The importance of age as prognostic factor for the outcome of patients with hepatoblastoma: Analysis from the Children's Hepatic tumors International Collaboration (CHIC) database

Beate Haeberle, Arun Rangaswami, Mark Krailo, Piotr Czauderna, Eiso Hiyama, Rudolf Maibach, Dolores Lopez-Terrada, Daniel C. Aronson, Rita Alaggio, Marc Ansari, Marcio H. Malogolowkin, Giorgio Perilongo, Allison F. O'Neill, Angela D. Trobaugh-Lotrario, Kenichiro Watanabe, Irene Schmid, Dietrich von Schweinitz, Sarangarajan Ranganathan, Kenichi Yoshimura, Tomoro HishikiYukichi Tanaka, Jin Piao, Yurong Feng, Eugenia Rinaldi, Davide Saraceno, Marisa Derosa, Rebecka L. Meyers

Research output: Contribution to journalArticle

Abstract

Purpose: Treatment outcomes for hepatoblastoma have improved markedly in the contemporary treatment era, principally due to therapy intensification, with overall survival increasing from 35% in the 1970s to 90% at present. Unfortunately, these advancements are accompanied by an increased incidence of toxicities. A detailed analysis of age as a prognostic factor may support individualized risk-based therapy stratification. Methods: We evaluated 1605 patients with hepatoblastoma included in the CHIC database to assess the relationship between event-free survival (EFS) and age at diagnosis. Further analysis included the age distribution of additional risk factors and the interaction of age with other known prognostic factors. Results: Risk for an event increases progressively with increasing age at diagnosis. This pattern could not be attributed to the differential distribution of other known risk factors across age. Newborns and infants are not at increased risk of treatment failure. The interaction between age and other adverse risk factors demonstrates an attenuation of prognostic relevance with increasing age in the following categories: metastatic disease, AFP < 100 ng/mL, and tumor rupture. Conclusion: Risk for an event increased with advancing age at diagnosis. Increased age attenuates the prognostic influence of metastatic disease, low AFP, and tumor rupture. Age could be used to modify recommended chemotherapy intensity.

Original languageEnglish (US)
Article numbere28350
JournalPediatric Blood and Cancer
Volume67
Issue number8
DOIs
StatePublished - Aug 1 2020

Keywords

  • age
  • CHIC
  • hepatoblastoma
  • pediatric liver tumor
  • prognostic factor

ASJC Scopus subject areas

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

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    Haeberle, B., Rangaswami, A., Krailo, M., Czauderna, P., Hiyama, E., Maibach, R., Lopez-Terrada, D., Aronson, D. C., Alaggio, R., Ansari, M., Malogolowkin, M. H., Perilongo, G., O'Neill, A. F., Trobaugh-Lotrario, A. D., Watanabe, K., Schmid, I., von Schweinitz, D., Ranganathan, S., Yoshimura, K., ... Meyers, R. L. (2020). The importance of age as prognostic factor for the outcome of patients with hepatoblastoma: Analysis from the Children's Hepatic tumors International Collaboration (CHIC) database. Pediatric Blood and Cancer, 67(8), [e28350]. https://doi.org/10.1002/pbc.28350