BMC Pediatr. 2025 Mar 4;25(1):166. doi: 10.1186/s12887-025-05487-x.
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.
PMID:40038677 | DOI:10.1186/s12887-025-05487-x
