Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Surgical Oncology Program and Liver Tumor Program, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA.
Department of Pediatrics, Section of Pediatric and Adult Congenital Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
Pediatr Blood Cancer. 2024 Nov;71(11):e31214. doi: 10.1002/pbc.31214. Epub 2024 Aug 8.
Patients with hepatoblastoma (HB) have a higher risk of congenital heart defects (CHD). There is limited literature on the management and outcomes of these patients. The purpose of this study was to identify demographics and outcomes of these patients in a single tertiary referral center.
An Institutional Review Board (IRB)-approved retrospective chart review of patients with newly diagnosed HB from October 2004 to January 2021 was performed. CHD was defined as the presence of a septal defect, patent ductus arteriosus, pulmonary atresia, or bicuspid aortic valve. Chi-square and t-test were utilized for statistical analyses.
Of the 151 patients diagnosed with HB during the study timeframe, 29 patients were found to have CHD. Five-year overall survival (OS) for non-CHD HB patients was 81.9% compared to 68.9% in the CHD cohort (p = .12). The 5-year OS for patients without surgically intervened CHD was 63.6% compared to 70.5% for those with surgically repaired CHD (p = .88). Pre-treatment extent of tumor IV was present more often in patients with HB and CHD who passed away (6/9, 66.7%) compared to those who survived (3/16,18.8%, p = .01).
Patients with HB and CHD have similar survival compared to those without CHD. Our data support that patients with HB and CHD should be treated with curative intent including cardiac surgical intervention, medical oncology therapy, and oncological surgery for their HB.
患有肝母细胞瘤(HB)的患者先天性心脏病(CHD)的风险较高。关于这些患者的管理和结局的文献有限。本研究的目的是在一家三级转诊中心确定这些患者的人口统计学特征和结局。
对 2004 年 10 月至 2021 年 1 月期间新诊断为 HB 的患者进行了机构审查委员会(IRB)批准的回顾性图表审查。CHD 的定义为存在间隔缺损、动脉导管未闭、肺动脉闭锁或二叶主动脉瓣。使用卡方检验和 t 检验进行统计分析。
在研究期间,151 名被诊断为 HB 的患者中,有 29 名患者被发现患有 CHD。非 CHD HB 患者的 5 年总生存率(OS)为 81.9%,而 CHD 组为 68.9%(p=0.12)。无手术干预 CHD 的患者 5 年 OS 为 63.6%,而手术修复 CHD 的患者为 70.5%(p=0.88)。死亡的 HB 和 CHD 患者中,术前肿瘤 IV 期更常见(6/9,66.7%),而存活的患者中则更少见(3/16,18.8%,p=0.01)。
患有 HB 和 CHD 的患者与无 CHD 的患者的生存率相似。我们的数据支持对患有 HB 和 CHD 的患者应采用根治性治疗,包括心脏外科干预、肿瘤内科治疗和肿瘤外科手术治疗其 HB。