Analysis of risk factors affecting the prognosis of hepatoblastoma

[Abstract] Objective To analyze the risk factors affecting the prognosis of comprehensive treatment of children with hepatoblastoma Methods Retrospective analysis of clinical and pathological data and follow-up (112 cases) information of 136 children with hepatoblastoma admitted by our hospital from 2001 to 2012, treated with surgery plus chemotherapy, which was divided into preoperative chemotherapy and postoperative chemotherapy. The follow-up time was 35.6 (3-144) months. Kaplan-Meier curve and Log-Rank test were applied for survival analysis, and Cox proportional risk regression model was used for single and multi-factor analysis. SPSS19.0 software was used for statistical analysis. The median tumor diameter was 8.37±3.09 (2.9-19) cm, the median AFP level was 6453.8±47699.2 (12.9-484000) ug/L, and the tumor PRETEXT I, II, III and IV stages were 3 (2.7%), 16 (14.3%), 42 (37.5 ), 42 cases (37.5%), 51 cases (45.5%), 96 cases (85.7%) with single tumor, 16 cases (14.3%) with multiple tumors, 27 cases (24.1%) with distant metastases, and 85 cases (75.9%) without distant metastases. The K-M survival curve analysis showed that the risk factors affecting the prognosis of children with hepatoblastoma included AFP level, PRETEXT stage, single and multiple tumors, presence of metastasis, and vascular invasion. The 5-year survival rate of children with serum alpha-fetoprotein (AFP) <100ug/L or (AFP) >10,000ug/L group (47%) was lower than that of 100ug/L 10,000ug/L group (71.3%); the 5-year survival rate of children with multiple tumors (25.9%) was lower than that of children with single tumors (68.8%); the 5-year survival rate of children with PRETEXT stage IV high-risk group (41.8%) was lower than that of children with PRETEXT stage IV. The 5-year survival rate was lower in the group with metastases (24.3%) than in the group without metastases (67.9%), and in the group with vascular invasion (35%) than in the group without vascular invasion (64.3%). 10000ug/L ([HR] 2.454, [95% CI] 1.207-4.987,P=0.013); PRETEXT IV ([HR] 2.817, [95% CI] 1.373-5.783,P=0.005); multiple tumors ([HR] 2.852, [95% CI] 1.256-6.475. P=0.012); distant metastases ([HR] 2.654, [95% CI] 1.342-5.267,P=0.005); and vascular invasion ([HR] 2.272, [95% CI] 1.102-4.687,P=0.026). Conclusion The prognosis of children with hepatoblastoma is related to AFP level, single and multiple tumors, PRETEXT stage, presence of metastasis, and vascular invasion, and can vary in the presence of different risk factors Ge Juntao, Department of Pediatric Surgery, Shandong Qianfo Mountain Hospital