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Article: Treatment outcome and pattern of failure in hepatoblastoma treated with a consensus protocol in Hong Kong

TitleTreatment outcome and pattern of failure in hepatoblastoma treated with a consensus protocol in Hong Kong
Authors
KeywordsHepatoblastoma
Pediatric
Pretreatment extent of disease
Relapse
Risk stratification
Issue Date2019
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1545-5017/
Citation
Pediatric Blood & Cancer, 2019, v. 66 n. 1, article no. e27482 How to Cite?
AbstractBackground and aim: We reviewed the results and pattern of failure of the consensus HB/HCC 1996 treatment protocol for pediatric hepatoblastoma (HB) in Hong Kong. The role of SIOPEL and Children's Hepatic tumors International Collaboration (CHIC) risk stratification was evaluated. Methods: Patients enrolled on the protocol from 1996 to 2014 were included. PRETEXT staging, SIOPEL, and CHIC risk groups were retrospectively assigned. Results: Sixty patients were enrolled with median age at diagnosis of 1.1 years and median follow-up time of 6.8 years. Alpha-fetoprotein (AFP) was raised (>100 ng/mL) in 58 (97%) patients. Five (8%) had metastases at presentation and 7 (12%) experienced tumor rupture prior to or during treatment. Twenty-nine patients (48%) received a first-line cisplatin, 5-fluorouracil, and vincristine regimen only while 23 (38%) also had alternative chemotherapeutic agents. Hepatic resection could be performed in 48 (80%) patients. Three (5%) patients underwent upfront liver transplantation. Five-year event-free survival and overall survival rates were 69.2% ± 6.1% and 77.6% ± 5.5% respectively. Among the 16 patients with relapse/progression, 9 had intrahepatic failure only, 5 had distant failure only, and 2 had combined local and distant failure. Predictors of inferior outcome included advanced Evans staging, disease involving both lobes, rupture, low AFP, and suboptimal response to first-line chemotherapy. Assigned in 44 patients, PRETEXT staging, SIOPEL, and CHIC risk groups significantly predicted EFS and OS. Conclusions: Although the consensus HB/HCC 1996 protocol led to cure in three-quarters of pediatric HB patients, an upfront risk stratification system is required to identify and improve the outcome of high-risk patients.
Persistent Identifierhttp://hdl.handle.net/10722/264246
ISSN
2017 Impact Factor: 2.646
2015 SCImago Journal Rankings: 1.505
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLiu, APY-
dc.contributor.authorIp, JJK-
dc.contributor.authorLeung, AWK-
dc.contributor.authorLuk, CW-
dc.contributor.authorLi, CH-
dc.contributor.authorHo, KKH-
dc.contributor.authorLo, CLR-
dc.contributor.authorChan, EKW-
dc.contributor.authorChan, ACY-
dc.contributor.authorChung, HY-
dc.contributor.authorChiang, AKS-
dc.date.accessioned2018-10-22T07:51:52Z-
dc.date.available2018-10-22T07:51:52Z-
dc.date.issued2019-
dc.identifier.citationPediatric Blood & Cancer, 2019, v. 66 n. 1, article no. e27482-
dc.identifier.issn1545-5009-
dc.identifier.urihttp://hdl.handle.net/10722/264246-
dc.description.abstractBackground and aim: We reviewed the results and pattern of failure of the consensus HB/HCC 1996 treatment protocol for pediatric hepatoblastoma (HB) in Hong Kong. The role of SIOPEL and Children's Hepatic tumors International Collaboration (CHIC) risk stratification was evaluated. Methods: Patients enrolled on the protocol from 1996 to 2014 were included. PRETEXT staging, SIOPEL, and CHIC risk groups were retrospectively assigned. Results: Sixty patients were enrolled with median age at diagnosis of 1.1 years and median follow-up time of 6.8 years. Alpha-fetoprotein (AFP) was raised (>100 ng/mL) in 58 (97%) patients. Five (8%) had metastases at presentation and 7 (12%) experienced tumor rupture prior to or during treatment. Twenty-nine patients (48%) received a first-line cisplatin, 5-fluorouracil, and vincristine regimen only while 23 (38%) also had alternative chemotherapeutic agents. Hepatic resection could be performed in 48 (80%) patients. Three (5%) patients underwent upfront liver transplantation. Five-year event-free survival and overall survival rates were 69.2% ± 6.1% and 77.6% ± 5.5% respectively. Among the 16 patients with relapse/progression, 9 had intrahepatic failure only, 5 had distant failure only, and 2 had combined local and distant failure. Predictors of inferior outcome included advanced Evans staging, disease involving both lobes, rupture, low AFP, and suboptimal response to first-line chemotherapy. Assigned in 44 patients, PRETEXT staging, SIOPEL, and CHIC risk groups significantly predicted EFS and OS. Conclusions: Although the consensus HB/HCC 1996 protocol led to cure in three-quarters of pediatric HB patients, an upfront risk stratification system is required to identify and improve the outcome of high-risk patients.-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1545-5017/-
dc.relation.ispartofPediatric Blood & Cancer-
dc.subjectHepatoblastoma-
dc.subjectPediatric-
dc.subjectPretreatment extent of disease-
dc.subjectRelapse-
dc.subjectRisk stratification-
dc.titleTreatment outcome and pattern of failure in hepatoblastoma treated with a consensus protocol in Hong Kong-
dc.typeArticle-
dc.identifier.emailLiu, APY: apyliu@hku.hk-
dc.identifier.emailLo, CLR: loregina@hku.hk-
dc.identifier.emailChung, HY: chungphy@hku.hk-
dc.identifier.emailChiang, AKS: chiangak@hku.hk-
dc.identifier.authorityLiu, APY=rp01357-
dc.identifier.authorityLo, CLR=rp01359-
dc.identifier.authorityChung, HY=rp02002-
dc.identifier.authorityChiang, AKS=rp00403-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/pbc.27482-
dc.identifier.pmid30270490-
dc.identifier.scopuseid_2-s2.0-85054193667-
dc.identifier.hkuros294442-
dc.identifier.volume66-
dc.identifier.issue1-
dc.identifier.spagearticle no. e27482-
dc.identifier.epagearticle no. e27482-
dc.identifier.isiWOS:000450821000039-
dc.publisher.placeUnited States-

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