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Research article
Tianyou Yang
Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Affiliated Women and Children's Medical Center of Guangzhou Medical University, Guangzhou, China.
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9140-3806
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: To report the outcomes of hepatoblastoma resected in our institution. Methods: We diagnosed 135 children with hepatoblastoma at our institution between January 2010 and December 2017. Patients who underwent liver resection were included for analysis. However, patients who abandoned treatment after diagnosis were excluded from analysis, but their clinical characteristics were provided in the supplementary material. Results: Forty-two patients abandoned treatment, whereas 93 patients underwent liver resection and were included for statistical analysis. Thirty-six, 23, 3, and 31 patients had PRETEXT stages II, III, IV, and unspecified tumours, respectively. Seven patients had ruptured tumour; 9 had lung metastasis (one patient had portal vein thrombosis concurrently). Sixteen patients underwent primary liver resection; 22, 25, and 30 patients received cisplatin-based neoadjuvant chemotherapy and delayed surgery, preoperative transarterial chemoembolization (TACE) and delayed surgery, and a combination of cisplatin-based neoadjuvant chemotherapy, TACE, and delayed surgery, respectively. Forty patients had both PRETEXT and POST-TEXT information available for analysis. Twelve patients were down-staged after preoperative treatment, including 2, 8, and 2 patients from stages IV to III, III to II, and II to I, respectively. Ten patients with unspecified PRETEXT stage were confirmed to have POST-TEXT stages II (n=8) and I (n=2) tumours. Seven tumours were associated with positive surgical margins, and 12 patients had microvascular involvement. During a median follow-up period of 30.5 months, 84 patients survived without relapse, 9 experienced tumour recurrence, and 4 died. The 2-year event-free survival (EFS) and overall survival (OS) rates were 89.4±3.4%, and 95.2±2.4%, respectively; they were significantly better among patients without metastasis (no metastasis vs metastasis: EFS, 93.5±3.7% vs 46.7±19.0%, adjusted p=0.002. OS, 97.6±2.4% vs 61.0±18.1%, adjusted p=0.005), and similar among patients treated with different preoperative strategies (chemotherapy only vs TACE only vs Both: EFS, 94.7±5.1% vs 91.7±5.6% vs 85.6±6.7%, p=0.542. OS, 94.1±5.7% vs 95.7±4.3% vs 96.7±3.3%, p=0.845). Conclusion: The OS for patients with hepatoblastoma who underwent liver resection was satisfactory. Neoadjuvant chemotherapy and TACE seemed to have a similar effect on OS. However, the abandonment of treatment by patients with hepatoblastoma was common, and may have biased our results.
Keywords
hepatoblastoma; surgery; children; liver tumour
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Received 08 Oct, 2019
Reviewer #5 agreed
On 30 Sep, 2019
Review #4 received
Received 30 Sep, 2019
Review #3 received
Received 30 Sep, 2019
Reviewer #4 agreed
On 29 Sep, 2019
Reviewer #3 agreed
On 27 Sep, 2019
Reviewer #2 agreed
On 26 Sep, 2019
Reviewer #1 agreed
On 24 Sep, 2019
Submission checks complete
On 24 Sep, 2019
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On 24 Sep, 2019
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Learn more about In Review
Research article
Tianyou Yang
Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Affiliated Women and Children's Medical Center of Guangzhou Medical University, Guangzhou, China.
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9140-3806
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pediatrics.
No community comments so far
Editor assigned
On 30 Mar, 2020
Editorial decision: Accept
On 30 Mar, 2020
Submission checks complete
On 29 Mar, 2020
Editor invited
On 29 Mar, 2020
Version 3
Posted 03 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 23 Mar, 2020
Review #1 received
Received 19 Mar, 2020
Review #3 received
Received 19 Mar, 2020
Review #2 received
Received 19 Mar, 2020
Reviewer #3 agreed
On 08 Mar, 2020
Reviewers invited
Invitations sent on 05 Mar, 2020
Reviewer #1 agreed
On 05 Mar, 2020
Reviewer #2 agreed
On 05 Mar, 2020
Editor assigned
On 03 Mar, 2020
Editor invited
On 02 Mar, 2020
Submission checks complete
On 02 Mar, 2020
No comments provided
Review #1 received
Received 16 Feb, 2020
Editorial decision: Minor revision
On 16 Feb, 2020
Review #4 received
Received 10 Feb, 2020
Review #2 received
Received 07 Feb, 2020
Review #3 received
Received 01 Feb, 2020
Reviewer #4 agreed
On 28 Jan, 2020
Reviewer #3 agreed
On 26 Jan, 2020
Reviewer #2 agreed
On 25 Jan, 2020
Reviewers invited
Invitations sent on 23 Jan, 2020
Reviewer #1 agreed
On 23 Jan, 2020
Editor assigned
On 22 Jan, 2020
Submission checks complete
On 21 Jan, 2020
Editor invited
On 21 Jan, 2020
No comments provided
Review #2 received
Received 14 Oct, 2019
Editorial decision: Major revision
On 14 Oct, 2019
Review #5 received
Received 12 Oct, 2019
Review #1 received
Received 08 Oct, 2019
Reviewer #5 agreed
On 30 Sep, 2019
Review #4 received
Received 30 Sep, 2019
Review #3 received
Received 30 Sep, 2019
Reviewer #4 agreed
On 29 Sep, 2019
Reviewer #3 agreed
On 27 Sep, 2019
Reviewer #2 agreed
On 26 Sep, 2019
Reviewer #1 agreed
On 24 Sep, 2019
Submission checks complete
On 24 Sep, 2019
Editor assigned
On 24 Sep, 2019
Reviewers invited
Invitations sent on 24 Sep, 2019
Editor invited
On 23 Sep, 2019
First submitted
On 20 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pediatrics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pediatrics.
Background: To report the outcomes of hepatoblastoma resected in our institution. Methods: We diagnosed 135 children with hepatoblastoma at our institution between January 2010 and December 2017. Patients who underwent liver resection were included for analysis. However, patients who abandoned treatment after diagnosis were excluded from analysis, but their clinical characteristics were provided in the supplementary material. Results: Forty-two patients abandoned treatment, whereas 93 patients underwent liver resection and were included for statistical analysis. Thirty-six, 23, 3, and 31 patients had PRETEXT stages II, III, IV, and unspecified tumours, respectively. Seven patients had ruptured tumour; 9 had lung metastasis (one patient had portal vein thrombosis concurrently). Sixteen patients underwent primary liver resection; 22, 25, and 30 patients received cisplatin-based neoadjuvant chemotherapy and delayed surgery, preoperative transarterial chemoembolization (TACE) and delayed surgery, and a combination of cisplatin-based neoadjuvant chemotherapy, TACE, and delayed surgery, respectively. Forty patients had both PRETEXT and POST-TEXT information available for analysis. Twelve patients were down-staged after preoperative treatment, including 2, 8, and 2 patients from stages IV to III, III to II, and II to I, respectively. Ten patients with unspecified PRETEXT stage were confirmed to have POST-TEXT stages II (n=8) and I (n=2) tumours. Seven tumours were associated with positive surgical margins, and 12 patients had microvascular involvement. During a median follow-up period of 30.5 months, 84 patients survived without relapse, 9 experienced tumour recurrence, and 4 died. The 2-year event-free survival (EFS) and overall survival (OS) rates were 89.4±3.4%, and 95.2±2.4%, respectively; they were significantly better among patients without metastasis (no metastasis vs metastasis: EFS, 93.5±3.7% vs 46.7±19.0%, adjusted p=0.002. OS, 97.6±2.4% vs 61.0±18.1%, adjusted p=0.005), and similar among patients treated with different preoperative strategies (chemotherapy only vs TACE only vs Both: EFS, 94.7±5.1% vs 91.7±5.6% vs 85.6±6.7%, p=0.542. OS, 94.1±5.7% vs 95.7±4.3% vs 96.7±3.3%, p=0.845). Conclusion: The OS for patients with hepatoblastoma who underwent liver resection was satisfactory. Neoadjuvant chemotherapy and TACE seemed to have a similar effect on OS. However, the abandonment of treatment by patients with hepatoblastoma was common, and may have biased our results.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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