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The importance of age as prognostic factor for the outcome of patients with hepatoblastoma: Analysis from the Children's Hepatic tumors International Collaboration (CHIC) database
- Source :
- Pediatric blood & cancer, Vol. 67, No 8 (2020) P. e28350
- Publication Year :
- 2019
-
Abstract
- Purpose: Treatment outcomes for hepatoblastoma have improved markedly in the contemporary treatment era, principally due to therapy intensification, with overall survival increasing from 35% in the 1970s to 90% at present. Unfortunately, these advancements are accompanied by an increased incidence of toxicities. A detailed analysis of age as a prognostic factor may support individualized risk-based therapy stratification.Methods: We evaluated 1605 patients with hepatoblastoma included in the CHIC database to assess the relationship between event-free survival (EFS) and age at diagnosis. Further analysis included the age distribution of additional risk factors and the interaction of age with other known prognostic factors.Results: Risk for an event increases progressively with increasing age at diagnosis. This pattern could not be attributed to the differential distribution of other known risk factors across age. Newborns and infants are not at increased risk of treatment failure. The interaction between age and other adverse risk factors demonstrates an attenuation of prognostic relevance with increasing age in the following categories: metastatic disease, AFP < 100 ng/mL, and tumor rupture.Conclusion: Risk for an event increased with advancing age at diagnosis. Increased age attenuates the prognostic influence of metastatic disease, low AFP, and tumor rupture. Age could be used to modify recommended chemotherapy intensity.
- Subjects :
- Hepatoblastoma
Male
Pediatric liver tumor
pediatric liver tumor
Databases, Factual
medicine.medical_treatment
Disease
Liver Neoplasms / mortality
computer.software_genre
0302 clinical medicine
Risk Factors
Prospective Studies
Age of Onset
Neoplasm Metastasis
Prospective cohort study
prognostic factor
Child
Prognostic factor
ddc:618
Database
Liver Neoplasms / diagnosis
Incidence (epidemiology)
Incidence
Liver Neoplasms
Hematology
Liver Neoplasms / therapy
3. Good health
Survival Rate
Oncology
Hepatoblastoma / diagnosis
030220 oncology & carcinogenesis
Child, Preschool
CHIC
Female
Adolescent
Liver Neoplasms / pathology
Disease-Free Survival
03 medical and health sciences
Age
medicine
Humans
Survival rate
Chemotherapy
Hepatoblastoma / therapy
business.industry
age
hepatoblastoma
Hepatoblastoma / pathology
Infant, Newborn
Infant
medicine.disease
Pediatrics, Perinatology and Child Health
Age of onset
Hepatoblastoma / mortality
business
computer
030215 immunology
Subjects
Details
- ISSN :
- 15455017 and 15455009
- Volume :
- 67
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Pediatric bloodcancerREFERENCES
- Accession number :
- edsair.doi.dedup.....69730aefa7dd5266f40ea54d23985651