{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T13:05:51Z","timestamp":1779541551789,"version":"3.53.1"},"reference-count":56,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Therapeutic advances in pediatric oncology have significantly improved overall survival, with a higher incidence of long\u2010term adverse effects and sequelae. Among pediatric cancer survivors, the highest incidence of hepatic lesions has been observed in those previously treated for high\u2010risk neuroblastoma (HRNB). While hepatic nodules in these patients historically raised concern for tumor locations, recent attention has shifted toward non\u2010tumoral, late\u2010onset hepatic sequelae.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, we retrospectively reviewed long\u2010term liver outcomes from an institutional perspective follow\u2010up protocol, including long\u2010term HRNB survivors (&gt;5\u00a0years from diagnosis) treated between 1996 and 2018 at a tertiary pediatric center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 47 patients were included, with a median follow\u2010up of 11.1\u00a0years. Liver parenchyma was normal in 11 (23%) patients throughout the whole follow\u2010up period. Diffuse parenchymal inhomogeneity was observed in 36 patients out of 47 (76%). Out of 36 patients, 16 showed a stable, diffuse, non\u2010nodular alteration of the liver during the whole follow\u2010up period, while in seven patients, the liver involvement completely regressed after a median of 2.8\u00a0years. Moreover, 13 out of 36 patients (36%) with diffuse parenchymal inhomogeneity developed nodular lesions after a median of 7.7\u00a0years from diagnosis and 1.7\u00a0years from the onset of parenchymal alterations. Alpha\u2010fetoprotein levels were normal in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A structured, integrated, multidisciplinary follow\u2010up program revealed an unexpectedly high prevalence of hepatic abnormalities on imaging. Further studies are needed to define the long\u2010term risk of developing liver complications, both in terms of malignancy and functional impairment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70127","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T11:28:06Z","timestamp":1768044486000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Liver\u2010Related Late Effects in Long\u2010Term Survivors of High\u2010Risk Neuroblastoma: Insights From a Comprehensive Prospective Follow\u2010Up Study"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8368-0715","authenticated-orcid":false,"given":"Angelo","family":"Zarfati","sequence":"first","affiliation":[{"name":"Surgical Oncology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"},{"name":"University of Tor Vergata  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9197-1761","authenticated-orcid":false,"given":"Giorgia","family":"Romano","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"},{"name":"University of Tor Vergata  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2157-4233","authenticated-orcid":false,"given":"Alessandro","family":"Crocoli","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Monti","sequence":"additional","affiliation":[{"name":"Radiology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8093-2726","authenticated-orcid":false,"given":"Giorgio","family":"Persano","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piercesare","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Department of Life and Health Professions Sciences Link Campus University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7742-8838","authenticated-orcid":false,"given":"Giovanni","family":"Rollo","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"},{"name":"University of Tor Vergata  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Soglia","sequence":"additional","affiliation":[{"name":"Radiology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Di Giannatale","sequence":"additional","affiliation":[{"name":"Onco\u2010Hematology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Serra","sequence":"additional","affiliation":[{"name":"Onco\u2010Hematology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pietrobattista","sequence":"additional","affiliation":[{"name":"Metabolic Diseases and Hepatology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2113-4505","authenticated-orcid":false,"given":"Maria Antonietta","family":"De Ioris","sequence":"additional","affiliation":[{"name":"Onco\u2010Hematology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2022.1356"},{"key":"e_1_2_11_3_1","volume-title":"Beyond Image Defined Risk Factors (IDRFs): A Delphi Survey Highlighting Definition of the Surgical Complexity Index (SCI) in Neuroblastoma","author":"Avanzini S.","year":"2023"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2020.101848"},{"key":"e_1_2_11_5_1","volume-title":"SEER Cancer Statistics Review","author":"Horner M. J.","year":"2009"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018483405637"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2008.00983.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2019.09.025"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.14810"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31851"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.210156"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.230007"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.11.022"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29537"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705809"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp230"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002767"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2009.03.011"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2020.01.009"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-022-05420-9"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/215064"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050768"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11452"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2021.102296"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2023.12.001"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2010.10.023"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2004.tb03048.x"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.03144"},{"key":"e_1_2_11_29_1","first-page":"5527","article-title":"Comparison of Two Different Conditioning Regimens Before Autologous Transplantation for Children With High\u2010Risk Neuroblastoma","volume":"32","author":"DE Ioris M. A.","year":"2012","journal-title":"Anticancer Research"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2025.104541"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.220043"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)31370-5"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-010-1600-3"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2014.04.010"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-021-05058-z"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.175.3.1750687"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2019.19398"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31920"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e3181691709"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2018.06.008"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31610-0"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.03681"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v13.i7.98000"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00637-4"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2021.102296"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-010-1839-8"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.01.049"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11452"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23077"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2012.07.009"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29537"},{"key":"e_1_2_11_52_1","first-page":"133","article-title":"Hepatocellular Carcinoma in Fontan\u2010Associated Liver Disease","volume":"38","author":"D'Amato J.","year":"2025","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16020307"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2025.105794"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2305296"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03449-x"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2210859"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70127","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/1545-5017.70127","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T12:25:03Z","timestamp":1779539103000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/1545-5017.70127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,10]]},"references-count":56,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/1545-5017.70127"],"URL":"https:\/\/doi.org\/10.1002\/1545-5017.70127","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,10]]},"assertion":[{"value":"2025-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70127"}}