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- PMID: 30270490
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Article: Treatment outcome and pattern of failure in hepatoblastoma treated with a consensus protocol in Hong Kong
Title | Treatment outcome and pattern of failure in hepatoblastoma treated with a consensus protocol in Hong Kong |
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Authors | |
Keywords | Hepatoblastoma Pediatric Pretreatment extent of disease Relapse Risk stratification |
Issue Date | 2019 |
Publisher | John 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? |
Abstract | Background 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 Identifier | http://hdl.handle.net/10722/264246 |
ISSN | 2023 Impact Factor: 2.4 2023 SCImago Journal Rankings: 0.992 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Liu, APY | - |
dc.contributor.author | Ip, JJK | - |
dc.contributor.author | Leung, AWK | - |
dc.contributor.author | Luk, CW | - |
dc.contributor.author | Li, CH | - |
dc.contributor.author | Ho, KKH | - |
dc.contributor.author | Lo, CLR | - |
dc.contributor.author | Chan, EKW | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Chung, HY | - |
dc.contributor.author | Chiang, AKS | - |
dc.date.accessioned | 2018-10-22T07:51:52Z | - |
dc.date.available | 2018-10-22T07:51:52Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | Pediatric Blood & Cancer, 2019, v. 66 n. 1, article no. e27482 | - |
dc.identifier.issn | 1545-5009 | - |
dc.identifier.uri | http://hdl.handle.net/10722/264246 | - |
dc.description.abstract | Background 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.language | eng | - |
dc.publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1545-5017/ | - |
dc.relation.ispartof | Pediatric Blood & Cancer | - |
dc.subject | Hepatoblastoma | - |
dc.subject | Pediatric | - |
dc.subject | Pretreatment extent of disease | - |
dc.subject | Relapse | - |
dc.subject | Risk stratification | - |
dc.title | Treatment outcome and pattern of failure in hepatoblastoma treated with a consensus protocol in Hong Kong | - |
dc.type | Article | - |
dc.identifier.email | Liu, APY: apyliu@hku.hk | - |
dc.identifier.email | Lo, CLR: loregina@hku.hk | - |
dc.identifier.email | Chung, HY: chungphy@hku.hk | - |
dc.identifier.email | Chiang, AKS: chiangak@hku.hk | - |
dc.identifier.authority | Liu, APY=rp01357 | - |
dc.identifier.authority | Lo, CLR=rp01359 | - |
dc.identifier.authority | Chung, HY=rp02002 | - |
dc.identifier.authority | Chiang, AKS=rp00403 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1002/pbc.27482 | - |
dc.identifier.pmid | 30270490 | - |
dc.identifier.scopus | eid_2-s2.0-85054193667 | - |
dc.identifier.hkuros | 294442 | - |
dc.identifier.hkuros | 300409 | - |
dc.identifier.volume | 66 | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | article no. e27482 | - |
dc.identifier.epage | article no. e27482 | - |
dc.identifier.isi | WOS:000450821000039 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1545-5009 | - |