Incidence trends and survival prediction of hepatoblastoma in children: a population‐based study

Abstract

BackgroundHepatoblastoma is a rare disease that nevertheless accounts for the majority of liver malignancies in children. Due to limited epidemiological data, therapy for hepatoblastoma tends to be individualized. This study aimed to evaluate incidence trends of hepatoblastoma and to develop a nomogram to predict the survival of children with newly diagnosed hepatoblastoma on a population-based level.MethodsIndividuals up to 18 years of age with hepatoblastoma recorded in 18 registries of the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015 were examined. Joinpoint regression analyses were applied to assess incidence trends in annual percentage change (APC). Multivariable Cox regression was used to identify factors associated with overall survival (OS). A nomogram was constructed to predict OS in individual cases based on independent predictors. Concordance index (C-index) and calibration curves were used to evaluate predictive performance.ResultsBetween 2004 and 2015, hepatoblastoma incidence increased significantly (APC, 2.2%; 95% confidence interval [CI] 0.5% to 3.8%, P < 0.05). In particular, this increase was observed among 2- to 4-year-old patients, males, and African–Americans. The 5- and 10-year OS rates were 81.5% and 81.0%, respectively. Age of 2 to 4 years, African–American ethnicity, and no surgery were independent predictors for short OS. Distant disease at presentation was found not to be an independent factor of survival. The nomogram had a C-index of 0.79 (95% CI 0.74–0.84) with appropriate calibration curve fitting.ConclusionsWe constructed a nomogram that integrates common factors associated with survival for hepatoblastoma patients. It provides accurate prognostic prediction for children with hepatoblastoma.

Global trends in incidence rates of childhood liver cancers: A systematic review and meta‐analysis

“…While HB incidence rates were stable over nine years from 2001 onwards among children aged <20 in the USA, 29 another USA-based study reported that longer-term trends increased among this age group. 38 Long-term trends among ages 0-14 years also increased in Canada, 30 Germany, 39 and Taiwan 40 over recent decades (from around the mid-1990s-2012). However, two other studies reported stable trends for this age group from 1983 to 2007 in Spain 35 and 1976 to 2011 in Italy.…”

Liver Transplantation for Pediatric Liver Cancer

“…Of 150 total HCC cases recorded during 2004-2015, 80 were treated surgically [14]. Twenty In reviews of the SEER database, HB incidence increased significantly between 2004 and 2015 (annual percentage change, 2.2%; 95% confidence interval (CI) 0.5% to 3.8%, p < 0.05) [13]. In particular, this increase was observed among 2-to 4-year-old patients, males, and African-Americans.…”

“…Reports based on the SEER registry have compared outcomes after surgical resection and LT, while those based on the SRTR database have described outcomes after LT for all liver cancers by era, and the effect of systemic changes on these outcomes [13][14][15][16][17]70]. These changes include assigning higher model-for-end-stage-liver-disease (MELD) or pediatric end-stage-liver-disease (PELD) scores for these tumors since 2010, the addition of doxorubicin and other agents to cisplatin-based COG protocols, AHEP-0731 (2009), and the use of PLADO with sorafenib for HCC (2007) [70].…”

Development and external validation of a nomogram for predicting the effect of tumor size on cancer specific survival of resected gallbladder cancer: a population-based study.

“…The age-standardized incidence of GBC was expressed as per 100,000 individuals using the 2000 US Standard Population. Annual percentage change (APC) in the incidence was calculated using the weighted least squares method 16 . Statistical analysis was conducted using R software 3.6.2 (R foundation, Vienna, Austria) and SPSS version 21.0 (SPSS Inc., Chicago, IL, USA).…”