Population-based treatment results of hepatoblastoma in children of Hong Kong

Abstract

PURPOSE/OBJECTIVE: The five hospitals of Hong Kong forming the Hong Kong Paediatric Haematology and Oncology Study Group (HKPHOSG) established a uniform treatment protocol for hepatoblastoma (HB) since 1996 comprising of primary surgical resection for resectable tumour or in most instances, neoadjuvant chemotherapy (cisplatinum, 5-fluorouracil and vincristine or alternative regimen of cisplatinum and doxorubicin) followed by complete surgical resection of tumour. We reviewed the population-based treatment results of HB in Hong Kong. MATERIALS AND METHODS: The clinical data of all cases diagnosed between 1-Jun-1996 and 31-Dec-2011 were reviewed up to the date of 31-Dec-2012. Each case was assigned as standard risk (SR) or high risk (HR) according to the following criteria, HR: presence of either AFP < ? 100 ng/ml or unresectable tumour or tumour rupture or distant metastases or portal vein thrombosis; SR: resectable tumour without the HR features. RESULTS: During the study period, a total of 51 cases of HB including 35 SR and 16 HR cases were diagnosed. Twenty-eight (55%) were males. The median ages of the whole group, SR and HR were 1.2 years (range, 0.1 to 14.6 years), 1.0 year (0.1 to 14.6 years) and 1.2 years (0.3 to 11.3 years), respectively. The median follow up duration was 3.7 years (range, 0.0 to 15.8 years). The 5-year event-free survival (EFS) and overall survival (S) of the whole group were 74.5% and 79.9%, respectively. The 5-year EFS and S of the SR cases were 93.4% and 100% whilst those of the HR cases were 36.5% and 41.7%, respectively (p < 0.0001 for SR v HR). CONCLUSIONS: The treatment results of the SR HB are significantly better than those of the HR cases. Future goals may aim at reducing the chemotherapy for the SR cases and improving the survival of the HR cases.