| Analysis of prognostic factors in children with hepatoblastoma |
| Received:March 17, 2022 Revised:April 14, 2022 Click here to download the full text |
| Citation of this paper:LIANG Yu,GAO Hong-xiang,SHAN Yu-hua,XIE Chen-jie,XU Min,GU Song.Analysis of prognostic factors in children with hepatoblastoma[J].Chinese Journal of Clinical Medicine,2022,29(3):338-345 |
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| Author Name | Affiliation | E-mail | | LIANG Yu | Department of General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China | | | GAO Hong-xiang | Department of General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China | | | SHAN Yu-hua | Department of General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China | | | XIE Chen-jie | Department of General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China | | | XU Min | Department of General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China | | | GU Song | Department of General Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China | gusong@shsmu.edu.cn |
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| Abstract:Objective To explore the prognostic factors of children with hepatoblastoma. Methods A retrospective analysis was performed on 120 children with hepatoblastoma who were newly diagnosed in Shanghai Children's Medical Center from January 2011 to January 2019. The age, gender, PRETEXT stage, pathological type, distant metastasis, serum AFP at admission, therapy protocols and follow-up were recorded. According to the Shanghai Children's Medical Center risk stratification, all patients were divided into standard (n=39) and high-risk groups (n=81) and received different chemotherapy protocols. Univariate and multivariate analysis were used to study the risk factors involving event-free survival and overall survival in children with hepatoblastoma. Results Among the 120 cases, 73 cases were male and 47 cases were female; the median age of onset was 16 months, 103 cases were under 3 years old, and 17 cases were over 3 years old. There were 20 cases with distant metastasis and 100 cases without distant metastasis. There were 2 cases with serum AFP ≤ 100 ng/mL and 118 cases with AFP>100 ng/mL. There were 92 cases with preoperative LAR (lactate dehydrogenase to albumin ratio) ≤ 31.6 and 28 cases with LAR>31.6. The follow-up time was 29.0 (10.3, 62.8) months, and the 5-year event-free survival (EFS) and 5-year overall survival (OS) rates were 79.8%±4.1% and 84.9%±3.7%, respectively. Multivariate regression analysis showed that independent prognostic factors for children with hepatoblastoma included age (HR=1.029, 95%CI 1.015-1.042 for EFS; HR=1.030, 95%CI 1.014-1.046 for OS), AFP ≤ 100 ng/mL at admission (HR=18.10, 95%CI 3.20-102.53 for EFS; HR=19.82, 95%CI 3.26-120.56 for OS), with distant metastasis (HR=3.13, 95%CI 1.07-9.20 for EFS; HR=4.36, 95%CI 1.22-15.60 for OS) and LAR> 31.6 (HR=5.77, 95%CI 1.89-17.66 for EFS; HR=7.69, 95%CI 1.91-31.02 for OS), all P<0.05. Conclusion Age, distant metastasis, AFP ≤ 100 ng/mL at admission, and LAR>31.6 were independent risk factors involving the prognosis of patients with hepatoblastoma, and LAR can be used as a new prognostic biomarker for children with hepatoblastoma. |
| keywords:hepatoblastoma prognostic factors lactate dehydrogenase to albumin ratio biomarker |
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