Abstract
Background
Hepatoblastomas (HBs)are malignant liver tumors that most commonly develop in pediatric
patients. Although lymph node metastasis is rare in HBs, angiolymphatic invasion (ALI)
is a risk factor affecting the prognosis of HBs. This study aimed to evaluate the
risk factors for angiolymphatic invasion in HBs.
Methods
We retrospectively analyzed the clinical data of 165 patients with HBs who underwent
surgical resection at our institution between March 2016 and May 2021 and established
binary logistic regression models to predict risk factors for ALI. The R software
was used to construct the nomogram.
Results
For the regression model based on the Children's Hepatic Tumors International Collaboration–Hepatoblastoma
Stratification (CHIC–HS) system, tumor diameter, tumor response to neoadjuvant chemotherapy
(NACT), and CHIC–HS were identified as independent risk factors for angiolymphatic
invasion. For the regression model based on the pretreatment extent of the tumor (PRETEXT)
stages with annotation factors, tumor diameter, multifocality, macrovascular involvement,
tumor response to NACT, and PRETEXT stages were identified as independent risk factors
for angiolymphatic invasion.
Conclusions
Using the CHIC–HS system/PRETEXT stages with annotation factors, tumor diameter and
tumor response to NACT were identified as independent risk factors for angiolymphatic
invasion. The distance between the tumor and portal vein was negatively correlated
with the occurrence of multifocal tumors.
Level of evidence
Level III.
Keywords
Abbreviations:
AFP (alpha-fetoprotein), ALI (angiolymphatic invasion), AUC (area under the roc curve), BMI (body mass index), CHIC–HS (children's hepatic tumors international collaboration–hepatoblastoma stratification), COG (children's oncology group), CT (computed tomography), HB (hepatoblastoma), MRI (magnetic resonance imaging), NACT (neoadjuvant chemotherapy), PD (progressive disease), PHITT (Pediatric Hepatic International Tumor Trial), PRETEXT (pretreatment extent of the tumor), POSTTEXT (posttreatment extent of disease), ROC (receiver operating characteristic curve), SCUD (small cell undifferentiated), SD (stable disease), SIOPEL (International Childhood Liver Tumors Strategy Group)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Hepatoblastoma.Treasure island (FL). StatPearls, 2021
- Surgical management of hepatoblastoma and recent advances.Cancers. 2019; 11 (Basel)
- Hepatoblastoma–a rare liver tumor with review of literature.J Gastrointest Cancer. 2014; 45: 261-264
- Hepatoblastoma and pediatric hepatocellular carcinoma: an update.Pediatr Dev Pathol. 2020; 23: 79-95
- Hepatoblastoma state of the art: pre-treatment extent of disease, surgical resection guidelines and the role of liver transplantation.Curr Opin Pediatr. 2014; 26: 29-36
- PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT).Pediatr Radiol. 2017; 48 (2018): 536-554
- Risk-stratified staging in paediatric hepatoblastoma: a unified analysis from the Children's Hepatic tumors international collaboration.Lancet Oncol. 2017; 18: 122-131
- Hepatoblastoma: recent developments in research and treatment.Semin Pediatr Surg. 2012; 21: 21-30
- Successful treatment of childhood high-risk hepatoblastoma with dose-intensive multiagent chemotherapy and surgery: final results of the SIOPEL-3HR study.J Clin Oncol. 2010; 28: 2584-2590
- Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the Children's Cancer Group and the Pediatric Oncology Group.J Clin Oncol. 2000; 18: 2665-2675
Honda S, Hishiki T, Yokoi A, Kazama T, Takama Y, Hoshino K, et al. Paediatric Hepatic International Tumour Trial%J The Japanese Journal of Pediatric Hematology/Oncology%J The Japanese Journal of Pediatric Hematology/Oncology. 2019;56(2):107–12.
- The Children's Hepatic tumors International Collaboration (CHIC): novel global rare tumor database yields new prognostic factors in hepatoblastoma and becomes a research model.Eur J Cancer. 2016; 52: 92-101
- Characterization of pulmonary metastases in children with hepatoblastoma treated on Children's Oncology Group protocol AHEP0731 (the treatment of children with all stages of hepatoblastoma): a report from the Children's Oncology Group.J Clin Oncol. 2017; 35: 3465-3473
- Rare case of hemorrhagic brain metastasis from hepatoblastoma.J Pediatr Neurosci. 2012; 7: 73-74
- Contemporary management of hepatoblastoma.Curr Opin Organ Transplant. 2019; 24: 113-117
- Identification and validation of lymphovascular invasion as a prognostic and staging factor in node-negative esophageal squamous cell carcinoma.J Thorac Oncol. 2016; 11: 583-592
- A system of classifying microvascular invasion to predict outcome after resection in patients with hepatocellular carcinoma.Gastroenterology. 2009; 137: 850-855
- Significance of clinicopathological features and microsatellite variations in hepatoblastoma.Chin J Cancer Prev Treat. 2016; 23: 722-726
- The prognostic role of angiolymphatic invasion in N0 esophageal carcinoma: a meta-analysis and systematic review.J Thorac Dis. 2019; 11: 3276-3283
- Clinicopathological features, recurrence patterns, and prognosis of pancreatic adenocarcinoma with normal serum CA19-9. A consecutive series of 154 cases from a single institute.J Gastrointest Surg. 2020; 24: 855-865
- Aberrant metastatic behavior and particular features of early gastric cancer.APMIS. 2015; 123: 999-1006
- Immunohistochemical coexpression of epithelial cell adhesion molecule and alpha-fetoprotein in hepatocellular carcinoma.Can J Gastroenterol Hepatol. 2018; 20185970852
- 2005 PRETEXT: a revised staging system for primary malignant liver tumours of childhood developed by the SIOPEL group.Pediatr Radiol. 2007; 37 (quiz 249-150): 123-132
- Towards an international pediatric liver tumor consensus classification: proceedings of the Los Angeles COG liver tumors symposium.Mod Pathol. 2014; 27: 472-491
- Small cell undifferentiated variant of hepatoblastoma: adverse clinical and molecular features similar to rhabdoid tumors.Pediatr Blood Cancer. 2009; 52: 328-334
- Hepatoblastoma state of the art: pathology, genetics, risk stratification, and chemotherapy.Curr Opin Pediatr. 2014; 26: 19-28
- Current chemotherapeutic approaches for hepatoblastoma.Int J Clin Oncol. 2013; 18: 955-961
- Hepatoblastoma in children.Formos J Surg. 2013; 46: 105-108
- Cisplatin, doxorubicin, and delayed surgery for childhood hepatoblastoma: a successful approach–results of the first prospective study of the International Society of Pediatric Oncology.J Clin Oncol. 2000; 18: 3819-3828
- Kinetics of primary tumor regression with chemotherapy: implications for the timing of surgery.Ann Surg Oncol. 1996; 3: 521-525
- Efficiency and toxicity of ifosfamide, cisplatin and doxorubicin in the treatment of childhood hepatoblastoma. Study Committee of the Cooperative Paediatric Liver Tumour Study HB89 of the German Society for Paediatric Oncology and Haematology.Eur J Cancer. 1997; 33: 1243-1249
- Outcomes and predictors of microvascular invasion of solitary hepatocellular carcinoma.Hepatol Res. 2014; 44: 846-853
- Nomogram for preoperative estimation of microvascular invasion risk in hepatitis B virus-related hepatocellular carcinoma within the Milan criteria.JAMA Surg. 2016; 151: 356-363
- Review of angiogenesis in hepatocellular carcinoma.Hepatol Res. 2015; 45: 1-9
Article info
Publication history
Published online: March 06, 2022
Accepted:
February 28,
2022
Received in revised form:
February 14,
2022
Received:
September 6,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.