1. Children’s Hepatic Tumors International Collaboration-Hepatoblastoma Stratification (CHIC-HS) System for Pediatric Patients with Hepatoblastoma: A Retrospective, Hospital-Based Cohort Study in South Korea
- Author
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Pyeong Hwa Kim, Haesung Yoon, Mi Jung Lee, Chuhl Joo Lyu, Hee Mang Yoon, Jung Woo Han, Kyung-Nam Koh, Dae Yeon Kim, Young Ah Cho, Jung-Man Namgoong, Young Hun Choi, Hyun Joo Shin, and Seung Min Hahn
- Subjects
Hepatoblastoma ,Male ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Survival ,Pediatric Cancer ,Pediatrics ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Risk groups ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Stage (cooking) ,Child ,Proportional Hazards Models ,Retrospective Studies ,PRETEXT ,CHIC-HS ,business.industry ,Proportional hazards model ,Liver Neoplasms ,Infant ,Retrospective cohort study ,Hospital based ,medicine.disease ,Progression-Free Survival ,030104 developmental biology ,Oncology ,Child, Preschool ,030220 oncology & carcinogenesis ,Original Article ,Female ,business ,Cohort study - Abstract
Purpose In 2017, the Children's Hepatic Tumors International Collaboration-Hepatoblastoma Stratification (CHIC-HS) system was introduced. We aimed to evaluate the accuracy of Children's Hepatic Tumors International Collaboration-Hepatoblastoma Stratification (CHIC-HS) System for the prediction of event-free survival in Korean pediatric patients with hepatoblastoma. Materials and methods This two-center retrospective study included consecutive Korean pediatric patients with histopathologically confirmed hepatoblastoma from March 1988 through September 2019. We compared event-free survival (EFS) among four risk groups according to the CHIC-HS system. Discriminatory ability of CHIC-HS system was also evaluated using optimism-corrected C-statistics. Factors associated with EFS were explored using multivariable Cox regression analysis. Results We included 129 patients (mean age, 2.6±3.3 years; female:male, 63:66). The 5-year EFS rates in the very low, low, intermediate, and high-risk groups, according to the CHIC-HS system were 90.0%, 82.8%, 73.5%, and 51.3%, respectively. The CHIC-HS system aligned significantly well with EFS outcomes (p=0.004). The optimism-corrected C index of CHIC-HS was 0.644 (95% CI, 0.561-0.727). Age ≥8 (vs. age ≤2; HR, 2.781; 95% CI, 1.187-6.512; p=0.018), PRE-Treatment EXTent of tumor (PRETEXT) stage IV (vs. PRETEXT I or II; HR, 2.774; 95% CI, 1.228-5.974; p=0.009), and presence of metastasis (HR, 2.886; 95% CI, 1.457-5.719; p=0.002), which are incorporated as the first three nodes in the CHIC-HS system, were independently associated with EFS. Conclusion The CHIC-HS system aligned significantly well with EFS outcomes in Korean pediatric patients with hepatoblastoma. Age group, PRETEXT stage, and presence of metastasis were independently associated with EFS.
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- 2022