{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T20:04:34Z","timestamp":1777752274974,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,12,20]],"date-time":"2011-12-20T00:00:00Z","timestamp":1324339200000},"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":[[2012,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tumor response to chemotherapy has been shown to predict outcome in children with acute lymphoblastic leukemia, osteosarcoma, and Ewing Sarcoma. We evaluated whether tumor necrosis following neo\u2010adjuvant chemotherapy is prognostic for survival in hepatoblastoma (HB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>Primary tumors from children with newly diagnosed stage III and IV HB who underwent surgical resection following neo\u2010adjuvant chemotherapy were evaluated histologically for the extent of tumor necrosis (total diameter of necrotic and fibrotic tissue divided by total diameter of tumor). Clinical features, laboratory values, pathological features, treatment delivered, and vital status were recorded. Univariate and multivariate Cox regression analyses were performed to evaluate prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010two patients were evaluable. After a median of four cycles of neo\u2010adjuvant chemotherapy gross total surgical resection was achieved in 29 patients and complete resection documented by histology in 22 patients. Three\u2010year event free survival (EFS) and overall survival (OS) of the evaluable patients were 70.3\u2009\u00b1\u20098.3% and 76.8\u2009\u00b1\u20097.6%, respectively. Extent of tumor necrosis, platelet count at diagnosis, decline in serum alpha fetoprotein, and surgical margin status (positive vs. negative) were statistically significant predictors for both EFS and OS by univariate analysis. Multivariate analyses revealed that extent of tumor necrosis and surgical margin status predicted improved EFS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and OS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Extent of tumor necrosis following neo\u2010adjuvant chemotherapy is an independent prognostic factor in patients with newly diagnosed HB. Histological response may potentially be used in strategies to modify post\u2010surgical therapy to improve survival in HB. Pediatr Blood Cancer 2012;59:493\u2013498. \u00a9 2011 Wiley Periodicals, Inc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.24038","type":"journal-article","created":{"date-parts":[[2011,12,20]],"date-time":"2011-12-20T10:34:43Z","timestamp":1324377283000},"page":"493-498","source":"Crossref","is-referenced-by-count":35,"title":["Tumor necrosis predicts survival following neo\u2010adjuvant chemotherapy for hepatoblastoma"],"prefix":"10.1002","volume":"59","author":[{"given":"Rajkumar","family":"Venkatramani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jemily","family":"Malvar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Dias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Sposto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcio H.","family":"Malogolowkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Mascarenhas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,12,20]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2006.05.011"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.14.2665"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10632"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10282"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(00)00074-5"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.3109\/15513819209023293"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.3.1190"},{"key":"e_1_2_5_9_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_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22412"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950180403"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.7.2452"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181ce5f1e"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199312000-00008"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1990.10474929"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.22.4857"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199806043382304"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-0284-9_18"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1080\/107710497174318"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19890901)64:5<1082::AID-CNCR2820640520>3.0.CO;2-G"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22088"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2007.11.022"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.08.030"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.24038","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.24038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T23:18:13Z","timestamp":1696893493000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.24038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12,20]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,9]]}},"alternative-id":["10.1002\/pbc.24038"],"URL":"https:\/\/doi.org\/10.1002\/pbc.24038","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718423059.793541286","asserted-by":"object"}]},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12,20]]}}}