{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:40:54Z","timestamp":1792176054135,"version":"4.4.0"},"reference-count":24,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"30","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2017,10,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To determine whether the pattern of lung nodules in children with metastatic hepatoblastoma (HB) correlates with outcome. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Thirty-two patients with metastatic HB were enrolled on Children\u2019s Oncology Group Protocol AHEP0731 and treated with vincristine and irinotecan (VI). Responders to VI received two additional cycles of VI intermixed with six cycles of cisplatin\/fluorouracil\/vincristine\/doxorubicin (C5VD), and nonresponders received six cycles of C5VD alone. Patients were imaged after every two cycles and at the conclusion of therapy. All computed tomography scans and pathology reports were centrally reviewed, and information was collected regarding lung nodule number, size, laterality, timing of resolution, and pulmonary surgery. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Among the 29 evaluable patients, only 31% met Response Evaluation Criteria in Solid Tumors (RECIST) for measurable metastatic disease. The presence of measurable disease by RECIST, the sum of nodule diameters greater than or equal to the cumulative cohort median size, bilateral disease, and \u2265 10 nodules were each associated with an increased risk for an event-free survival event ( P = .48, P = .08, P = .065, P = .03, respectively), with nodule number meeting statistical significance. Ten patients underwent pulmonary resection\/metastasectomy at various time points, the benefit of which could not be determined because of small patient numbers. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Children with metastatic HB have a poor prognosis. Overall tumor burden may be an important prognostic factor for these patients. Lesions that fail to meet RECIST size criteria (ie, those &lt; 10 mm) at diagnosis may contain viable tumor, whereas residual lesions at the end of therapy may constitute eradicated tumor\/scar tissue. Patients may benefit from risk stratification on the basis of the burden of lung metastatic disease at diagnosis. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2017.73.5654","type":"journal-article","created":{"date-parts":[[2017,9,11]],"date-time":"2017-09-11T19:59:18Z","timestamp":1505159958000},"page":"3465-3473","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":59,"title":["Characterization of Pulmonary Metastases in Children With Hepatoblastoma Treated on Children\u2019s Oncology Group Protocol AHEP0731 (The Treatment of Children With All Stages of Hepatoblastoma): A Report From the Children\u2019s Oncology Group"],"prefix":"10.1200","volume":"35","author":[{"given":"Allison F.","family":"O\u2019Neill","sequence":"first","affiliation":[{"name":"Allison F. O\u2019Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children\u2019s Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children\u2019s Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children\u2019s Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. Beth McCarville, Wayne L...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Towbin","sequence":"additional","affiliation":[{"name":"Allison F. O\u2019Neill and Christopher B. Weldon, Dana-Farber Cancer Institute, Boston Children\u2019s Hospital, and Harvard Medical School, Boston, MA; Alexander J. Towbin and Greg M. Tiao, Cincinnati Children\u2019s Hospital, Cincinnati, OH; Mark D. Krailo, University of Southern California Keck School of Medicine, Los Angeles; Caihong Xia and Yun Gao, Children\u2019s Oncology Group, Monrovia; Marcio Malogolowkin, University of California Davis Comprehensive Cancer Center, Sacramento, CA; M. 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