Clinical characteristics and prognosis of 132 cases of infantile hepatoblastoma — A 14-year retrospective study from a single center

Background: The study aimed to summarize the clinical data of hepatoblastoma (HB) in infants under 1 year of age, analyze their treatment effects and factors that affect the prognosis. Methods: Clinical data of 132 pathologically confirmed children under the age of 1 year old with hepatoblastoma who were admitted to the pediatric single center of Beijing Tongren Hospital,Capital Medical University from May 2005 to May 2019 were collected. The clinical efficacy and prognosis of combined treatment were summarized through retrospective analysis. Results: 1. Of the 132 children enrolled, 74 were male and 58 were female; median age was 8.40 months; the onset of disease was the most common (75.0%) of abdominal distension; infant HB had high AFP at the initial diagnosis, with an average level of (127406.5 ± 7232.5) ng/ml, the platelet value was (405 ± 166) × 10 9 /L; the pathological type was mainly epithelial (57.6%), and most of the epithelial types were fetal (67.1%); the PRETEXT stage was mainly stage III (54.5%), followed by stage II (34.1%); 45 cases had distant metastases, most of which were lung metastases (86.7%); 24 patients (18.2%) had portal vein or hepatic vein or vena cava invasion, 5 (3.8%) had tumor rupture, and 26 (19.7%) had multiple intrahepatic lesions. 2. The patients were followed up to May 2020, with a median follow-up time of 58 months. Among them, 84 cases had complete remission and 18 cases had partial remission. According to Kaplan-Meier survival analysis, the 5-year overall survival rates (OS) were 80.1%; the event-free survival rates (EFS) were 77.5%. Log-rank test showed that HB patients with AFP> 1210ng/ml at first diagnosis had a good prognosis; the EFS of the patients at PRETEXT IV stage was only 28.6%;children with distant tumor metastasis and multiple primary tumor lesions had poor prognosis, which were risk factors affecting the prognosis of infant HB (P < 0.05). Conclusions: Infant HB has its own characteristics. Through comprehensive treatment, the prognosis is relatively good, but it is still susceptible to multiple factors such as AFP level, PRETEXT stage, the presence of distant metastasis and multiple intrahepatic lesions.