{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:01:57Z","timestamp":1790744517417,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"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":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We retrospectively investigated the role of neoadjuvant chemotherapy in low\u2010risk patients with hepatoblastoma (HB) who underwent curative resection between February 2009 and December 2017. We also verified the feasibility of the risk stratification system to select the optimal patients for upfront surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We compared 5\u2010year overall survival (OS) and event\u2010free survival (EFS) between the upfront surgery (<jats:italic>n<\/jats:italic> = 26) and neoadjuvant chemotherapy (<jats:italic>n<\/jats:italic> = 104) groups at three oncology centers in Beijing, China. To reduce the effect of covariate imbalance, propensity score matching (PSM) was used. We explored whether preoperative chemotherapy affected surgical outcomes and identified the risk factors for events and death, including resection margin status, PRETreatment EXTent of disease stages, age, sex, pathology classification, and \u03b1\u2010fetoprotein levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up period was 64 (interquartile range 60\u201372) months. After PSM, 22 pairs of patients were identified, and the patient characteristics were similar for all variables included in PSM. In the upfront surgery group, the 5\u2010year EFS and OS rates were 81.8% and 86.3%, respectively. In the neoadjuvant chemotherapy group, the 5\u2010year EFS and OS rates were 81.8% and 90.9%, respectively. No significant differences in EFS or OS were observed between the groups. Pathological classification was the only risk factor for death, disease progression, tumor recurrence, other tumors found during HB diagnosis, and death from any cause (<jats:italic>p<\/jats:italic> = .007 and .032, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Upfront surgery achieved long\u2010term disease control in low\u2010risk patients with resectable HB, thus reduced the cumulative toxicity of platinum\u2010based chemotherapy drugs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30470","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T17:23:05Z","timestamp":1686158585000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Neoadjuvant chemotherapy or upfront surgery in hepatoblastoma: A multicenter retrospective study"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6315-3715","authenticated-orcid":false,"given":"Yu","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery Capital Institute of Pediatrics\u2010Peking University Teaching Hospital Beijing China"},{"name":"Research Unit of Minimally Invasive Pediatric Surgery on Diagnosis and Treatment, Chinese Academy of Medical Sciences 2021RU015 Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinghai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Capital Institute of Pediatrics\u2010Peking University Teaching Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Public Health China Medical University Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Capital Institute of Pediatrics\u2010Peking University Teaching Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guimin","family":"Huang","sequence":"additional","affiliation":[{"name":"Child Health Big Data Research Center Capital Institute of Pediatrics Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianghai","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Colorectal and Anal Surgery Zhongnan Hospital of Wuhan University Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Beijing Tongren Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Beijing Tongren Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0358-3929","authenticated-orcid":false,"given":"Long","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Beijing Tsinghua Changgeng Hospital Beijing 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