Treatment and prognosis analysis of 56 cases of childhood hepatoblastoma in advanced stage with pulmonary metastasis
10.3760/cma.j.issn.2095-428X.2018.03.014
- VernacularTitle:儿童晚期肝母细胞瘤伴肺转移56例的治疗及预后分析
- Author:
Tian ZHI
1
;
Weiling ZHANG
;
Dongsheng HUANG
;
Yi ZHANG
;
Huimin HU
;
You YI
;
Yanan GAO
Author Information
1. 100176,首都医科大学附属北京同仁医院儿科
- Keywords:
Hepatoblastoma;
Pulmonary metastasis;
Chemotherapy;
Child;
Alpha fetoprotein;
Prognosis
- From:
Chinese Journal of Applied Clinical Pediatrics
2018;33(3):217-220
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the treatment and prognosis of advanced stage childhood hepatoblastoma with pulmonary metastasis.Methods Fifty-six cases of advanced stage hepatoblastoma with pulmonary metastasis diagnosed through pathology from April 2006 to June 2014 in Department of Pediatrics,Beijing Tongren Hospital Affilia-ted to Capital Medical University were enrolled,among them 33 cases were males and 23 cases were females,and the median age was 2.33 years old(1 month-15 years and 1 month old).The clinical effects of multidisciplinary therapy were analyzed.Results (1)Follow-up studies were conducted till December 2016,in which 21 cases of 56 children achieved complete remission,the complete remission rate was 37.5%(21/56 cases),while 12 cases were partial re-mission and 14 cases were deceased,and the effective rate reached 58.9%(33/56 cases).The follow-up period of 41 children were over 24 months,in which the 2-year free event survival(EFS)rate was 37.5%,2-year overall survi-val(OS)rate was 75.0%,5-year survival rate was 42.4%,and the 95% average survival confidence interval was 35.7-55.9 months.(2)The OS rate of children with small age(≤3 years old)was 88.1%(36/42 cases),the ove-rall prognosis was better than that of >3 years old children(35.7%,5/14 cases)(P=0.003).The survival rate of children with complete tumor resection[OS rate was 89.2%(33/37 cases)]was significantly higher than that of the incomplete excision[OS rate was 47.4%(9/19 cases)],and the difference was statistically significant(P=0.001). The prognosis of epithelial type cases was better than that of other types,and the difference was statistically significant (P<0.05),while the fetal type prognosis was the best,and the difference was statistically significant(χ2=8.56,P=0.014).The growth of alpha fetoprotein was negatively correlated with the clinical efficacy and prognosis(r=-0.468, P=0.023).Conclusions Lung is the most common metastatic site of hepatoblastoma,and the marginal lung metasta-sis is more common.With insidious onset and poor prognosis.Therefore,it should be treated with early diagnosis and multidisciplinary therapy to improve prognosis.
