Children’s Hepatic Tumors International Collaboration-Hepatoblastoma Stratification (CHIC-HS) System for Pediatric Patients with Hepatoblastoma: A Retrospective, Hospital-Based Cohort Study in South Korea

• Published in: Cancer research and treatment Vol. 54; no. 1; pp. 253 - 258
• Main Authors: Kim, Pyeong Hwa, Shin, Hyun Joo, Yoon, Hee Mang, Choi, Young Hun, Namgoong, Jung-Man, Kim, Dae Yeon, Koh, Kyung-Nam, Lee, Mi-Jung, Yoon, Haesung, Lyu, Chuhl Joo, Han, Jung Woo, Hahn, Seung Min, Cho, Young Ah
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01.01.2022; 대한암학회
• Subjects: Child; Child, Preschool; Female; Hepatoblastoma - classification; Hepatoblastoma - mortality; Hepatoblastoma - pathology; Humans; Infant; Liver Neoplasms - classification; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Male; Original; Progression-Free Survival; Proportional Hazards Models; Republic of Korea - epidemiology; Retrospective Studies; 의학일반; Republic of Korea; Pediatrics; PRETEXT; CHIC-HS; Child; Survival; Hepatoblastoma
• ISSN: 1598-2998; 2005-9256; 2005-9256
• DOI: 10.4143/crt.2021.265

Purpose In 2017, the Children’s Hepatic Tumors International Collaboration-Hepatoblastoma Stratification (CHIC-HS) system was introduced. We aimed to evaluate the accuracy of CHIC-HS System for the prediction of event-free survival (EFS) in Korean pediatric patients with hepatoblastoma.Materials and Methods This two-center retrospective study included consecutive Korean pediatric patients with histopathologically confirmed hepatoblastoma from March 1988 through September 2019. We compared EFS among four risk groups according to the CHIC-HS system. Discriminatory ability of CHIC-HS system was also evaluated using optimism-corrected C-statistics. Factors associated with EFS were explored using multivariable Cox regression analysis.Results We included 129 patients (mean age, 2.6±3.3 years; female:male, 63:66). The 5-year EFS rates in the very low, low, intermediate, and high-risk groups, according to the CHIC-HS system were 90.0%, 82.8%, 73.5%, and 51.3%, respectively. The CHIC-HS system aligned significantly well with EFS outcomes (p=0.004). The optimism-corrected C index of CHIC-HS was 0.644 (95% confidence interval [CI], 0.561 to 0.727). Age ≥ 8 (vs. age ≤ 2; hazard ratio [HR], 2.781; 95% CI, 1.187 to 6.512; p=0.018), PRE-Treatment EXTent of tumor (PRETEXT) stage IV (vs. PRETEXT I or II; HR, 2.774; 95% CI, 1.228 to 5.974; p=0.009), and presence of metastasis (HR, 2.886; 95% CI, 1.457 to 5.719; p=0.002), which are incorporated as the first three nodes in the CHIC-HS system, were independently associated with EFS.Conclusion The CHIC-HS system aligned significantly well with EFS outcomes in Korean pediatric patients with hepatoblastoma. Age group, PRETEXT stage, and presence of metastasis were independently associated with EFS.