Clinical effectiveness of multimodality treatment on advanced pediatric hepatoblastoma

Y. Zhang, W.-l. Zhang, D.-s. Huang, L. Hong, Y.-z. Wang, X. Zhu, H.-m. Hu, P.-w. Zhang, Y. Yi, T. Han

Department of Pediatrics, Chinese PLA General Hospital, Beijing, P.R. China. dongshenghuang99@163.com

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• Oncology

OBJECTIVES: To investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma and the factors affecting the prognosis.

PATIENTS AND METHODS: 35 childhood patients were treated with multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. Patients were followed up every month.

RESULTS: 33 patients completed the follow-up, of which 17 were in complete remission, 5 were in partial remission, 1 case got worse, and 10 died. The remission rate was 66.7% (22/33), and the overall survival rate was 69.7% (23/33). 1 patient with advanced hepatoblastoma got high-dose chemotherapy combined with autologous peripheral blood stem cell transplantation (APBSCT) treatment, and a primary lesion by 18 x 15 x 9 cm reduced to 10 x 8 x 4 cm. Remote metastases significantly alleviated, and partial remission reached six months. The overall survival was 9 months after transplantation. Patients with the mixed phenotype of hepatoblastoma had a worse prognosis than with the epithelial phenotype (p < 0.001), and patients in stage IV had a lower survival rate than in stage III (p < 0.001).

CONCLUSIONS: Multimodality treatment can effectively improve remission rate and prolong the survival of children with the advanced hepatoblastoma. In addition, alpha-fetoprotein (AFP), hepatoblastoma pathological classification and staging are of great use in prediction of prognosis.

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