{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:05:22Z","timestamp":1793642722760,"version":"4.5.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Special Fund of The Pediatric Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals","award":["XTZD20180203"],"award-info":[{"award-number":["XTZD20180203"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cancer"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This study explores and analyzes the clinical characteristics and prognostic factors of hepatoblastoma (HB) in children under 6 years old and establishes a new risk-stratification system for individualized therapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The clinical data of 382 pediatric patients under 6 years old (231 males and 151 females) who had been diagnosed with HB by pathology between May 2005 and May 2019 were collected. By analyzing the risk factors influencing the survival rate of patients with HB, a new risk-stratification system was established, and it was compared with previous risk-stratification systems by a receiver operating characteristic (ROC) curve.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p><jats:list list-type=\"order\">\n                  \n                    \n                    <jats:list-item>\n                      <jats:p>According to a Kaplan-Meier survival analysis, the one-year, three-year, and five-year overall survival (OS) was 93.7, 84.0, and 73.9%, respectively, and the event-free survival (EFS) was 90.5, 79.2, and 67.5%, respectively.<\/jats:p>\n                    <\/jats:list-item>\n                  \n                  \n                    \n                    <jats:list-item>\n                      <jats:p>The independent risk factors influencing prognosis in pediatric patients with HB were alpha-fetoprotein (AFP) &lt;\u2009100\u2009ng\/ml or\u2009&gt;\u20091000\u2009ng\/ml (HR\u2009=\u20093.341, <jats:italic>P<\/jats:italic>\u2009=\u20090.005); platelet count &gt;\u2009400\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L (pooled hazard ratio [HR]\u2009=\u20092.123, <jats:italic>P<\/jats:italic>\u2009=\u20090.026); PRETEXT stage IV (HR\u2009=\u20094.026, <jats:italic>P<\/jats:italic>\u2009=\u20090.001); vascular involvement (HR\u2009=\u20092.178, <jats:italic>P<\/jats:italic>\u2009=\u20090.019); distant metastasis (HR\u2009=\u20092.634, <jats:italic>P<\/jats:italic>\u2009=\u20090.010);and multifocality (HR\u2009=\u20092.215, <jats:italic>P<\/jats:italic>\u2009=\u20090.012).<\/jats:p>\n                    <\/jats:list-item>\n                  \n                  \n                    \n                    <jats:list-item>\n                      <jats:p>A new risk-stratification system was established and divided into three groups: low risk, moderate risk, and high risk. There were statistical differences among the three groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.002). Compared with the previous risk-staging systems, there was no significant difference in the survival rate. Although the effect in the guiding therapy was the same, the area under the curve for the ROC curve was 0.835 (95% CI: 0.784\u20130.885) for the new stratification system.<\/jats:p>\n                    <\/jats:list-item>\n                  \n                <\/jats:list><\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This new risk-stratification system had a better predictive value for the prognosis of pediatric patients with HB than other stratification systems.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12885-021-08095-x","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T08:03:48Z","timestamp":1618301028000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A new risk-stratification system for hepatoblastoma in children under six years old and the significance for prognosis evaluation\u2014a 14-year retrospective study from a single center"],"prefix":"10.1186","volume":"21","author":[{"given":"Tian","family":"Zhi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Ling","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Min","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Zhuo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Sheng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"issue":"29","key":"8095_CR1","doi-asserted-by":"publisher","first-page":"l0l37","DOI":"10.3748\/wjg.v20.i29.10137","volume":"20","author":"D Ayllon Teran","year":"2014","unstructured":"Ayllon Teran D, G\u00f3mez Beltran O, Ciria Bru R, et al. 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This study was conducted with approval from the Ethics Committee of Beijing Tongren Hospital Capital Medical University (No. TRECKY2019\u2013033). This study was conducted in accordance with the declaration of Helsinki. Written consent to participate was obtained from the parents\/guardians of the minors included in this study (minors are considered anyone under the age of 16).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"397"}}