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Prognostic factors for event‐free survival in liver transplantation for hepatoblastoma: A single‐center experience
Author(s) -
Lauferman Leandro,
Halac Esteban,
Aredes Diego,
Cañon Reyes Isabel,
Cervio Guillermo,
Dip Marcelo,
Minetto Julia,
Reijenstein Hayellen,
Meza Veronica,
Gole Maria,
Jacobo Dillon Agustina,
Rose Adriana,
Imventarza Oscar
Publication year - 2019
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13581
Subject(s) - medicine , hepatoblastoma , liver transplantation , single center , multivariate analysis , gastroenterology , univariate analysis , chemotherapy , oncology , transplantation , neoadjuvant therapy , survival analysis , cancer , breast cancer
Abstract Hepatoblastoma (HB) is the most common malignant liver tumor in children. Twenty percent of the cases may remain unresectable after neoadjuvant chemotherapy and, for these patients, liver transplant (LT) is an accepted therapeutic option. To analyze the risk factors to event‐free survival (EFS) that influence the clinical outcome of patients with HB receiving LT, we retrospectively analyzed 21 patients with HB who underwent LT between January 1, 2005, and May 1, 2018. Overall survival (OS) was 90%. The univariate analysis shows that the AFP level at the time of LT was associated with a higher risk of EFS. With a ROC curve analysis, we established a cutoff point value of AFP levels at 16 000 ng/dL, with a sensitivity of 71.43% and a specificity of 85.71%. Multivariate analysis showed that patients with higher values of pretransplant AFP (>16 000 ng/dL) had a significantly higher risk of EFS than those transplanted with lower levels (HR: 10.180; 95% CI: 1.54‐66.97; P = .02). Efforts should be made to improve the selection of candidates for LT for unresectable HB, aiming at a better definition of chemoresistance as a risk factor of poor outcomes.