The importance of age as a prognostic predictor of childhood hepatoblastoma: an analysis of single-center childhood hepatoblastoma in China

Abstract

Abstract Objective The study investigates the impact of age at initial diagnosis on the prognosis of pediatric hepatoblastoma (HB) patients, aiming to provide a basis for optimizing risk stratification. Methods Data from 403 patients with HB diagnosed at the First Affiliated Hospital of Sun Yat-sen University between February 2010 and September 2023 were collected. Kaplan‒Meier survival analysis, Cox regression analysis, and binary logistic regression were employed for statistical analysis. Results The hazard ratios (HRs) for event-free survival (EFS) reduction in HB patients were 1, 0.862, 1.393, 2.008, 1.325, 1.859, 3.667 (P = 0.001), and 2.502 (P = 0.023) for first–diagnosis ages of 0–1, 1–2, 2–3, 3–4, 4–5, 5–6, 6–8, and ≥ 8 years, respectively. After adjusting for newly diagnosed alpha-fetoprotein (AFP), pretreatment extent of tumor (PRETEXT) stage, and PRETEXT stage annotation factors, the prognosis of HB for patients diagnosed at ≥ 6 years old and < 6 years old remained significantly different. Children diagnosed at age ≥ 6 years who received the full-course high-risk group chemotherapy regimen had a higher EFS compared to those who did not receive the full-course high-risk group chemotherapy regimen (P = 0.033). Conclusion Age ≥ 6 years is an independent risk factor for poor prognosis in HB patients. The inclusion of patients aged ≥ 6 years at first diagnosis in the high-risk group for risk stratification was deemed appropriate. This age factor can guide adjustments in chemotherapy intensity. Clinical trial number Not applicable.

Keywords

• Age
• Hepatoblastoma
• Child
• Prognosis