title: Pure fetal histology subtype was associated with better prognosis of children with hepatoblastoma: A Chinese population-based study.
abstract: OBJECTIVE
  The aim of this study is to identify the association between histologic types and the prognosis of hepatoblastoma (HB) in a large Asian cohort of a single institution and to explore the interaction of histologic types with other independently risk factors in the process of affecting prognosis of HB.
  
  
  METHODS
  We retrospectively reviewed 176 children with HB (82 female, 94 male) managed in our institution between May 1, 2001 and July 30, 2014. Prognostic factors were evaluated using Kaplan-Meier curves and Cox proportional hazards models.
  
  
  RESULTS
  For the entire cohort of 176 patients, the overall median survival was 80.4 months(95% CI: 71.6-89.2 months), and the 5-year event-free survival and overall survival rates were 54.6 and 66.7%. Descriptive survival statistics and Kaplan-Meier curves suggested that alpha fetoprotein levels, tumor metastases, multifocality, histologic types, and Pre-Treatment Extent of Disease staging System stage had prognostic significance in this relatively selected cohort. Moreover, after eliminating the impact of the interaction of different classification methods of histologic types, pure fetal histologic (PFH) was an independent prognostic factor of HB (hazard ratio [HR]: 2.752, P = 0.021). Further stratification analysis showed that the impaction of other identified risk factors on the influence of PFH on the prognosis of HB patients was different.
  
  
  CONCLUSIONS
  We have confirmed that the HB prognostic factors of HB and PFH was associated with better prognosis of children with HB based on an Asian population. PFH showed different significance in the process of affecting prognosis of HB with the interaction of other independent risk factors.
authors.affiliation: Department of Medical Oncology, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, China.|Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China.
authors.forename: Guo-liang
authors.initials: GL
authors.lastname: Qiao
authors.affiliation: Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China.
authors.forename: Juntao
authors.initials: J
authors.lastname: Ge
authors.affiliation: Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, China.
authors.forename: Long
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ren
mesh_terms: D044466:Asian People; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006498:Hepatectomy; D018197:Hepatoblastoma / Q000145:classification / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: hepatoblastoma; histologic types; prognosis