Comparison of the Risk Stratification Systems of CHIC and New CCCG in the Prognostic Evaluation of Hepatoblastoma
10.11714/jsysu.med.YX20250133
- VernacularTitle:儿童肝肿瘤国际协作组和中国儿童肿瘤组新危险度分层在肝母细胞瘤预后评估中的应用比较
- Author:
Zhen LI
1
;
Hong JIANG
2
;
Wenqing WANG
3
;
Yuanqi WANG
4
;
Libin HUANG
5
;
Juncheng LIU
2
;
Hongman XUE
6
Author Information
1. Pediatric Intensive Care Unit， The Seventh Affiliated Hospital of Sun Yat-sen University， Shenzhen 518107， China
2. Department of Pediatric Surgery， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510062， China
3. Department of Gastrointestinal Surgery， The Seventh Affiliated Hospital of Sun Yat-sen University， Shenzhen 518107， China
4. Department of Hepatobiliary Surgery， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510062， China
5. Second Department of Pediatrics， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510062， China
6. Pediatric Hematology Laboratory， Division of Hematology// Oncology， Department of Pediatrics， The Seventh Affiliated Hospital of Sun Yat-sen University， Shenzhen 518107， China
- Publication Type:Journal Article
- Keywords:
child;
hepatoblastoma;
risk stratification;
chemotherapy;
prognosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(2):346-353
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo compare the Children's Hepatic tumors International Collaboration （CHIC） and the new Chinese Children's Cancer Group （CCCG） hepatoblastoma （HB） risk stratification systems in terms of their prognostic prediction efficacy and chemotherapy guidance value for Chinese children with HB， aiming to identify the risk stratification system more suitable for Chinese HB patients. MethodsThis retrospective study analyzed the clinical data of 403 pediatric patients with HB aged ＜ 18 years who were initially diagnosed at The First Affiliated Hospital of Sun Yat-sen University between February 2010 and September 2023. The prognostic predictive efficacy and chemotherapy-guided value of the CHIC and CCCG risk stratification systems was compared. Statistical analysis was performed using SPSS 27.0. Results①Using the new CCCG risk stratification， the 5-year event-free survival （EFS） rates for children who received versus did not receive risk-stratified chemotherapy according to the CCCG-HB-2016 protocol were 82.5% and 67.7% （P=0.002）， respectively， and the 5-year overall survival （OS） rates were 91.5% and 85.1% （P=0.038）. Using CHIC risk stratification， the corresponding 5-year EFS rates for children who received versus did not receive risk-stratified chemotherapy according to the CCCG-HB-2016 protocol were 80.3% and 68.5% （P=0.030）， and the 5-year OS rates were 90.9% and 85.8% （P=0.151）. ②Among children treated with the CCCG-HB-2016 protocol stratified by the new CCCG system， the 5-year EFS rates for the very low-risk （6 cases）， low-risk （20 cases）， intermediate-risk （61 cases）， and high-risk （69 cases） groups were 100%， 94.1%， 94.7%， and 66.2% （P＜0.001）， respectively， and the 5-year OS rates were 100%， 100%， 96.5%， and 82.0% （P=0.017）. Among children treated with the CCCG-HB-2016 protocol stratified by the CHIC system， the 5-year EFS rates for the very low-risk （32 cases）， low-risk （22 cases）， intermediate-risk （37 cases）， and high-risk （54 cases） groups were 93.8%， 95.2%， 76.1%， and 66.8% （P=0.003）， respectively， and the 5-year OS rates were 93.1%， 100%， 89.5%， and 85.6% （P=0.190）. ③For patients receiving CCCG-HB-2016 risk-stratified chemotherapy， the P-values for EFS comparisons between the CHIC and new CCCG systems within the very low-risk， low-risk， intermediate-risk， and high-risk groups were 0.537， 0.879， 0.023， and 0.934， respectively. Among patients who received stratified chemotherapy according to the CCCG-HB-2016 regimen， the intermediate-risk group in the new CCCG risk stratification system exhibited a significant advantage in 5-year event-free survival （EFS） compared with the intermediate-risk group in the CHIC risk stratification system （94.7% vs. 76.1%）. ConclusionCompared to the CHIC risk stratification， the new CCCG stratification may offer better prognostic prediction and guidance value for chemotherapy in Chinese HB patients， with the intermediate-risk group showing superior outcomes.
