Complete surgical resection for children with pure fetal histology hepatoblastoma (PFH): A report of the Childrens Oncology Group (COG)

Abstract

10049 Background: Approximately 4% of all children with hepatoblastoma (HB) have PFH. These children have been shown to have excellent clinical outcomes following complete surgical resection (stage I) with or without limited adjuvant chemotherapy Methods: Twenty-six children with stage I PFH were treated in 2 consecutive studies. Nine, on INT-0098 were non-randomly assigned to receive chemotherapy with single-agent doxorubicin after surgical resection, and 17, on P9645, received no post-surgery chemotherapy. Central pathology review was performed on all cases. Detailed surgery and pathology reports were retrospectively reviewed when available for determination of their PRETEXT stage prior to any therapy for their disease. Results: The five-year EFS and OS for all 9 patients treated on INT-0098 were 100% respectively. Similarly, all 17 patients enrolled onto P9645 study were alive and free of disease at the time of last contact. PRETEXT determination was feasible in 21 patients; of these 7 were group I; 10 group II and 4 group III. Conclusions: Children with completely resected (stage I) PFH can achieve long-term survival without further chemotherapy. Upfront surgical resection of hepatoblastoma, when feasible, can identify children who can be spared the toxicities associated with chemotherapy. No significant financial relationships to disclose.