The importance of age as prognostic factor for the outcome of patients with hepatoblastoma: Analysis from the Children's Hepatic tumors International Collaboration (CHIC) database.
- Haeberle B Division of Pediatric Surgery, University of Munich, Munich, Germany.
- Rangaswami A Division of Pediatric Hematology and Oncology, University of California San Francisco, San Francisco, California.
- Krailo M Department of Preventive Medicine, University of Southern California, California, Los Angeles.
- Czauderna P Department of Surgery for Children and Adolescents, Medical University of Gdansk, Gdansk, Poland.
- Hiyama E Department of Pediatric Surgery, Hiroshima University, Hiroshima, Japan.
- Maibach R IBCSG Coordinating Center, Bern, Switzerland.
- Lopez-Terrada D Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.
- Aronson DC Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland.
- Alaggio R Department of Pathology, Bambino Gesu Pediatric Hospital, Roma, Italy.
- Ansari M Pediatric Department, Onco-Hematology Unit, Geneva University Hospital, Geneva, Switzerland.
- Malogolowkin MH Division of Pediatric Hematology Oncology, University of California Davis Comprehensive Cancer Center, California, Sacramento.
- Perilongo G Department of Pediatrics, University of Padua, Padua, Italy.
- O'Neill AF Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
- Trobaugh-Lotrario AD Department of Pediatric Hematology/Oncology, Providence Sacred Heart Children's Hospital Spokane, Washington.
- Watanabe K Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan.
- Schmid I Department of Pediatric Hematology and Oncology, University of Munich, Munich, Germany.
- von Schweinitz D Division of Pediatric Surgery, University of Munich, Munich, Germany.
- Ranganathan S Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Mediacla Center, Cincinnati, Ohio.
- Yoshimura K Innovative Clinical Research Center (iCREK), Kanazawa University Hospital, Japan.
- Hishiki T Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
- Tanaka Y Department of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan.
- Piao J Department of Preventive Medicine, University of Southern California, California, Los Angeles.
- Feng Y Children's Oncology Group, Los Angeles, California.
- Rinaldi E CINECA, Bologna, Italy.
- Saraceno D CINECA, Bologna, Italy.
- Derosa M CINECA, Bologna, Italy.
- Meyers RL Division of Pediatric Surgery, University of Utah School of Medicine, Utah, Salt Lake City.
- 2020-05-09
Published in:
- Pediatric blood & cancer. - 2020
CHIC
age
hepatoblastoma
pediatric liver tumor
prognostic factor
Adolescent
Age of Onset
Child
Child, Preschool
Databases, Factual
Disease-Free Survival
Female
Hepatoblastoma
Humans
Incidence
Infant
Infant, Newborn
Liver Neoplasms
Male
Neoplasm Metastasis
Prospective Studies
Risk Factors
Survival Rate
English
PURPOSE
Treatment outcomes for hepatoblastoma have improved markedly in the contemporary treatment era, principally due to therapy intensification, with overall survival increasing from 35% in the 1970s to 90% at present. Unfortunately, these advancements are accompanied by an increased incidence of toxicities. A detailed analysis of age as a prognostic factor may support individualized risk-based therapy stratification.
METHODS
We evaluated 1605 patients with hepatoblastoma included in the CHIC database to assess the relationship between event-free survival (EFS) and age at diagnosis. Further analysis included the age distribution of additional risk factors and the interaction of age with other known prognostic factors.
RESULTS
Risk for an event increases progressively with increasing age at diagnosis. This pattern could not be attributed to the differential distribution of other known risk factors across age. Newborns and infants are not at increased risk of treatment failure. The interaction between age and other adverse risk factors demonstrates an attenuation of prognostic relevance with increasing age in the following categories: metastatic disease, AFP < 100 ng/mL, and tumor rupture.
CONCLUSION
Risk for an event increased with advancing age at diagnosis. Increased age attenuates the prognostic influence of metastatic disease, low AFP, and tumor rupture. Age could be used to modify recommended chemotherapy intensity.
Treatment outcomes for hepatoblastoma have improved markedly in the contemporary treatment era, principally due to therapy intensification, with overall survival increasing from 35% in the 1970s to 90% at present. Unfortunately, these advancements are accompanied by an increased incidence of toxicities. A detailed analysis of age as a prognostic factor may support individualized risk-based therapy stratification.
METHODS
We evaluated 1605 patients with hepatoblastoma included in the CHIC database to assess the relationship between event-free survival (EFS) and age at diagnosis. Further analysis included the age distribution of additional risk factors and the interaction of age with other known prognostic factors.
RESULTS
Risk for an event increases progressively with increasing age at diagnosis. This pattern could not be attributed to the differential distribution of other known risk factors across age. Newborns and infants are not at increased risk of treatment failure. The interaction between age and other adverse risk factors demonstrates an attenuation of prognostic relevance with increasing age in the following categories: metastatic disease, AFP < 100 ng/mL, and tumor rupture.
CONCLUSION
Risk for an event increased with advancing age at diagnosis. Increased age attenuates the prognostic influence of metastatic disease, low AFP, and tumor rupture. Age could be used to modify recommended chemotherapy intensity.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1002/pbc.28350
- PMID 32383794
- Persistent URL
- https://folia.unifr.ch/global/documents/269280
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