Clinical Efficacy and Prognosis Factors for Advanced Hepatoblastoma in Children: A 6-year Retrospective Study

Objective: This study aimed to investigate the effect of multimodality treatment of advanced paediatrichepatoblastoma (HB) and the factors affecting prognosis.
Methods: A total of 35 children underwent multimodalitytreatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stemcell transplantation. The patients were followed up every month.
Results: Serum AFP levels in 33 out of 35patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the valuesof serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases withlocally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventionaltreatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission(PR), 1 became disease progressive (DP) , and 10 died. The remission and overall survival rates were 66.7%(22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than theepithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P <0.001).
Conclusion: Multimodality treatment can effectively improve remission rate and prolong the survival ofchildren with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors,HB pathological classification, and staging are highly useful in predicting prognosis.