Predictive power of pretreatment prognostic factors in children with hepatoblastoma: A report from the Children's Oncology Group

Rebecka L. Meyers, Jon R. Rowland, Mark Krailo, Zhengjia Chen, Howard M. Katzenstein, Marcio Malogolowkin

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

Background. PRETEXT is used to stratify risk in children with hepatoblastoma by the Liver Tumor Strategy Group (SIOPEL) of the International Society of Pediatric Oncology (SIOP). A recent analysis excluding patients that did not survive neoadjuvant chemotherapy, concluded that PRETEXT was superior to Children's Oncology Group (COG) stage for predicting survival. Puzzled by this result, we made a similar comparison of PRETEXT and COG stage. This time, however, we include all patients, and we compare predictive value at diagnosis, instead of after neoadjuvant chemotherapy. Methods. Hepatoblastoma patients in INT-0098 were retrospectively reviewed for PRETEXT and other potential prognostic factors including pathologic subtype, and alpha-fetoprotein (AFP). Results. Five-year overall survival by PRETEXT was 88.9%, 84.5%, 71.6%, and 30.9%, for PRETEXT I, II, III, and IV, respectively. The 5-year overall survival rates by COG stage were 100%, 97.5%, 100%, 70.2%, and 39.3% for Stage I pure fetal histology (PFH), Stage I unfavorable histology (UH = not PFH), Stage II, Stage III, and Stage IV, respectively. PRETEXT added significant additional prognostic information within the COG Stage III, but not COG Stage IV. Additional prognostic factors statistically significant for an increased risk of death were small-cell-undifferentiated (SCU) histologic subtype and AFP < 100 at diagnosis. Conclusions. PRETEXT, COG stage, SCU histology, and AFP < 100, as assessed at diagnosis, are important determinants of survival that will allow us to better develop common international criteria for risk stratification. Common risk stratification is an essential prerequisite to establish effective cooperation across the ocean in this field of rare tumors.

Original languageEnglish (US)
Pages (from-to)1016-1022
Number of pages7
JournalPediatric Blood and Cancer
Volume53
Issue number6
DOIs
StatePublished - Dec 8 2009
Externally publishedYes

Fingerprint

Hepatoblastoma
Histology
alpha-Fetoproteins
Survival
Drug Therapy
Oceans and Seas
Neoplasms
Survival Rate
Pediatrics
Liver

Keywords

  • Alpha-fetoprotein
  • Hepatoblastoma
  • Overall survival
  • PRETEXT
  • Prognostic factors
  • Small cell undifferentiated histology
  • Stage
  • Surgical margin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Predictive power of pretreatment prognostic factors in children with hepatoblastoma : A report from the Children's Oncology Group. / Meyers, Rebecka L.; Rowland, Jon R.; Krailo, Mark; Chen, Zhengjia; Katzenstein, Howard M.; Malogolowkin, Marcio.

In: Pediatric Blood and Cancer, Vol. 53, No. 6, 08.12.2009, p. 1016-1022.

Research output: Contribution to journalArticle

Meyers, Rebecka L. ; Rowland, Jon R. ; Krailo, Mark ; Chen, Zhengjia ; Katzenstein, Howard M. ; Malogolowkin, Marcio. / Predictive power of pretreatment prognostic factors in children with hepatoblastoma : A report from the Children's Oncology Group. In: Pediatric Blood and Cancer. 2009 ; Vol. 53, No. 6. pp. 1016-1022.
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abstract = "Background. PRETEXT is used to stratify risk in children with hepatoblastoma by the Liver Tumor Strategy Group (SIOPEL) of the International Society of Pediatric Oncology (SIOP). A recent analysis excluding patients that did not survive neoadjuvant chemotherapy, concluded that PRETEXT was superior to Children's Oncology Group (COG) stage for predicting survival. Puzzled by this result, we made a similar comparison of PRETEXT and COG stage. This time, however, we include all patients, and we compare predictive value at diagnosis, instead of after neoadjuvant chemotherapy. Methods. Hepatoblastoma patients in INT-0098 were retrospectively reviewed for PRETEXT and other potential prognostic factors including pathologic subtype, and alpha-fetoprotein (AFP). Results. Five-year overall survival by PRETEXT was 88.9{\%}, 84.5{\%}, 71.6{\%}, and 30.9{\%}, for PRETEXT I, II, III, and IV, respectively. The 5-year overall survival rates by COG stage were 100{\%}, 97.5{\%}, 100{\%}, 70.2{\%}, and 39.3{\%} for Stage I pure fetal histology (PFH), Stage I unfavorable histology (UH = not PFH), Stage II, Stage III, and Stage IV, respectively. PRETEXT added significant additional prognostic information within the COG Stage III, but not COG Stage IV. Additional prognostic factors statistically significant for an increased risk of death were small-cell-undifferentiated (SCU) histologic subtype and AFP < 100 at diagnosis. Conclusions. PRETEXT, COG stage, SCU histology, and AFP < 100, as assessed at diagnosis, are important determinants of survival that will allow us to better develop common international criteria for risk stratification. Common risk stratification is an essential prerequisite to establish effective cooperation across the ocean in this field of rare tumors.",
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T1 - Predictive power of pretreatment prognostic factors in children with hepatoblastoma

T2 - A report from the Children's Oncology Group

AU - Meyers, Rebecka L.

AU - Rowland, Jon R.

AU - Krailo, Mark

AU - Chen, Zhengjia

AU - Katzenstein, Howard M.

AU - Malogolowkin, Marcio

PY - 2009/12/8

Y1 - 2009/12/8

N2 - Background. PRETEXT is used to stratify risk in children with hepatoblastoma by the Liver Tumor Strategy Group (SIOPEL) of the International Society of Pediatric Oncology (SIOP). A recent analysis excluding patients that did not survive neoadjuvant chemotherapy, concluded that PRETEXT was superior to Children's Oncology Group (COG) stage for predicting survival. Puzzled by this result, we made a similar comparison of PRETEXT and COG stage. This time, however, we include all patients, and we compare predictive value at diagnosis, instead of after neoadjuvant chemotherapy. Methods. Hepatoblastoma patients in INT-0098 were retrospectively reviewed for PRETEXT and other potential prognostic factors including pathologic subtype, and alpha-fetoprotein (AFP). Results. Five-year overall survival by PRETEXT was 88.9%, 84.5%, 71.6%, and 30.9%, for PRETEXT I, II, III, and IV, respectively. The 5-year overall survival rates by COG stage were 100%, 97.5%, 100%, 70.2%, and 39.3% for Stage I pure fetal histology (PFH), Stage I unfavorable histology (UH = not PFH), Stage II, Stage III, and Stage IV, respectively. PRETEXT added significant additional prognostic information within the COG Stage III, but not COG Stage IV. Additional prognostic factors statistically significant for an increased risk of death were small-cell-undifferentiated (SCU) histologic subtype and AFP < 100 at diagnosis. Conclusions. PRETEXT, COG stage, SCU histology, and AFP < 100, as assessed at diagnosis, are important determinants of survival that will allow us to better develop common international criteria for risk stratification. Common risk stratification is an essential prerequisite to establish effective cooperation across the ocean in this field of rare tumors.

AB - Background. PRETEXT is used to stratify risk in children with hepatoblastoma by the Liver Tumor Strategy Group (SIOPEL) of the International Society of Pediatric Oncology (SIOP). A recent analysis excluding patients that did not survive neoadjuvant chemotherapy, concluded that PRETEXT was superior to Children's Oncology Group (COG) stage for predicting survival. Puzzled by this result, we made a similar comparison of PRETEXT and COG stage. This time, however, we include all patients, and we compare predictive value at diagnosis, instead of after neoadjuvant chemotherapy. Methods. Hepatoblastoma patients in INT-0098 were retrospectively reviewed for PRETEXT and other potential prognostic factors including pathologic subtype, and alpha-fetoprotein (AFP). Results. Five-year overall survival by PRETEXT was 88.9%, 84.5%, 71.6%, and 30.9%, for PRETEXT I, II, III, and IV, respectively. The 5-year overall survival rates by COG stage were 100%, 97.5%, 100%, 70.2%, and 39.3% for Stage I pure fetal histology (PFH), Stage I unfavorable histology (UH = not PFH), Stage II, Stage III, and Stage IV, respectively. PRETEXT added significant additional prognostic information within the COG Stage III, but not COG Stage IV. Additional prognostic factors statistically significant for an increased risk of death were small-cell-undifferentiated (SCU) histologic subtype and AFP < 100 at diagnosis. Conclusions. PRETEXT, COG stage, SCU histology, and AFP < 100, as assessed at diagnosis, are important determinants of survival that will allow us to better develop common international criteria for risk stratification. Common risk stratification is an essential prerequisite to establish effective cooperation across the ocean in this field of rare tumors.

KW - Alpha-fetoprotein

KW - Hepatoblastoma

KW - Overall survival

KW - PRETEXT

KW - Prognostic factors

KW - Small cell undifferentiated histology

KW - Stage

KW - Surgical margin

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