Clinical effectiveness of multimodality treatment on advanced pediatric hepatoblastoma.
OBJECTIVE
To investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma and the factors affecting the prognosis.


METHODS
35 childhood patients were treated with multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. Patients were followed up every month.


RESULTS
33 patients completed the follow-up, of which 17 were in complete remission, 5 were in partial remission, 1 case got worse, and 10 died. The remission rate was 66.7% (22/33), and the overall survival rate was 69.7% (23/33). 1 patient with advanced hepatoblastoma got high-dose chemotherapy combined with autologous peripheral blood stem cell transplantation (APBSCT) treatment, and a primary lesion by 18 x 15 x 9 cm reduced to 10 x 8 x 4 cm. Remote metastases significantly alleviated, and partial remission reached six months. The overall survival was 9 months after transplantation. Patients with the mixed phenotype of hepatoblastoma had a worse prognosis than with the epithelial phenotype (p < 0.001), and patients in stage IV had a lower survival rate than in stage III (p < 0.001).


CONCLUSIONS
Multimodality treatment can effectively improve remission rate and prolong the survival of children with the advanced hepatoblastoma. In addition, alpha-fetoprotein (AFP), hepatoblastoma pathological classification and staging are of great use in prediction of prognosis.
Department of Pediatrics, Chinese PLA General Hospital, Beijing, P.R. China. dongshenghuang99@163.com.
Y
Y
Zhang
W-L
WL
Zhang
D-S
DS
Huang
L
L
Hong
Y-Z
YZ
Wang
X
X
Zhu
H-M
HM
Hu
P-W
PW
Zhang
Y
Y
Yi
T
T
Han
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D018197:Hepatoblastoma / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D011859:Radiography; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
D000970:Antineoplastic Agents; D000509:alpha-Fetoproteins