Huang Junting, Hu Yang, Jiang Hong, Xu Yanjie, Lu Suying, Sun Feifei, Zhu Jia, Wang Juan, Sun Xiaofei, Liu Juncheng, Zhen Zijun, Zhang Yizhuo
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Front Oncol. 2020 Nov 18;10:552079. doi: 10.3389/fonc.2020.552079. eCollection 2020.
The aim of this study was to compare the accuracy of the Children's Oncology Group (COG) risk stratification system to the Children's Hepatic tumor International Collaboration (CHIC) risk stratification system for predicting the prognosis of Chinese children with hepatoblastoma (HB).
Clinicopathological data of 86 patients diagnosed with HB between January 2014 and December 2017 were retrieved. The study endpoints were the 1- and 3-year overall survival (OS) and disease-free survival (DFS) were analyzed to evaluate the predictive value.
The 1-, 3-year OS and DFS of the 86 patients were 86.0%, 76.3%, and 74.4%, 54.0%, respectively. Univariate analyses revealed that age at diagnosis had a significant role in prognosis for both OS and DFS, along with PRETEXT staging and metastasis at diagnosis. Multivariate analysis showed that metastasis at diagnosis (HR 3.628, 95% CI 1.404-9.378, P=0.008), PRETEXT staging system (HR 2.176, 95% CI 1.230-3.849, P=0.008) and age at diagnosis (HR 2.268, 95% CI 1.033-4.982, P=0.041) were independent factors for OS. For DFS, the independent factors were the PRETEXT staging system (HR 2.241, 95% CI 1.533-3.277, P<0.001) and age at diagnosis (HR 1.792, 95% CI 1.018-3.154, P=0.043). Both COG and CHIC risk stratification systems could effectively predict the prognosis of children with HB for OS. For DFS, the CHIC risk stratification system was more effective. In addition, the CHIC risk stratification system had a higher c-index (OS 0.743, DFS 0.730), compared to the COG risk stratification system (OS 0.726, DFS 0.594).
Age at diagnosis played a significant role in prognosis. Compared to the COG risk stratification system, the CHIC risk stratification system was superior in predicting the survival of Chinese children with HB.
本研究旨在比较儿童肿瘤学组（COG）风险分层系统与儿童肝肿瘤国际协作组（CHIC）风险分层系统对中国儿童肝母细胞瘤（HB）预后的预测准确性。
检索2014年1月至2017年12月期间确诊为HB的86例患者的临床病理数据。研究终点为1年和3年总生存期（OS）及无病生存期（DFS），分析其以评估预测价值。
86例患者的1年、3年OS及DFS分别为86.0%、76.3%以及74.4%、54.0%。单因素分析显示，诊断时年龄对OS和DFS的预后均有显著作用，同时还有诊断时的PRETEXT分期和转移情况。多因素分析表明，诊断时转移（HR 3.628，95%CI 1.404 - 9.378，P = 0.008）、PRETEXT分期系统（HR 2.176，95%CI 1.230 - 3.849，P = 0.008）以及诊断时年龄（HR 2.268，95%CI 1.033 - 4.982，P = 0.041）是OS的独立因素。对于DFS，独立因素为PRETEXT分期系统（HR 2.241，95%CI 1.533 - 3.277，P < 0.001）和诊断时年龄（HR 1.792，95%CI 1.018 - 3.154，P = 0.043）。COG和CHIC风险分层系统均可有效预测儿童HB患者的OS预后。对于DFS，CHIC风险分层系统更有效。此外，与COG风险分层系统（OS 0.726，DFS 0.594）相比，CHIC风险分层系统具有更高的c指数（OS 0.743，DFS 0.730）。
诊断时年龄对预后有显著作用。与COG风险分层系统相比，CHIC风险分层系统在预测中国儿童HB患者的生存情况方面更具优势。
