Beate Haeberle1, Arun Rangaswami2, Mark Krailo3, Piotr Czauderna4, Eiso Hiyama5, Rudolf Maibach6, Dolores Lopez-Terrada7, Daniel C Aronson8, Rita Alaggio9, Marc Ansari10, Marcio H Malogolowkin11, Giorgio Perilongo12, Allison F O'Neill13, Angela D Trobaugh-Lotrario14, Kenichiro Watanabe15, Irene Schmid16, Dietrich von Schweinitz1, Sarangarajan Ranganathan17, Kenichi Yoshimura18, Tomoro Hishiki19, Yukichi Tanaka20, Jin Piao3, Yurong Feng21, Eugenia Rinaldi22, Davide Saraceno22, Marisa Derosa22, Rebecka L Meyers23. 1. Division of Pediatric Surgery, University of Munich, Munich, Germany. 2. Division of Pediatric Hematology and Oncology, University of California San Francisco, San Francisco, California. 3. Department of Preventive Medicine, University of Southern California, California, Los Angeles. 4. Department of Surgery for Children and Adolescents, Medical University of Gdansk, Gdansk, Poland. 5. Department of Pediatric Surgery, Hiroshima University, Hiroshima, Japan. 6. IBCSG Coordinating Center, Bern, Switzerland. 7. Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas. 8. Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland. 9. Department of Pathology, Bambino Gesu Pediatric Hospital, Roma, Italy. 10. Pediatric Department, Onco-Hematology Unit, Geneva University Hospital, Geneva, Switzerland. 11. Division of Pediatric Hematology Oncology, University of California Davis Comprehensive Cancer Center, California, Sacramento. 12. Department of Pediatrics, University of Padua, Padua, Italy. 13. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts. 14. Department of Pediatric Hematology/Oncology, Providence Sacred Heart Children's Hospital Spokane, Washington. 15. Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan. 16. Department of Pediatric Hematology and Oncology, University of Munich, Munich, Germany. 17. Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Mediacla Center, Cincinnati, Ohio. 18. Innovative Clinical Research Center (iCREK), Kanazawa University Hospital, Japan. 19. Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. 20. Department of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan. 21. Children's Oncology Group, Los Angeles, California. 22. CINECA, Bologna, Italy. 23. Division of Pediatric Surgery, University of Utah School of Medicine, Utah, Salt Lake City.
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.
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.
Authors: Pavel Sumazin; Tricia L Peters; Stephen F Sarabia; Hyunjae R Kim; Martin Urbicain; Emporia Faith Hollingsworth; Karla R Alvarez; Cintia R Perez; Alice Pozza; Mohammad Javad Najaf Panah; Jessica L Epps; Kathy Scorsone; Barry Zorman; Howard Katzenstein; Allison F O'Neill; Rebecka Meyers; Greg Tiao; Jim Geller; Sarangarajan Ranganathan; Arun A Rangaswami; Sarah E Woodfield; John A Goss; Sanjeev A Vasudevan; Andras Heczey; Angshumoy Roy; Kevin E Fisher; Rita Alaggio; Kalyani R Patel; Milton J Finegold; Dolores H López-Terrada Journal: J Hepatol Date: 2022-05-14 Impact factor: 30.083
Authors: Juri Fuchs; Anastasia Murtha-Lemekhova; Markus Kessler; Fabian Ruping; Patrick Günther; Alexander Fichtner; Dominik Sturm; Katrin Hoffmann Journal: Cancers (Basel) Date: 2022-01-06 Impact factor: 6.639