{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:06:27Z","timestamp":1792263987457,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,7,8]],"date-time":"2009-07-08T00:00:00Z","timestamp":1247011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>PRETEXT is used to stratify risk in children with hepatoblastoma by the Liver Tumor Strategy Group (SIOPEL) of the International Society of Pediatric Oncology (SIOP). A recent analysis excluding patients that did not survive neoadjuvant chemotherapy, concluded that PRETEXT was superior to Children's Oncology Group (COG) stage for predicting survival. Puzzled by this result, we made a similar comparison of PRETEXT and COG stage. This time, however, we include all patients, and we compare predictive value at diagnosis, instead of after neoadjuvant chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Hepatoblastoma patients in INT\u20100098 were retrospectively reviewed for PRETEXT and other potential prognostic factors including pathologic subtype, and alpha\u2010fetoprotein (AFP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five\u2010year overall survival by PRETEXT was 88.9%, 84.5%, 71.6%, and 30.9%, for PRETEXT I, II, III, and IV, respectively. The 5\u2010year overall survival rates by COG stage were 100%, 97.5%, 100%, 70.2%, and 39.3% for Stage I pure fetal histology (PFH), Stage I unfavorable histology (UH\u2009=\u2009not PFH), Stage II, Stage III, and Stage IV, respectively. PRETEXT added significant additional prognostic information within the COG Stage III, but not COG Stage IV. Additional prognostic factors statistically significant for an increased risk of death were small\u2010cell\u2010undifferentiated (SCU) histologic subtype and AFP\u2009&lt;\u2009100 at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PRETEXT, COG stage, SCU histology, and AFP\u2009&lt;\u2009100, as assessed at diagnosis, are important determinants of survival that will allow us to better develop common international criteria for risk stratification. Common risk stratification is an essential prerequisite to establish effective cooperation across the ocean in this field of rare tumors. Pediatr Blood Cancer 2009;53:1016\u20131022. \u00a9 2009 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.22088","type":"journal-article","created":{"date-parts":[[2009,7,10]],"date-time":"2009-07-10T01:29:08Z","timestamp":1247189348000},"page":"1016-1022","source":"Crossref","is-referenced-by-count":167,"title":["Predictive power of pretreatment prognostic factors in children with hepatoblastoma: A report from the Children's Oncology Group"],"prefix":"10.1002","volume":"53","author":[{"given":"Rebecka L.","family":"Meyers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon R.","family":"Rowland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Krailo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengjia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard M.","family":"Katzenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio H.","family":"Malogolowkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,7,8]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19820901)50:5<821::AID-CNCR2820500502>3.0.CO;2-K"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2002.32886"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.14.2665"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(92)90564-N"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19971219)74:6<593::AID-IJC6>3.0.CO;2-P"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(00)00074-5"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-005-0067-0"},{"key":"e_1_2_5_9_2","first-page":"240","article-title":"Into the year 2000 with SIOPEL 3: Cisplatin alone or in combination for standard and high risk hepatoblastoma","volume":"31","author":"Plaschkes J","year":"1998","journal-title":"Med Pediatr Oncol"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10282"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1053\/spsu.2000.18844"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.07.145"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-005-0029-6"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2005.02.004"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2005.11.004"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(00)00138-6"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.05.020"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2005.07.012"},{"key":"e_1_2_5_19_2","first-page":"204","article-title":"The current management of hepatoblastoma: A combination of chemotherapy, conventional resection and liver transplantation","volume":"146","author":"Tiao GM","year":"2005","journal-title":"J Pediatr Surg"},{"key":"e_1_2_5_20_2","first-page":"177","article-title":"Hepatoblastoma: Microscopic residual disease after delayed surgery, prognostic implications","volume":"35","author":"Brugieres L","year":"2000","journal-title":"Med Pediatr Oncol"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.01.035"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-34484"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2003.10.013"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-006-0361-5"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21979"},{"key":"e_1_2_5_26_2","volume-title":"The statistical analysis of failure time data","author":"Kalbfleisch JD","year":"1980"}],"container-title":["Pediatric Blood &amp; 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