Clinical risk stratification of children with SIOPEL high-risk hepatoblastoma in Taiwan

Hsu, Wei-Yun; Chang, Hsiu-Hao; Lu, Meng‐Yao; Yang, Yung‐Li; Jou, Shiann-Tarng; Chen, Huey‐Ling; Ni, Yen‐Hsuan; Hsu, Hong–Yuan; Wu, Jia‐Feng

doi:10.1016/j.pedneo.2020.03.012

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Most of the features were similar between our study and one of the largest studies on hepatoblastoma conducted by Hsu et al ( 30 ) at the National Taiwan University Hospital ( Table 2 ).…”

Section: Discussionsupporting

confidence: 88%

A Clinicopathological Study with Risk-Stratified Staging of Pediatric Hepatoblastoma: A 5-Year Experience from a Tertiary Cancer Center

Oklay,

Prakash,

et al. 2023

Iran J Pathol

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Background & Objective: Hepatoblastoma encompasses 1% of pediatric malignancies and is the most common liver malignancy in children. Ninety percent of cases are younger than 5 years of age. Clinical and pathological risk stratification forms a crucial role in determining the treatment strategy. This study aimed to assess the clinicopathological profile of hepatoblastoma with risk stratification and follow-up in children. Methods: A retrospective evaluation was performed on all pediatric patients diagnosed as hepatoblastoma between 2016 and 2020 in our institution. Clinical, radiological, biochemical, pathological, and treatment data were analyzed. Cases were stratified based on the SIOPEL protocol and compared with the outcome. Results: The median age of all children was 1 year, the male-to-female ratio was 2.3:1, and elevated α-fetoprotein (AFP) was observed in all cases. SIOPEL risk stratification showed that 50% of children were at high risk. The histopathological types were fetal (30%), embryonal (20%), and macrotrabecular (5%) patterns under epithelial type and mixed epithelial and mesenchymal type (45%) with 1 case showing teratoid features. During the follow-up period, 6 out of the 7 children who died, belonged to the high-risk SIOPEL category, and 5 presented a mixed epithelial and mesenchymal pattern. Conclusion: Our study found a significant correlation between clinicopathological data, histopathological patterns, and outcomes. Accordingly, histopathological patterns could be considered one of the criteria for risk stratification. Histopathological risk stratification indicators (such as SIOPEL and PRETEXT) have strong prognostic and predictive outcomes; hence, our study emphasizes such parameters to aid oncologists

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“…Most of the features were similar between our study and one of the largest studies on hepatoblastoma conducted by Hsu et al ( 30 ) at the National Taiwan University Hospital ( Table 2 ).…”

Section: Discussionsupporting

confidence: 88%

A Clinicopathological Study with Risk-Stratified Staging of Pediatric Hepatoblastoma: A 5-Year Experience from a Tertiary Cancer Center

Oklay,

Prakash,

et al. 2023

Iran J Pathol

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“…Hepatoblastoma is the most common liver malignancy in children with an incidence of approximately 1.2-1.5 cases per million [8 , 9] . It accounts for 1% of the pediatric malignancies [9] and it is usually diagnosed before the age of 3 years [8] . These type of liver tumors arise from pluripotent stem cells derived from hepatoblast which can differentiate mainly into epithelial and mesenchymal elements [10] .…”

Section: Discussionmentioning

confidence: 99%

Use of drug-coated balloons in the management of a recalcitrant postsurgical hepatic vein stenosis in a pediatric patient

Parra

Brandão

2020

Radiology Case Reports

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Drug-coated balloons (DCB) are a treatment alternative to conventional angioplasty in arterial, hemodialysis fistulas, and venous stenoses. This case report describes a child with the diagnosis of hepatoblastoma treated with chemotherapy and a right extended hepatectomy with venous reconstruction. The patient presented with signs and symptoms of portal hypertension due to a hepatic venous outflow obstruction secondary to stenosis of the surgical anastomosis. The response to conventional angioplasty was limited with frequent recurrence of symptoms. DCBs were used as an alternative prior to stent consideration aiming to assess if these devices could provide improvement of the symptoms and as a long-term therapy. The use of DCBs increased the time interval of reinterventions in comparison with conventional angioplasty. The patient eventually required stents due to recurrence of the primary disease. While this report does not provide an in-depth evaluation in terms of the efficacy and safety of DCB, this case illustrates a potential novel treatment modality to be considered for children, when stenotic venous lesions not amenable for stenting are present.

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“…A study by Huang et al showed a comparative analysis of the COG and CHIC-HS risk stratification methods, and their findings led them to conclude that the CHIC-HS method has more accuracy in predicting survival outcomes ( 15 ). In contrast, Hsu et al observed no statistically significant variation in survival rates between children classified as intermediate-risk and high-risk when using the CHIC-HS risk stratification method ( 16 ). Despite the endeavors mentioned above, the established prognostic variables and the generally recognized staging methods need to offer an ideal framework for accurately evaluating individual patient survival probability.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of nomogram-based models for personalized survival assessment in pediatric hepatoblastoma patients

Chen,

Zhang,

Zhang

et al. 2024

Transl Cancer Res

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Background Hepatoblastoma (HB) is a prevalent form of liver cancer in pediatric patients, characterized by an embryonal malignant tumor. In the current study, a clinical prediction model was developed; that can effectively assess the likelihood of a patient’s survival with HB. Methods Data from the Surveillance, Epidemiology, and End Results (SEER) database for cases of HB between 2010 and 2019 were used in this retrospective research. Information on clinicopathologic characteristics, therapeutic interventions, and survival outcomes were included in the data. The HB patients were randomly assigned to the training or validation cohort in a 7:3 ratio. Using univariate and multivariate Cox proportional hazards regression models, the prognostic indicators for overall survival (OS) and cancer-specific survival (CSS) were identified. The area under the receiver operating characteristic curve (AUC-ROC), calibration plots, and concordance index (C-index) were used to evaluate the accuracy and calibration of these models. The clinical utility of the models was examined using decision curve analysis (DCA). Results The multivariate Cox regression analysis revealed multiple autonomous prognostic determinants for the OS and CSS, including age, surgical interventions, and chemotherapy administration. Significantly, tumor size was found to be a strong predictor of OS. AUC values of 0.915, 0.846, and 0.847 for 1-, 3-, and 5-year OS, respectively, indicated that the nomogram-based models were highly accurate at predicting outcomes. Similarly, the AUC values for CSS were 0.871, 0.814, and 0.825. The C-index measurements, which quantify the discriminatory performance of the models, produced CSS values of 0.836 and OS values of 0.864. Furthermore, the calibration plots accurately represented the actual survival rates. Concurrently, the DCA had validated the clinical relevance of the nomogram-based models. Conclusions The present study successfully developed and validated user-friendly nomogram-based models, allowing for accurate assessment of OS and CSS in pediatric HB patients. These tools enable personalized survival predictions, enhance risk stratification, and strengthen clinical decision-making for managing HB.

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Clinical risk stratification of children with SIOPEL high-risk hepatoblastoma in Taiwan

Cited by 3 publications

References 18 publications

A Clinicopathological Study with Risk-Stratified Staging of Pediatric Hepatoblastoma: A 5-Year Experience from a Tertiary Cancer Center

A Clinicopathological Study with Risk-Stratified Staging of Pediatric Hepatoblastoma: A 5-Year Experience from a Tertiary Cancer Center

Use of drug-coated balloons in the management of a recalcitrant postsurgical hepatic vein stenosis in a pediatric patient

Development and validation of nomogram-based models for personalized survival assessment in pediatric hepatoblastoma patients

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