Conflict of interest: Nothing to declare.
Is multifocality a prognostic factor in childhood hepatoblastoma?
Article first published online: 23 APR 2014
© 2014 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 61, Issue 9, pages 1593–1597, September 2014
How to Cite
Saettini, F., Conter, V., Provenzi, M., Rota, M., Giraldi, E., Foglia, C., Cavalleri, L. and D'Antiga, L. (2014), Is multifocality a prognostic factor in childhood hepatoblastoma?. Pediatr. Blood Cancer, 61: 1593–1597. doi: 10.1002/pbc.25077
- Issue published online: 17 JUL 2014
- Article first published online: 23 APR 2014
- Manuscript Accepted: 19 MAR 2014
- Manuscript Received: 24 MAY 2013
- liver tumors;
- risk factors;
The aim of this study was to assess the prognostic value of multifocality and the effectiveness of two different therapeutic strategies in patients with newly diagnosed hepatoblastoma.
Between 1998 and 2011, 31 patients diagnosed with hepatoblastoma were referred to Ospedale Papa Giovanni XXIII, Bergamo, Italy. Patients were stratified according to SIOPEL protocols into high-risk (HR if AFP <100 ng/mL and/or PRETEXT IV and/or vascular invasion and/or extra-hepatic intra-abdominal disease and/or metastases) and standard-risk (SR, all others). The patient data we evaluated were: multifocality; patient age; gender; platelet count; AFP level at diagnosis, during treatment and follow-up; histotype; gestational age; birth weight; surgery (either resection or transplantation) and chemotherapy regimen adopted before and after surgery. The outcome measures were event free survival (EFS) and overall survival (OS); survival curves were estimated according to Kaplan–Meier.
EFS and OS were associated significantly with multifocality (3-year EFS 40% vs. 95%, P = 0.006; 3-year OS 42% vs. 95%, P = 0.004). Multivariate analysis demonstrated that multifocality predicts lower EFS (hazard ratio 10.01, P = 0.007). Other factors at diagnosis did not reach statistical significance. A marked treatment dependent improvement was associated with intensive chemotherapy given both before and after liver transplantation (P = 0.06).
Patients diagnosed with multifocal tumors had lower EFS levels. Multifocality should be taken into account for future stratification and further studied to assess genetic profile, immunochemistry and prognostic role. Pediatr Blood Cancer 2014;61:1593–1597. © 2014 Wiley Periodicals, Inc.