{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:56:07Z","timestamp":1789750567569,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,30]],"date-time":"2018-09-30T00:00:00Z","timestamp":1538265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005954","name":"Children\u2019s Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005954","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aim<\/jats:title><jats:p>We reviewed the results and pattern of failure of the consensus HB\/HCC 1996 treatment protocol for pediatric hepatoblastoma (HB) in Hong Kong. The role of SIOPEL and Children's Hepatic tumors International Collaboration (CHIC) risk stratification was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients enrolled on the protocol from 1996 to 2014 were included. PRETEXT staging, SIOPEL, and CHIC risk groups were retrospectively assigned.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty patients were enrolled with median age at diagnosis of 1.1 years and median follow\u2010up time of 6.8 years. Alpha\u2010fetoprotein (AFP) was raised (&gt;100\u00a0ng\/mL) in 58 (97%) patients. Five (8%) had metastases at presentation and 7 (12%) experienced tumor rupture prior to or during treatment. Twenty\u2010nine patients (48%) received a first\u2010line cisplatin, 5\u2010fluorouracil, and vincristine regimen only while 23 (38%) also had alternative chemotherapeutic agents. Hepatic resection could be performed in 48 (80%) patients. Three (5%) patients underwent upfront liver transplantation. Five\u2010year event\u2010free survival and overall survival rates were 69.2%\u00a0\u00b1\u00a06.1% and 77.6%\u00a0\u00b1\u00a05.5% respectively. Among the 16 patients with relapse\/progression, 9 had intrahepatic failure only, 5 had distant failure only, and 2 had combined local and distant failure. Predictors of inferior outcome included advanced Evans staging, disease involving both lobes, rupture, low AFP, and suboptimal response to first\u2010line chemotherapy. Assigned in 44 patients, PRETEXT staging, SIOPEL, and CHIC risk groups significantly predicted EFS and OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although the consensus HB\/HCC 1996 protocol led to cure in three\u2010quarters of pediatric HB patients, an upfront risk stratification system is required to identify and improve the outcome of high\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.27482","type":"journal-article","created":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T05:25:53Z","timestamp":1538371553000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Treatment outcome and pattern of failure in hepatoblastoma treated with a consensus protocol in Hong Kong"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8597-9128","authenticated-orcid":false,"given":"Anthony P. Y.","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine The University of Hong Kong Queen Mary Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice J. K.","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Radiology Queen Mary Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex W. K.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Prince of Wales Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. W.","family":"Luk","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Queen Elizabeth Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. H.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Tuen Mun Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin K. H.","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Princess Margaret Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Hong Kong Queen Mary Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin K. W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Surgery Prince of Wales Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert C. Y.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong Queen Mary Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick H. Y.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong Queen Mary Hospital  Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1089-5325","authenticated-orcid":false,"given":"Alan K. 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