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.
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.
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.
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
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)
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Published online: March 06, 2022
Accepted: February 28, 2022
Received in revised form: February 14, 2022
Received: September 6, 2021
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