{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:39:45Z","timestamp":1792175985712,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2011,3,2]],"date-time":"2011-03-02T00:00:00Z","timestamp":1299024000000},"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":[[2011,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We evaluated the outcomes and prognostic factors, especially serum levels of alpha\u2010fetoprotein (AFP) and their changes during the treatment of hepatoblastoma (HB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We retrospectively analyzed the medical records of 43 consecutive children with HB treated at a single institution between 1991 and 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 43 patients, 5 (12%) underwent primary tumor resection at diagnosis and 38 (88%) received preoperative chemotherapy. Of those 38 patients, 7 (16%) died of progressive disease during preoperative chemotherapy, and 31 (72%) underwent curative operations, including 5 who underwent liver transplantation, after a median 4 cycles of chemotherapy (range, 3\u201314 cycles). The 5\u2010year overall survival and disease\u2010free survival rates were 62.1\u2009\u00b1\u20098.3% and 65.6\u2009\u00b1\u20097.6%, respectively. AFP &gt;263,000\u2009ng\/mL at diagnosis, a decline of &lt;1 log in AFP levels after the first cycle of chemotherapy, preoperative AFP levels in the highest tertile, and postoperative AFP levels in the highest tertiles were significantly associated with treatment failure. Age younger than 1 year at diagnosis, thrombocytosis at diagnosis, and early PRETEXT (<jats:italic>pret<\/jats:italic>reatment <jats:italic>ext<\/jats:italic>ent of disease) stage were significantly associated with better survival outcomes, whereas gender and metastasis were not. Multivariate analysis showed that high level of preoperative AFP was an independent predictor of treatment failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Serial monitoring of changes in AFP levels during the treatment, especially perioperative changes, may help identify favorable and poor responders to chemotherapy. Alternative treatment, such as liver transplantation, should be considered for poor responders. Pediatr Blood Cancer 2011; 57: 554\u2013560. \u00a9 2011 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.23069","type":"journal-article","created":{"date-parts":[[2011,3,3]],"date-time":"2011-03-03T04:56:05Z","timestamp":1299128165000},"page":"554-560","source":"Crossref","is-referenced-by-count":26,"title":["Prognostic implications of serum alpha\u2010fetoprotein response during treatment of hepatoblastoma"],"prefix":"10.1002","volume":"57","author":[{"given":"Kyung Nam","family":"Koh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meerim","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo Eun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keun Wook","family":"Bae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Mo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Joon","family":"Im","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Jin","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,3,2]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2010.02.013"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.09.011"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-009-2349-3"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10632"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(97)00095-6"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22088"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(00)00074-5"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.07.145"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199957040-00001"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2007.11.022"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.3.1190"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2009.10.023"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10282"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.14.2665"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2001.22953"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2002.32886"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.05.020"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.07.400"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2003.10.012"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02306083"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002680020052"},{"key":"e_1_2_6_23_2","first-page":"337","article-title":"Clinical study of hepatoblastoma in children","volume":"63","author":"Park J","year":"2002","journal-title":"J Korean Surg Soc"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19800115)45:2<315::AID-CNCR2820450219>3.0.CO;2-W"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/stem.160329"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(86)80513-9"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.10376"}],"container-title":["Pediatric Blood &amp; 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