title: Multidisciplinary effort in treating children with hepatoblastoma in China.
abstract: The purpose of this study is to report the first nationwide protocol (Wuhan Protocol) developed by Chinese Children's Cancer Group and the results of multidisciplinary effort in treating hepatoblastoma. In this study, we reported the final analysis, which includes 153 hepatoblastoma patients in 13 hospitals from January 2006 to December 2013. The 6-year overall survival and event-free survival rates were 83.3 ± 3.1% and 71.0 ± 3.7%, respectively, in this cohort. The univariate analysis revealed that female (P = 0.027), under 5 years of age (P = 0.039), complete surgical resection (P = 0.000), no metastases (P = 0.000), and delayed surgery following neoadjuvant chemotherapy (P = 0.000) had better prognosis. In multivariate analysis, male, 5 years of age or above, stage PRETEXT III or IV, and incomplete surgical resection were among the some adverse factors contributing to poor prognosis. The preliminary results from this study showed that patients who underwent treatment following Wuhan Protocol had similar OS and EFS rates compared to those in developed countries. However, the protocol remains to be further optimized in standardizing surgical resection (including liver transplantation), refining risk stratification and risk-based chemotherapy.
authors.affiliation: Department of Pediatric Hematology/Oncology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Yuan
authors.affiliation: Department of Surgical Oncology, Beijing Children's Hospital Affiliated to Capital Medical University, China.
authors.forename: Huan-Min
authors.initials: HM
authors.lastname: Wang
authors.affiliation: Department of Pediatric Hematology/Oncology, Children's Hospital of Shanghai Affiliated to Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Pediatric Hematology/Oncology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Meng-Jie
authors.initials: MJ
authors.lastname: Tang
authors.affiliation: Department of Pediatric Surgery, Tianjin Medical University Cancer Institute and Hospital, China.
authors.forename: Zhang-Lin
authors.initials: ZL
authors.lastname: Li
authors.affiliation: Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zou
authors.affiliation: Department of Pediatric Hematology/Oncology, Nanjing Children's Hospital, China.
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Fang
authors.affiliation: Department of Pediatric Hematology/Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Ci
authors.initials: C
authors.lastname: Pan
authors.affiliation: Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, China.
authors.forename: Jin-Fa
authors.initials: JF
authors.lastname: Tou
authors.affiliation: Department of Pediatric Surgery, Shengjing Hospital of China Medical University, China.
authors.forename: Ke-Ren
authors.initials: KR
authors.lastname: Zhang
authors.affiliation: Department of Pediatric Surgery, Anhui Provincial Children's Hospital, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Pediatric Surgery, The First Affiliated Hospital of Anhui Medical University, China.
authors.forename: Wei-Song
authors.initials: WS
authors.lastname: Li
authors.affiliation: Department of Pediatric Hematology/Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Pediatric Hematology/Oncology, Children's Hospital of Soochow University, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Pediatric Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China. Electronic address: 13651718916@163.com.
authors.forename: Ye-Ming
authors.initials: YM
authors.lastname: Wu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D002681:China; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D018197:Hepatoblastoma / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D002945:Cisplatin; D005472:Fluorouracil
keywords: Hepatoblastoma; Multidisciplinary team; Neoadjuvant chemotherapy; Pediatrics; Surgery