve methods were used. RESULTS The 4-year event-free survival (EFS) and overall survival (OS) were 76.9 and 93.5%, respectively. The 4-year EFS rates for the very-low-risk, low-risk, intermediate-risk, and high-risk groups were 100%, 91.6%, 81.7%, and 51.0%, respectively. The 4-year OS was 100%, 97.3%, 94.4%, and 86.8%, respectively. Cox regression analysis found that age, tumor rupture (R +), and extrahepatic tumor extension (E +) were independent prognostic factors. A total of 299 patients had complete remission, and 19 relapsed. Patients with declining alpha-fetoprotein (AFP) > 75% after the first two cycles of neoadjuvant chemotherapy had a better EFS and OS than those ≤ 75%. CONCLUSIONS The survival outcome of HB children has dramatically improved since the implementation of CCCG-HB-2016 therapy. Age ≥ 8 years, R + , and E + were independent risk factors for prognosis. Patients with a declining AFP > 75% after the first two cycles of neoadjuvant chemotherapy had better EFS and OS.
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Affiliation(s)
- Meng-Jie Tang
- Department of Pediatric Hematology/Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Yangpu District, Shanghai, 200092, China
| | - Xiao-Li Ma
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xiang-Ling He
- Department of Hematology/Oncology, Children's Medical Center, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 41005, China
| | - Wei-Hua Pan
- Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xiao-Hong Zhang
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, National Children's Medical Center for South Central Region, Guangzhou, 510623, China
| | - Sha-Yi Jiang
- Department of Hematology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Ju Gao
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Fu Li
- Department of Hematology/Oncology, Qilu Children's Hospital of Shandong University, Jinan, 250022, China
| | - Wei Yao
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Song Gu
- Department of General Surgery, Shanghai Children's Medical Center (National Children's Medical Center-Shanghai), Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Wei-Ling Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Qiang Zhao
- Department of Pediatric Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China
| | - Shi-Hao Huang
- Department of Pediatric Hematology/Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Yangpu District, Shanghai, 200092, China
| | - Yong-Jun Fang
- Department of Hematology/Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Wei Liu
- Department of Hematology/Oncology, Henan Children's Hospital, Zhengzhou, 450018, China
| | - Hui-Zhong Niu
- Department of Pediatric General Surgery, Hebei Children's Hospital of Hebei Medical University, Shijiazhuang City, 050031, China
| | - Chun-Mei Wang
- Children's Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Li-Rong Sun
- Department of Paediatric Hematology/Oncology, the Affiliated Hospital of Qingdao University, Qingdao, 266000, China
| | - Hui Gao
- Department of Paediatric Hematology/Oncology, Dalian Women and Children's Medical Group, Dalian, 116037, China
| | - Yun-Peng Dai
- Department of Pediatric Hematology/Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China
| | - Shun-Gen Huang
- Department of General Surgery, Children's Hospital of Soochow University, Suzhou, 215028, China
| | - Zhi-Yong Zhong
- Department of Pediatric Surgery, the Second Hospital of HeBei Medical University, Shijiazhuang, 050000, China
| | - Xi-Ge Wang
- Department of Paediatric Hematology/Oncology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhong-Rong Li
- Department of Pediatric Surgery, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Liang-Chun Yang
- Department of Pediatrics, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Ye-Ming Wu
- Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Huan-Min Wang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Xin Sun
- Clinical Research and Innovation Unit, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Xiao-Jun Yuan
- Department of Pediatric Hematology/Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Yangpu District, Shanghai, 200092, China.
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