title: Towards an international pediatric liver tumor consensus classification: proceedings of the Los Angeles COG liver tumors symposium.
abstract: Liver tumors are rare in children, and their diagnoses may be challenging particularly because of the lack of a current consensus classification system. Systematic central histopathological review of these tumors performed as part of the pediatric collaborative therapeutic protocols has allowed the identification of histologic subtypes with distinct clinical associations. As a result, histopathology has been incorporated within the Children's Oncology Group (COG) protocols, and only in the United States, as a risk-stratification parameter and for patient management. Therefore, the COG Liver Tumor Committee sponsored an International Pathology Symposium in March 2011 to discuss the histopathology and classification of pediatric liver tumors, and hepatoblastoma in particular, and work towards an International Pediatric Liver Tumors Consensus Classification that would be required for international collaborative projects. Twenty-two pathologists and experts in pediatric liver tumors, including those serving as central reviewers for the COG, European Société Internationale d'Oncologie Pédiatrique, Gesellschaft für Pädiatrische Onkologie und Hämatologie, and Japanese Study Group for Pediatric Liver Tumors protocols, as well as pediatric oncologists and surgeons specialized in this field, reviewed more than 50 pediatric liver tumor cases and discussed classic and newly reported entities, as well as criteria for their classification. This symposium represented the first collaborative step to develop a classification that may lead to a common treatment-stratification system incorporating tumor histopathology. A standardized, clinically meaningful classification will also be necessary to allow the integration of new biological parameters and to move towards clinical algorithms based on patient characteristics and tumor genetics, which should improve future patient management and outcome.
authors.affiliation: Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Dolores
authors.initials: D
authors.lastname: López-Terrada
authors.affiliation: Division of Pathology, Department of Medicine-DIMED, Pathology Unit, Padova, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Alaggio
authors.affiliation: Departamento de Patologia, Hospital de Pediatría Prof. Dr. J.P. Garrahan, Buenos Aires, Argentina.
authors.forename: Maria T
authors.initials: MT
authors.lastname: de Dávila
authors.affiliation: Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czauderna
authors.affiliation: Department of Surgery, Natural Science Center for Basic Research and Development, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Eiso
authors.initials: E
authors.lastname: Hiyama
authors.affiliation: Aflac Cancer Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Katzenstein
authors.affiliation: Institut fur Pathologie, UNI-Klinikum Campus, Kiel, Germany.
authors.forename: Ivo
authors.initials: I
authors.lastname: Leuschner
authors.affiliation: Department of Pediatric Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Marcio
authors.initials: M
authors.lastname: Malogolowkin
authors.affiliation: Department of Pediatric Surgery, Primary Children's Medical Center, University of Utah, Salt Lake City, UT, USA.
authors.forename: Rebecka
authors.initials: R
authors.lastname: Meyers
authors.affiliation: Department of Pathology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
authors.forename: Sarangarajan
authors.initials: S
authors.lastname: Ranganathan
authors.affiliation: Division of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan.
authors.forename: Yukichi
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Division of Pediatric Hematology-Oncology, University of Texas Health Science Center, San Antonio, TX, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Tomlinson
authors.affiliation: Department of Pathology, Institut de Cancerologie Gustave Roussy, Villejuif, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Fabrè
authors.affiliation: Institute of Pathology, University of Bern, Bern, Switzerland.
authors.forename: Arthur
authors.initials: A
authors.lastname: Zimmermann
authors.affiliation: Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Milton J
authors.initials: MJ
authors.lastname: Finegold
mesh_terms: D002648:Child; D018197:Hepatoblastoma / Q000145:classification* / Q000175:diagnosis*; D006801:Humans; D008113:Liver Neoplasms / Q000145:classification* / Q000175:diagnosis*; D015141:Los Angeles; D010372:Pediatrics