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. 2013 Oct;15(10):741-6.
doi: 10.1111/hpb.12112. Epub 2013 Apr 22.

Predictors of survival and incidence of hepatoblastoma in the paediatric population

Bassan J Allan  1 , Punam P Parikh, Sofia Diaz, Eduardo A Perez, Holly L Neville, Juan E Sola
Affiliations

Predictors of survival and incidence of hepatoblastoma in the paediatric population

Bassan J Allan et al. HPB (Oxford). 2013 Oct.

Abstract

Objectives: This study evaluates current trends in incidence, clinical outcomes and factors predictive of survival in children with hepatoblastoma (HB).

Methods: The Surveillance, Epidemiology and End Results (SEER) database was queried for the period 1973-2009 for all patients aged <20 years with HB.

Results: A total of 606 patients were identified. The age-adjusted incidence was 0.13 patients per 100 000 in 2009. An annual percentage change of 2.18% (95% confidence interval (CI) 1.10-3.27; P < 0.05) was seen over the study period. Overall survival rates at 5, 10 and 20 years were 63%, 61% and 59%, respectively. Ten-year survival rates significantly improved in patients with resectable disease who underwent operative treatment in comparison with those with non-resectable HB (86% versus 39%; P < 0.0001). Multivariate analysis showed surgical treatment (hazard ratio (HR) = 0.23, 95% CI 0.17-0.31; P < 0.0001), Hispanic ethnicity (HR = 0.61, 95% CI 0.43-0.89; P = 0.01), local disease at presentation (HR = 0.43, 95% CI 0.29-0.63; P < 0.0001) and age < 5 years (HR = 0.63, 95% CI 0.41-0.95; P < 0.03) to be independent prognostic factors of survival.

Conclusions: The incidence of paediatric HB has increased over time. Hepatoblastoma is almost exclusively seen in children aged < 5 years. When HB presents after the age of 5 years, the prognosis is most unfavourable. Tumour extirpation markedly improves survival in paediatric patients with local disease.

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Figures

Figure 1
Figure 1
Incidence of hepatoblastoma in children over a 37-year period. The incidence of hepatoblastoma has increased over time (annual percentage change = 2.18%; P < 0.05), in line with increases in the incidence of all primary tumours of the liver in the paediatric population
Figure 2
Figure 2
Kaplan–Meier survival curves for paediatric patients with hepatoblastoma and resectable disease at presentation. Survival in patients with local disease is significantly better in those undergoing tumour resection compared with that in patients who do not undergo surgery (P < 0.0001)
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