Postchemotherapy alpha-fetoprotein and baseline PRETEXT groups in young children with hepatoblastoma in Lima, Peru
DOI:
https://doi.org/10.64716/aqkevp15Palabras clave:
Hepatoblastoma, Alpha-Fetoproteins, Neoplasm Staging, Child, Preschool, Peru, InfantResumen
Background: Biochemical markers and anatomical staging describe different aspects of hepatoblastoma and require interpretation according to treatment timing. Objective: To assess the association between postchemotherapy serum alpha-fetoprotein (AFP) categories and baseline pretreatment extent of tumor (PRETEXT) groups in young children with hepatoblastoma at a referral hospital in Lima, Peru. Methods: A retrospective analytical record review included 30 eligible patients from 37 identified during 2018–2024. Age, sex, baseline and postchemotherapy AFP, baseline PRETEXT group, and pulmonary metastasis were extracted from clinical records. Frequencies and percentages described the sample. Associations were assessed using the Fisher–Freeman–Halton exact test; Pearson chi-square and Cramér’s V were also calculated. Results: Eighteen patients (60.0%) were male. All patients had baseline AFP >1,000 ng/mL. After neoadjuvant chemotherapy, AFP was <100 ng/mL in 17 patients (56.7%), 100–1,000 ng/mL in three (10.0%), and >1,000 ng/mL in ten (33.3%). PRETEXT groups I, II, III, and IV accounted for 10.0%, 20.0%, 30.0%, and 40.0%, respectively. Pulmonary metastasis was documented in 14 patients (46.7%). The association between postchemotherapy AFP and baseline PRETEXT was not statistically significant (exact p = 0.287; Pearson χ² = 8.131, six degrees of freedom, p = 0.229; Cramér’s V = 0.368). Conclusions: Lower AFP categories were frequent after chemotherapy, including among children with extensive baseline hepatic involvement. These findings describe the joint distribution of biochemical and anatomical findings without establishing an association or prognostic performance.
Descargas
Referencias
Pio L, O'Neill AF, Woodley H, Murphy AJ, Tiao G, Franchi-Abella S, et al. Hepatoblastoma. Nat Rev Dis Primers. 2025;11(1):36. https://doi.org/10.1038/s41572-025-00620-7 DOI: https://doi.org/10.1038/s41572-025-00620-7
Cao Y, Wu S, Tang H. An update on diagnosis and treatment of hepatoblastoma. Biosci Trends. 2023;17(6):445-457. https://doi.org/10.5582/bst.2023.01311 DOI: https://doi.org/10.5582/bst.2023.01311
Davini M, Hastings C, Feusner J. The Utility of Serum Alpha-fetoprotein for Monitoring for Relapse of Alpha-fetoprotein-Positive Hepatoblastoma. J Pediatr Hematol Oncol. 2024;46(4):206-210. https://doi.org/10.1097/mph.0000000000002832 DOI: https://doi.org/10.1097/MPH.0000000000002832
Jeong H, Yoon HM, Kim PH, Jung AY, Cho YA, Lee JS, et al. Prognostic Value of POST-Treatment Extent of Tumor (POSTTEXT) System in Patients with Hepatoblastoma. Cancer Res Treat. 2025;57(4):1198-1206. https://doi.org/10.4143/crt.2024.600 DOI: https://doi.org/10.4143/crt.2024.600
Towbin AJ, Meyers RL, Woodley H, Miyazaki O, Weldon CB, Morland B, et al. 2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatr Radiol. 2018;48(4):536-554. https://doi.org/10.1007/s00247-018-4078-z DOI: https://doi.org/10.1007/s00247-018-4078-z
Schooler GR, Infante JC, Acord M, Alazraki A, Chavhan GB, Davis JC, et al. Imaging of pediatric liver tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer. 2023;70 Suppl 4:e29965. https://doi.org/10.1002/pbc.29965 DOI: https://doi.org/10.1002/pbc.29965
Zhi T, Zhang WL, Zhang Y, Hu HM, Huang DS. Clinical characteristics and prognostic factors of hepatoblastoma in 316 children aged under 3 years - a 14-year retrospective single-center study. BMC Pediatr. 2021;21(1):170. https://doi.org/10.1186/s12887-021-02630-2 DOI: https://doi.org/10.1186/s12887-021-02630-2
Song H, Bucher S, Rosenberg K, Tsui M, Burhan D, Hoffman D, et al. Single-cell analysis of hepatoblastoma identifies tumor signatures that predict chemotherapy susceptibility using patient-specific tumor spheroids. Nat Commun. 2022;13(1):4878. https://doi.org/10.1038/s41467-022-32473-z DOI: https://doi.org/10.1038/s41467-022-32473-z
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296. https://doi.org/10.1371/journal.pmed.0040296 DOI: https://doi.org/10.1371/journal.pmed.0040296
World Medical Association. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA. 2025;333(1):71-74. https://doi.org/10.1001/jama.2024.21972 DOI: https://doi.org/10.1001/jama.2024.21972
Saeki I, Ida K, Kurihara S, Watanabe K, Mori M, Hishiki T, et al. Successful treatment of young childhood standard-risk hepatoblastoma with cisplatin monotherapy using a central review system. Pediatr Blood Cancer. 2024;71(11):e31255. https://doi.org/10.1002/pbc.31255 DOI: https://doi.org/10.1002/pbc.31255
Watanabe K, Mori M, Hishiki T, Yokoi A, Ida K, Yano M, et al. Feasibility of dose-dense cisplatin-based chemotherapy in Japanese children with high-risk hepatoblastoma: Analysis of the JPLT3-H pilot study. Pediatr Blood Cancer. 2022;69(2):e29389. https://doi.org/10.1002/pbc.29389 DOI: https://doi.org/10.1002/pbc.29389
Kastenberg ZJ, Vasudevan SA, Dolmadjian L, Langham MR, Piao J, Tiao GM, et al. Implementation of Comprehensive Surgical Guidelines for Hepatoblastoma: Analysis of the Children's Oncology Group AHEP0731 Phase III Trial. Ann Surg. 2025. Published online September 25. https://doi.org/10.1097/sla.0000000000006951 DOI: https://doi.org/10.1097/SLA.0000000000006951
Trobaugh-Lotrario AD, Maibach R, Aronson DC, Rangaswami A, Häberle B, O'Neill AF, et al. Outcomes of Patients Treated for Hepatoblastoma with Low Alpha-Fetoprotein and/or Small Cell Undifferentiated Histology: A Report from the Children's Hepatic Tumors International Collaboration (CHIC). Cancers (Basel). 2023;15(2):467. https://doi.org/10.3390/cancers15020467 DOI: https://doi.org/10.3390/cancers15020467
Trobaugh-Lotrario A, Katzenstein HM, Ranganathan S, Lopez-Terrada D, Krailo MD, Piao J, et al. Small Cell Undifferentiated Histology Does Not Adversely Affect Outcome in Hepatoblastoma: A Report From the Children's Oncology Group (COG) AHEP0731 Study Committee. J Clin Oncol. 2022;40(5):459-467. https://doi.org/10.1200/jco.21.00803 DOI: https://doi.org/10.1200/JCO.21.00803
Hiyama E, Hishiki T, Yoshimura K, Krailo M, Maibach R, Haeberle B, et al. Upfront or delayed surgery in resectable hepatoblastoma: analysis from the children's hepatic tumors international collaboration database. EClinicalMedicine. 2024;76:102811. https://doi.org/10.1016/j.eclinm.2024.102811 DOI: https://doi.org/10.1016/j.eclinm.2024.102811
Fuchs J, Rabaux-Eygasier L, Ruping F, Kessler M, Günther P, Hoffmann K, et al. Reappraisal of liver resection as an alternative to transplantation in locally advanced hepatoblastoma: A systematic review and analysis of pooled individual patient data. Pediatr Blood Cancer. 2024;71(12):e31339. https://doi.org/10.1002/pbc.31339 DOI: https://doi.org/10.1002/pbc.31339
Honda M, Uchida K, Irie T, Hirukawa K, Kadohisa M, Shimata K, et al. Recent advances in surgical strategies and liver transplantation for hepatoblastoma. Cancer Med. 2023;12(4):3909-3918. https://doi.org/10.1002/cam4.5300 DOI: https://doi.org/10.1002/cam4.5300
Li F, Zhang W, Hu H, Zhu X, Zhang Y, Huang D. Factors influencing recurrence after complete remission in children with hepatoblastoma: A 14-year retrospective study in China. PLoS One. 2021;16(11):e0259503. https://doi.org/10.1371/journal.pone.0259503 DOI: https://doi.org/10.1371/journal.pone.0259503
Espinoza AF, Patel KR, Shetty PB, Whitlock RS, Sumazin P, Yu X, et al. Navigating relapsed hepatoblastoma: Predictive factors and surgical treatment strategy. Cancer Med. 2023;12(23):21270-21278. https://doi.org/10.1002/cam4.6705 DOI: https://doi.org/10.1002/cam4.6705
López-Terrada DH, Webster F, Alaggio R, Bush JW, Cho SJ, de Krijger RR, et al. Pathology reporting of hepatoblastoma resections: recommendations from the international collaboration on cancer reporting. Histopathology. 2025;87(6):802-814. https://doi.org/10.1111/his.15536 DOI: https://doi.org/10.1111/his.15536
Descargas
Publicado
Declaración de disponibilidad de datos
The aggregate findings are presented in the tables. Requests for de-identified study data may be addressed to the corresponding author for reasonable academic purposes, subject to institutional authorization and the privacy protections applicable to pediatric clinical records.
Número
Sección
Licencia
Derechos de autor 2026 Lizeth Lucila Calderón-Villavicencio, Johnny Fernando Quiñones-Jauregui (Autor/a)
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Los autores conservan los derechos de autor y conceden a TUMI Health Sciences Research el derecho de primera publicación. Los artículos se publican bajo la Licencia Internacional Creative Commons Atribución 4.0 (CC BY 4.0).
