Prognostic analysis for children with hepatoblastoma with lung metastasis: A single‐center analysis of 98 cases

Abstract

Background To analyze the factors affecting prognosis of hepatoblastoma (HB) with lung metastasis in children. Patients and Methods: 98 HB patients with lung metastases admitted to Beijing Tongren Hospital, Capital Medical University were collected and analysed. Results 64 patients had lung metastases at diagnosis (median age, 22.3 months). 34 patients developed lung metastases whilst on treatment (median time, 6.5 months). The time of diagnosis of lung metastasis in patients with HB did not signi cantly affect survival time or 3-year survival rate (P = 0.37). The survival time and 5-year survival rate of patients with standard treatment was signi cantly longer than that of without standard treatment (P < 0.001). The survival time and 3-year survival rate of patients with lung metastasis alone or underwent lung metastasectomy was signi cantly longer than that of patients with extrapulmonary involvement or without lung metastasectomy (P = 0.007, P = 0.099). Lung metastasis accompanied with extrapulmonary involvement was risk factors affecting prognosis (HR = 0.460, 95% CI 0.239-0.888). Conclusions The overall prognosis of HB with lung metastasis in children was poor, and the prognosis of patients with lung metastasis alone was better than those with extrapulmonary involvement. Standardized treatment and resection of lung tumor may prolong the survival of HB patients with lung metastasis.

Individualized chemotherapy and efficacy analysis of hepatoblastoma in children

“…Consequently, we observed a significant between‐group difference in the CR rate (73.68% vs. 37.5%, chi‐square = 4.644, p = .031) and EFS rate (79.3% vs. 26.7%, chi‐square = 4.008, p = .045). Therefore, individualized chemotherapy regimens led to a 3‐year EFS rate of higher than 70% for distant metastatic HB, which is a significantly better prognosis than previously reported values 5–7 . However, given the small sample size and short follow‐up time, future studies with larger sample sizes and longer follow‐up periods are warranted to validate our findings.…”

“…This indicates the clinical utility of the ITEC regimen for HB. In our department, the ITEC, ACP, or VICC regimens are applied for children with HB unresponsive to conventional chemotherapy treatment 7 . In our study, the most effective regimen for patients showing resistance to conventional regimens was the ITEC regimen [17/31, 54.84%], followed by the ACP regimen [5/31, 16.13%].…”

“…In addition to the recommended regimen for HB treatment in China, our department also uses the ACP and ITEC regimens 7 . In the JPLT‐2 study in Japan, CITA non‐responders were treated with the ITEC regimen; moreover, 39 out of 56 cases were treated with the ITEC regimen followed by surgical resection 19 .…”

“…However, the prognosis remains poor among patients with recurrence or distant metastases and cases of inoperable surgical resection after neoadjuvant chemotherapy. HB with distant metastases has a 5‐year overall survival (OS) rate of 25%–50% 5,6 ; further, we have previously reported a 5‐year OS rate of 56.3% for HB lung metastasis cases 7 …”

“…HB with distant metastases has a 5-year overall survival (OS) rate of 25%-50% 5,6 ; further, we have previously reported a 5-year OS rate of 56.3% for HB lung metastasis cases. 7 The patient-derived xenograft (PDX) model is the most representative mouse xenograft tumor model with respect to the genetic characteristics of human tumors. Unlike traditional cell line xenograft models and genetically engineered mouse models, the PDX model better preserves the specific functional genetic structure and tumor biomarkers as it directly adopts the patient's tumor tissue.…”