A single-center retrospective analysis of childhood hepatoblastoma in China

Abstract

Background: This study aimed to investigate the critical factors associated with prognosis for children with hepatoblastoma (HB) in mainland China combined with the aspect of health economics and management.

Methods: This study retrospectively reviewed children with HB in Renji Hospital Affiliated to the Shanghai Jiao Tong University School of Medicine from January 2013 to December 2019. Descriptive analysis was used to describe the essential characteristics. Kaplan-Meier method and Cox proportional hazard models were used to estimate the survival rate and prognosis factors.

Results: For the 87 children with HB, the average survival was 2,002.8 days (95% CI: 1,798.7-2,206.9 days), the 1- and 5-year survival rates were 87.7% and 78.9%, respectively. Undergoing surgery and sex were independent prognostic factors of childhood HB. Children with HB undergoing hepatectomy (HR: 0.039) or liver transplantation (HR: 0.142) had a better prognosis, while boys were associated with a poorer prognosis (HR: 3.614). The average medical expenses for childhood HB were 40,217.5±3,862.0 CNY and liver transplantation cost more than hepatectomy.

Conclusions: The results had a comparable survival rate with other studies globally. Surgical therapy and sex are associated with the prognosis of children with HB. The economic burden of childhood HB deserves to be further explored.

Keywords: Hepatoblastoma (HB); children; prognosis; survival.

Figure 1

Overall survival estimates. (A) The overall survival curve; (B) stratified by sex (P=0.485); (C) stratified by age (P=0.852); (D) stratified by surgery (P<0.0001); (E) stratified by preoperative chemotherapy (P=0.965); (F) stratified by postoperative chemotherapy (P=0.007); (G) stratified by length of stay (P=0.100).

Figure 2

Overall survival estimates. Stratified by (A) abdominal distension/abdominal mass (P=0.233); (B) increased abdominal circumference (P=0.826); (C) abdominal pain and discomfort (P=0.311); (D) fever/recurrent fever (P=0.136); (E) asymptomatic medical examination (P=0.938); (F) loss of appetite/nausea and vomiting (P=0.681); (G) abnormal urine (P=0.812); (H) yellow staining of skin sclera (P=0.900); (I) cough (P=0.545); (J) abdominal pain after trauma (P=0.454); (K) other presenting signs (P=0.055).

Figure 3

The survival curve. (A) Stratified by surgery after controlling other factors; (B) stratified by sex after controlling other factors.