{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:38:03Z","timestamp":1791229083558,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:00:00Z","timestamp":1593734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatoblastoma tumor rupture is a high\u2010risk criterion in the SIOPEL 3\/4 protocol. Little is known about the outcome of these children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Radiological signs of possible tumor rupture, defined as peritoneal effusion, peritoneal nodules, or hepatic subcapsular hematoma, were reported in 24 of 150 patients treated for hepatoblastoma in France from January 2000 to December 2014 after central radiological expert review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two patients with available clinical data were included (nine PRETEXT\u2010I\/II, six PRETEXT\u2010III, seven PRETEXT\u2010IV, and five had lung metastases). Five patients had a subcapsular hematoma only, and 17 patients had intraperitoneal rupture (subcapsular hematoma and peritoneal effusion). A hepatic biopsy was performed in 19 patients. Intraperitoneal rupture occurred before biopsy in 12 and after biopsy in three (including one with prebiopsy subcapsular hematoma) (missing data: two). All patients were treated with chemotherapy, with high\u2010risk regimens including cisplatin or carboplatin and doxorubicin in 19 and cisplatin or carboplatin alone in three. Liver surgery was performed in 20 patients (including three liver transplants). Fifteen patients (68%) achieved complete remission. With a median follow\u2010up of 5.5 years, 11 events occurred (six progressions and three relapses, including three peritoneal progressions\/relapses, one surgical complication, and one second cancer) and eight patients died. One of eight patients with no other high\u2010risk criterion had a relapse. The three\u2010year event\u2010free survival and overall survival rates were 49.6% (95% CI\u00a0=\u00a030\u201069) and 68.2% (40\u201084), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tumor rupture is predictive of poor prognosis with risk of peritoneal progression\/relapse. However, it should not be a contraindication for liver transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28549","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T12:04:33Z","timestamp":1593777873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Tumor rupture in hepatoblastoma: A high risk factor?"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4196-1081","authenticated-orcid":false,"given":"Morgane","family":"Pondrom","sequence":"first","affiliation":[{"name":"Gustave Roussy Department of Children and Adolescents Oncology Universit\u00e9 Paris\u2010Saclay  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Pariente","sequence":"additional","affiliation":[{"name":"Centre hospitalier universitaire de Bic\u00eatre APHP Department of Pediatric Radiology Le Kremlin\u2010Bic\u00eatre  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