Prognostic implications of serum alpha-fetoprotein response during treatment of hepatoblastoma

• Published in: Pediatric blood & cancer 2011-10, Vol.57 (4), p.554-560
• Main Authors: Koh, Kyung Nam, Park, Meerim, Kim, Bo Eun, Bae, Keun Wook, Kim, Kyung Mo, Im, Ho Joon, Seo, Jong Jin
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; alpha-fetoprotein; alpha-Fetoproteins - analysis; Antineoplastic Agents - administration & dosage; Area Under Curve; Biomarkers, Tumor - blood; Chemotherapy, Adjuvant; Child; Child, Preschool; Combined Modality Therapy; Disease-Free Survival; Female; Hepatectomy; hepatoblastoma; Hepatoblastoma - blood; Hepatoblastoma - therapy; Humans; Infant; Kaplan-Meier Estimate; Liver Neoplasms - blood; Liver Neoplasms - therapy; liver transplantation; Male; Neoadjuvant Therapy; Prognosis; prognostic factors; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Treatment Outcome; Young Adult
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.23069

Background We evaluated the outcomes and prognostic factors, especially serum levels of alpha‐fetoprotein (AFP) and their changes during the treatment of hepatoblastoma (HB). Procedure We retrospectively analyzed the medical records of 43 consecutive children with HB treated at a single institution between 1991 and 2010. Results Of 43 patients, 5 (12%) underwent primary tumor resection at diagnosis and 38 (88%) received preoperative chemotherapy. Of those 38 patients, 7 (16%) died of progressive disease during preoperative chemotherapy, and 31 (72%) underwent curative operations, including 5 who underwent liver transplantation, after a median 4 cycles of chemotherapy (range, 3–14 cycles). The 5‐year overall survival and disease‐free survival rates were 62.1 ± 8.3% and 65.6 ± 7.6%, respectively. AFP >263,000 ng/mL at diagnosis, a decline of