Pediatric hepatic cancer incidence and survival: 30‐year trends in Ontario, Canada; the United States; and Australia

Abstract

Background Pediatric hepatic cancer is a rare malignancy, comprising only approximately 2% of all cancers diagnosed in children aged <15 years. The authors sought to describe trends in pediatric hepatic cancer incidence and survival in Ontario, Canada; the United States; and Australia. Methods Children aged <15 years who were diagnosed with hepatic cancer from 1985 through 2013 were ascertained through population‐based registries and followed from the time of diagnosis until December 31, 2015. Age‐standardized incidence and 5‐year relative survival were calculated for each jurisdiction. Multivariable flexible parametric survival models were used to explore predictors of hepatic cancer mortality. Results A total of 794 children were identified in Ontario (148 children), the United States (400 children), and Australia (246 children). The average annual incidence increased by 2.2% (95% CI, 0.5%‐4.0%) in Australia, 2.1% (95% CI, 0.9%‐3.3%) in the United States, and 1.3% (95% CI, ‐0.4% to 3.0%) in Ontario. The 5‐year relative survival rate improved from 60% to 82% (P = .08) in Ontario and 62% to 78% (P = .02) in the United States between the diagnostic periods 1985 through 1994 and 2005 through 2013, whereas in Australia the rate remained constant (between 74% and 77%) during the study period. On multivariable analysis, there was no significant difference noted with regard to the hazard of death between jurisdictions (P = .06). Older age, the presence of metastatic disease, and being diagnosed with hepatocellular carcinoma were found to be associated with mortality. Conclusions The incidence of hepatic cancer in children appears to have increased over the last 30 years in Australia and North America. Survival differences between Australia; Ontario, Canada; and the United States observed in the 1980s and 1990s were no longer apparent and only marginal geographical differences in the hazard of mortality were observed.

Competitive risk analysis of the therapeutic value of liver transplantation for liver cancer in children: A population-based study

“…A study based on the SEER database showed that the 5-year OS rates of HB and HCC were 52.4% and 18.0%, respectively, from 1979 to 1996 ( 2 ). Another study showed that the 5-year OS of CLCa was 68.5% from 1985 to 2013 in the United States ( 17 ). OS rates of CLCa in this study were higher than those in the above studies, which may suggest that the prognosis of CLCa has improved recently.…”

“…OS rates of CLCa in this study were higher than those in the above studies, which may suggest that the prognosis of CLCa has improved recently. Studies have reported that the prognosis of CLCa was closely related to age, year of diagnosis, stage, histopathology type, and therapy ( 17 , 18 ). We performed the penalization procedure using LASSO Cox regression to address overfitting and miscalibration, which has been widely used in medical research ( 19 – 21 ).…”

“…After LT, the prognosis of children with HB was significantly better than that of children with HCC, which was in accordance with the results of other studies ( 10 , 27 , 28 ). However, we cannot ignore the fact that the prognosis of children with HB is better than that of children with HCC ( 2 , 17 ).…”

Prevalence of childhood cancer survivors in Europe: a scoping review

“…The mild increase in incidence rates [3] , partly sustained by improving diagnostic techniques, mainly in HIC [4] , [5] , and reduced mortality [6] contribute to growing prevalence. Mortality is decreasing due to the improved survival [1] , [2] , [7] , as seen in Europe [8] , the USA [1] , [9] , Canada, and Australia [9] , [10] . Better survival has been attributed to advances in tumour diagnostics, improved treatment effectiveness, advanced provision and organization of health care, supported by improving socioeconomic conditions, and general health status [8] .…”