A multicenter prospective study on the management of hepatoblastoma in children:a report from the Chinese Children's Cancer Group

Meng-Jie Tang ¹Xiao-Li Ma ²Xiang-Ling He ³Wei-Hua Pan ⁴Xiao-Hong Zhang ⁵Sha-Yi Jiang ⁶Ju Gao ⁷Fu Li ⁸Wei Yao ⁹Song Gu ¹⁰Wei-Ling Zhang ¹¹Qiang Zhao ¹²Shi-Hao Huang ¹Yong-Jun Fang ¹³Wei Liu ¹⁴Hui-Zhong Niu ¹⁵Chun-Mei Wang ¹⁶Li-Rong Sun ¹⁷Hui Gao ¹⁸Yun-Peng Dai ¹⁹Shun-Gen Huang ²⁰Zhi-Yong Zhong ²¹Xi-Ge Wang ²²Zhong-Rong Li ²³Liang-Chun Yang ²⁴Ye-Ming Wu ⁴Huan-Min Wang ²⁵Xin Sun ²⁶Xiao-Jun Yuan¹

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作者信息

1. 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
2. Medical Oncology Department,Pediatric Oncology Center,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China
3. Department of Hematology/Oncology,Children's Medical Center,Hunan Provincial People's Hospital,The First Affiliated Hospital of Hunan Normal University,Changsha 41005,China
4. Department of Pediatric Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China
5. Department of Hematology/Oncology,Guangzhou Women and Children's Medical Center,National Children's Medical Center for South Central Region,Guangzhou 510623,China
6. Department of Hematology,Shanghai Children's Hospital,Shanghai Jiao Tong University,Shanghai 200062,China
7. Department of Pediatrics,West China Second University Hospital,Sichuan University,Chengdu 610041,China
8. Department of Hematology/Oncology,Qilu Children's Hospital of Shandong University,Jinan 250022,China
9. Department of Pediatric Surgery,Children's Hospital of Fudan University,Shanghai 201102,China
10. 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
11. Department of Pediatrics,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China
12. Department of Pediatric Oncology,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300060,China
13. Department of Hematology/Oncology,Children's Hospital of Nanjing Medical University,Nanjing 210008,China
14. Department of Hematology/Oncology,Henan Children's Hospital,Zhengzhou 450018,China
15. Department of Pediatric General Surgery,Hebei Children's Hospital of Hebei Medical University,Shijiazhuang City 050031,China
16. Children's Hospital,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China
17. Department of Paediatric Hematology/Oncology,the Affiliated Hospital of Qingdao University,Qingdao 266000,China
18. Department of Paediatric Hematology/Oncology,Dalian Women and Children's Medical Group,Dalian 116037,China
19. Department of Pediatric Hematology/Oncology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China
20. Department of General Surgery,Children's Hospital of Soochow University,Suzhou 215028,China
21. Department of Pediatric Surgery,the Second Hospital of HeBei Medical University,Shijiazhuang 050000,China
22. Department of Paediatric Hematology/Oncology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China
23. Department of Pediatric Surgery,the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou 325027,China
24. Department of Pediatrics,Xiangya Hospital Central South University,Changsha 410008,China
25. Department of Surgical Oncology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China
26. Clinical Research and Innovation Unit,XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China
折叠

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 con-ducted.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％,respec-tively.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.

Key words

Alpha-fetoprotein/Hepatoblastoma/Multicenter/Prospective study/Survival

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基金项目

Shanghai Municipal Hospital New Frontier Technology Joint Key Project,Shanghai,China(SHDC12019115)

出版年

2024

世界儿科杂志(英文版)

CSTPCD

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