Characterization of Pulmonary Metastases in Children With Hepatoblastoma Treated on Children’s Oncology Group Protocol AHEP0731 (The Treatment of Children With All Stages of Hepatoblastoma): A Report From the Children’s Oncology Group

• DOI: 10.1200/jco.2017.73.5654
• Publication Date: 2017-09-11T19:59:18Z
• Authors: Allison F. O’Neill; Alexander J. Towbin; Mark D. Krailo; Caihong Xia; Yun Gao; M. Beth McCarville; Rebecka L. Meyers; Eugene D. McGahren; Greg M. Tiao; Stephen P. Dunn; Max R. Langham; Christopher B. We...; Milton J. Finegold; Sarangarajan Rang...; Wayne L. Furman; Marcio Malogolowkin; Carlos Rodriguez-...; Howard M. Katzens...
• Keywords: Hepatoblastoma; Metastasectomy; Nodule (geology)

Purpose To determine whether the pattern of lung nodules in children with metastatic hepatoblastoma (HB) correlates outcome. Methods Thirty-two patients HB were enrolled on Children’s Oncology Group Protocol AHEP0731 and treated vincristine irinotecan (VI). Responders to VI received two additional cycles intermixed six cisplatin/fluorouracil/vincristine/doxorubicin (C5VD), nonresponders C5VD alone. Patients imaged after every at conclusion therapy. All computed tomography scans pathology reports centrally reviewed, information was collected regarding nodule number, size, laterality, timing resolution, pulmonary surgery. Results Among 29 evaluable patients, only 31% met Response Evaluation Criteria Solid Tumors (RECIST) for measurable disease. The presence disease by RECIST, sum diameters greater than or equal cumulative cohort median bilateral disease, ≥ 10 each associated an increased risk event-free survival event ( P = .48, .08, .065, .03, respectively), number meeting statistical significance. Ten underwent resection/metastasectomy various time points, benefit which could not be determined because small patient numbers. Conclusion Children have a poor prognosis. Overall tumor burden may important prognostic factor these patients. Lesions that fail meet RECIST size criteria (ie, those < mm) diagnosis contain viable tumor, whereas residual lesions end therapy constitute eradicated tumor/scar tissue. from stratification basis diagnosis.