1
|
Huang S, Lin Y, Liu S, Shang J, Wang Z. Impact of treatment on the prognosis of childhood in hepatoblastoma: A SEER based analysis. Heliyon 2024; 10:e34510. [PMID: 39113986 PMCID: PMC11305182 DOI: 10.1016/j.heliyon.2024.e34510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
Background The prognosis of patients with hepatoblastoma has been unsatisfactory. This study analyzed the effects of different treatment methods on cancer-specific survival (CSS) in children with hepatoblastoma. Method From 2000 to 2018, patients with hepatoblastoma were included in the Surveillance, Epidemiology, and End Results (SEER) database. CSS was estimated using the Kaplan-Meier method. Cox regression analysis assessed prognostic factors. The predictive models were validated using the concordance index (C-index), calibration curve and receiver operating characteristic (ROC) curve. Result Of the 785 included patients, 730 (93.0 %) underwent chemotherapy, 516 (65.7 %) underwent liver tumour resection and 129 (16.4 %) underwent liver transplantation. Both chemotherapy and surgery could significantly improve the CSS rate (all p < 0.001). However, there was no difference in CSS rate between the two surgical methods (liver tumour resection and liver transplantation) (p = 0.613). Further subgroup analysis revealed that children who underwent liver tumour resection or liver transplantation based on chemotherapy (all p > 0.05) had a similar prognosis. Multivariate analysis revealed that age (p = 0.003), race (p = 0.001), operative method (p < 0.001), chemotherapy (p < 0.001), distant metastasis (p < 0.001) and tumour size (p < 0.001) were independent factors related to CSS. The C-index of the new nomogram was 0.759, and its consistency was good. The ROC curves verified that the nomogram had a better prediction ability for 1-, 3- and 5-year CSS rates. Conclusion In children with hepatoblastoma, there was no statistically significant difference in CSS between chemotherapy combined with liver transplantation and liver tumour resection. The nomogram we constructed demonstrated satisfactory CSS prediction ability.
Collapse
Affiliation(s)
- Sihan Huang
- Department of Hematology–Oncology, Fujian Children's Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Yaobin Lin
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shan Liu
- Department of Hematology–Oncology, Fujian Children's Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Jin Shang
- Department of Hematology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
| | - Zhihong Wang
- Department of Hematology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
| |
Collapse
|
2
|
Hu H, Zhang W, Zhang Y, Gao Y, Zhi T, Li F, Li J, Gu H, Liao R, Wu R, Huang D. Individualized chemotherapy and efficacy analysis of hepatoblastoma in children. Pediatr Blood Cancer 2024; 71:e30693. [PMID: 37937320 DOI: 10.1002/pbc.30693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/25/2023] [Accepted: 09/14/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE We aimed to assess the clinical utility of the mini patient-derived xenograft (MiniPDX) model in screening individualized chemotherapy regimens for pediatric hepatoblastoma. MATERIALS AND METHODS We included 31 children with hepatoblastoma who had unsatisfactory decreases in alpha-fetoprotein levels during neoadjuvant chemotherapy or poor clinical control of recurrence with or without metastasis. We established a MiniPDX model using surgically resected tumor tissue specimens. The sensitivities of five chemotherapeutic regimens were tested to determine the one with the lowest tumor proliferation rate, which was then set as the experimental group. We compared the clinical characteristics and efficacy with those of conventional chemotherapy regimens. RESULTS The median follow-up period for the experimental group was 27 months, with a complete remission (CR) rate of 80.64%. Among stage IV cases, there was a significant between-group difference in CR rate (experimental [73.68%] vs. control [37.5%]) and 3-year event-free survival rate (79.3% vs. 26.7%). The most effective individualized chemotherapy regimens were ifosfamide + pirarubicin + etoposide + carboplatin (54.84%), followed by pirubicin + cyclophosphamide + cisplatin (16.13%), ifosfamide + carboplatin + etoposide (12.90%), cisplatin + 5-fluorouracil + vincristine + adriamycin (12.90%), and vincristine + irinotecan + cyclophosphamide + cisplatin (3.23%). CONCLUSION Using the MiniPDX model to screen individualized chemotherapy regimens for pediatric hepatoblastoma can significantly improve the CR rate.
Collapse
Affiliation(s)
- Huimin Hu
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Weiling Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yanan Gao
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Tian Zhi
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Fan Li
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Huali Gu
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ru Liao
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Runhui Wu
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Dongsheng Huang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Whitlock RS, Portuondo JI, Espinoza AF, Ortega R, Galván NTN, Leung DH, Lopez-Terrada D, Masand P, Nguyen HN, Patel KA, Goss JA, Heczey AM, Vasudevan SA. Surgical Management and Outcomes of Patients with Multifocal Hepatoblastoma. J Pediatr Surg 2023; 58:1715-1726. [PMID: 37244849 DOI: 10.1016/j.jpedsurg.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To compare the outcomes of patients with multifocal hepatoblastoma (HB) treated at our institution with either orthotopic liver transplant (OLTx) or hepatic resection to determine outcomes and risk factors for recurrence. BACKGROUND Multifocality in HB has been shown to be a significant prognostic factor for recurrence and worse outcome. The surgical management of this type of disease is complex and primarily involves OLTx to avoid leaving behind microscopic foci of disease in the remnant liver. METHODS We performed a retrospective chart review on all patients <18 years of age with multifocal HB treated at our institution between 2000 and 2021. Patient demographics, operative procedure, post-operative course, pathological data, laboratory values, short- and long-term outcomes were analyzed. RESULTS A total of 41 patients were identified as having complete radiologic and pathologic inclusion criteria. Twenty-three (56.1%) underwent OLTx and 18 (43.9%) underwent partial hepatectomy. Median length of follow-up across all patients was 3.1 years (IQR 1.1-6.6 years). Cohorts were similar in rates of PRETEXT designation status identified on standardized imaging re-review (p = .22). Three-year overall survival (OS) estimate was 76.8% (95% CI: 60.0%-87.3%). There was no difference in rates of recurrence or overall survival in patients who underwent either resection or OLTx (p = .54 and p = .92 respectively). Older patients (>72 months), patients with a positive porta hepatis margin, and patients with associated tumor thrombus experienced worse recurrence rates and survival. Histopathology demonstrating pleomorphic features independently associated with worse rates of recurrence. CONCLUSIONS Through proper patient selection, multifocal HB was adequately treated with either partial hepatectomy or OLTx with comparable outcome results. HB with pleomorphic features, increased patient age at diagnosis, involved porta hepatis margin on pathology, and the presence of associated tumor thrombus may be associated with worse outcomes regardless of the local control surgery offered. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Richard S Whitlock
- Division of Pediatric Surgery, Texas Children's Surgical Oncology Program, Texas Children's Liver Tumor Program, Michael E. DeBakey Department of Surgery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Jorge I Portuondo
- Division of Pediatric Surgery, Texas Children's Surgical Oncology Program, Texas Children's Liver Tumor Program, Michael E. DeBakey Department of Surgery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Andres F Espinoza
- Division of Pediatric Surgery, Texas Children's Surgical Oncology Program, Texas Children's Liver Tumor Program, Michael E. DeBakey Department of Surgery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Rachel Ortega
- Division of Pediatric Surgery, Texas Children's Surgical Oncology Program, Texas Children's Liver Tumor Program, Michael E. DeBakey Department of Surgery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - N Thao N Galván
- Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Daniel H Leung
- Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition Section, Baylor College of Medicine, Houston, TX, USA
| | - Dolores Lopez-Terrada
- Departmant of Pathology, Texas Children's Hospital, Dan L. Duncan Cancer Center, Baylor College of Medicine Houston, TX, USA
| | - Prakash Masand
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - HaiThuy N Nguyen
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Kalyani A Patel
- Departmant of Pathology, Texas Children's Hospital, Dan L. Duncan Cancer Center, Baylor College of Medicine Houston, TX, USA
| | - John A Goss
- Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Andras M Heczey
- Texas Children's Cancer and Hematology Center, Department of Pediatrics, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Sanjeev A Vasudevan
- Division of Pediatric Surgery, Texas Children's Surgical Oncology Program, Texas Children's Liver Tumor Program, Michael E. DeBakey Department of Surgery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA.
| |
Collapse
|
4
|
Bownes LV, Julson JR, Quinn CH, Hutchins SC, Erwin MH, Markert HR, Stewart JE, Mroczek-Musulman E, Aye J, Yoon KJ, Ohlmeyer M, Beierle EA. The Effects of Protein Phosphatase 2A Activation with Novel Tricyclic Sulfonamides on Hepatoblastoma. J Pediatr Surg 2023; 58:1145-1154. [PMID: 36907775 PMCID: PMC10198925 DOI: 10.1016/j.jpedsurg.2023.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/10/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND The tumor suppressor, protein phosphatase 2A (PP2A), is downregulated in hepatoblastoma. We aimed to examine the effects of two novel compounds of the tricyclic sulfonamide class, ATUX-3364 (3364) and ATUX-8385 (8385), designed to activate PP2A without causing immunosuppression, on human hepatoblastoma. METHODS An established human hepatoblastoma cell line, HuH6, and a human hepatoblastoma patient-derived xenograft, COA67, were treated with increasing doses of 3364 or 8385, and viability, proliferation, cell cycle and motility were investigated. Cancer cell stemness was evaluated by real-time PCR and tumorsphere forming ability. Effects on tumor growth were examined using a murine model. RESULTS Treatment with 3364 or 8385 significantly decreased viability, proliferation, cell cycle progression and motility in HuH6 and COA67 cells. Both compounds significantly decreased stemness as demonstrated by decreased abundance of OCT4, NANOG, and SOX2 mRNA. The ability of COA67 to form tumorspheres, another sign of cancer cell stemness, was significantly diminished by 3364 and 8385. Treatment with 3364 resulted in decreased tumor growth in vivo. CONCLUSION Novel PP2A activators, 3364 and 8385, decreased hepatoblastoma proliferation, viability, and cancer cell stemness in vitro. Animals treated with 3364 had decreased tumor growth. These data provide evidence for further investigation of PP2A activating compounds as hepatoblastoma therapeutics.
Collapse
Affiliation(s)
- Laura V Bownes
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Janet R Julson
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Colin H Quinn
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Sara Claire Hutchins
- Division of Hematology/Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Michael H Erwin
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Hooper R Markert
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Jerry E Stewart
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | | | - Jamie Aye
- Division of Hematology/Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Karina J Yoon
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | | | - Elizabeth A Beierle
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
| |
Collapse
|
5
|
Tayfun Küpesiz F, Akınel AN, Akbaş H, Sivrice Ç, Tüysüz Kintrup G, Karagüzel G, Melikoğlu M, Gelen MT, Aydınlı B, Küpesiz A, Güler E. Multidisciplinary Management of Pediatric Hepatoblastoma: A 20-Year Single-Center Experience. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2022; 33:1069-1078. [PMID: 36262102 PMCID: PMC9797744 DOI: 10.5152/tjg.2022.21827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Hepatoblastoma is rare cancer that responds well to risk-based chemotherapy, and surgical treatment is needed to achieve complete remission and satisfactory survival rates in hepatoblastoma patients. In this study, we evaluated the clinical features and treatment outcomes of pediatric hepatoblastoma patients treated in our clinic. METHODS Eighteen patients with hepatoblastoma who were treated and followed up in our center between June 1999 and June 2020 were analyzed retrospectively. All patients were evaluated by a multidisciplinary team and managed using a risk-based protocol (SIOPEL-1 and SIOPEL-3). RESULTS The patients' mean age at diagnosis was 38.33 ± 52.34 months. Sixteen patients (89%) received neoadjuvant chemotherapy, and 2 patients (11%) who underwent complete mass excision at diagnosis received adjuvant chemotherapy. After neoadjuvant therapy, the tumor was completely resected in 8 patients (45%), while liver transplantation was performed in 6 patients (34%) because complete resection of the tumor was not possible. Two patients died before surgical treatment. One patient relapsed with lung metastasis after salvage chemotherapy. She is alive without disease at 64 months. The mean follow-up time was 59.3 ± 49.8 months; 5-year overall and disease-free survival rates were 88.9% and 80.8%, respectively. The 5-year overall survival rate was 100% for both liver transplant and resected patients, whereas 5-year disease-free survival was lower in transplant patients (75% vs 100%, P < .001). CONCLUSION Multidisciplinary follow-up is especially important for patients who may need liver transplantation. Some patients may benefit from new treatment options such as radiofrequency ablation and cyberknife treatment.
Collapse
Affiliation(s)
- Funda Tayfun Küpesiz
- Division of Pediatric Hematology, Oncology and BMT, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Ayşe Nur Akınel
- Division of Pediatric Hematology, Oncology and BMT, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Hilal Akbaş
- Department of Hematology-Oncology, Clinic of Pediatrics, Konya City Hospital, Konya, Turkey
| | - Çiğdem Sivrice
- Division of Pediatric Hematology, Oncology and BMT, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Gülen Tüysüz Kintrup
- Division of Pediatric Hematology, Oncology and BMT, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Güngör Karagüzel
- Department of Pediatric Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Mustafa Melikoğlu
- Department of Pediatric Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | | | - Bülent Aydınlı
- Division of Organ Transplantation, Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Alphan Küpesiz
- Division of Pediatric Hematology, Oncology and BMT, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Elif Güler
- Division of Pediatric Hematology, Oncology and BMT, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey,Corresponding author: Elif Güler, e-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Zhuo Z, Miao L, Hua W, Chen H, Yang Z, Li Y, Zhang J, Li S, Cheng J, Li L, Xia H, He J. Genetic variations in nucleotide excision repair pathway genes and hepatoblastoma susceptibility. Int J Cancer 2021; 149:1649-1658. [PMID: 34196959 DOI: 10.1002/ijc.33722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 02/05/2023]
Abstract
The etiology of hepatoblastoma is largely unknown due to the rarity of this disease. Nucleotide excision repair (NER), a versatile system in repairing DNA damage, is highly implicated in carcinogenesis. However, it remains unclear whether single nucleotide polymorphisms (SNPs) of genes in the NER pathway are related to hepatoblastoma risk. A total of 313 Chinese children diagnosed with hepatoblastoma and 1446 controls were recruited from seven hospitals across China. TaqMan assay was adopted to genotype 19 SNPs in NER pathway genes including ERCC1, XPA, XPC, XPD, XPF and XPG. Of them, only two SNPs in XPC gene predisposed to hepatoblastoma risk. The XPC rs2607775 polymorphism significantly contributed to hepatoblastoma risk (dominant model: adjusted OR = 1.44, 95% CI = 1.01-2.05, P = .046). However, XPC rs1870134 conferred a significantly decreased risk of hepatoblastoma in recessive model (adjusted OR = 0.50, 95% CI = 0.26-0.98, P = .042). Stratified analysis revealed that rs2607775 CG/GG genotype, rs1870134 CC genotype and four to five risk genotypes were associated with the risk of hepatoblastoma under certain subgroups. The significant relationships were confirmed by haplotype analyses and false-positive report probability analyses. In addition, expression quantitative trait locus analysis suggested that rs2607775 G increased expression of XPC mRNA. Collectively, our discover a promising candidate XPC gene as a biomarker for the risk of hepatoblastoma.
Collapse
Affiliation(s)
- Zhenjian Zhuo
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lei Miao
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wenfeng Hua
- Department of Central Laboratories, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Huitong Chen
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhonghua Yang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yong Li
- Department of Pediatric Surgery, Hunan Children's Hospital, Changsha, China
| | - Jiao Zhang
- Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Suhong Li
- Department of Pathology, Children Hospital and Women Health Center of Shanxi, Taiyuan, China
| | - Jiwen Cheng
- Department of Pediatric Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Li Li
- Kunming Key Laboratory of Children Infection and Immunity, Yunnan Key Laboratory of Children's Major Disease Research, Yunnan Institute of Pediatrics Research, Yunnan Medical Center for Pediatric Diseases, Kunming Children's Hospital, Kunming, China
| | - Huimin Xia
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
7
|
|
8
|
Yong CC, Chen CL, Li Z, Ong AD. Segment 6 monosegment-preserving hepatectomy for hepatoblastoma: individualizing treatment beyond the resectability criteria. Hepatobiliary Surg Nutr 2021; 10:142-145. [PMID: 33575308 DOI: 10.21037/hbsn-20-457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/24/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Chee-Chien Yong
- Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
| | - Chao-Long Chen
- Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
| | - Zhihao Li
- Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
| | - Aldwin D Ong
- Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
| |
Collapse
|
9
|
Grabski DF, Ratan A, Gray LR, Bekiranov S, Rekosh D, Hammarskjold ML, Rasmussen SK. Upregulation of human endogenous retrovirus-K (HML-2) mRNAs in hepatoblastoma: Identification of potential new immunotherapeutic targets and biomarkers. J Pediatr Surg 2021; 56:286-292. [PMID: 32682541 DOI: 10.1016/j.jpedsurg.2020.05.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/28/2020] [Accepted: 05/18/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Hepatoblastoma is the most common liver malignancy in children. In order to advance therapy against hepatoblastoma, novel immunologic targets and biomarkers are needed. Our purpose in this investigation is to examine hepatoblastoma transcriptomes for the expression of a class of genomic elements known as Human Endogenous Retrovirus (HERVs). HERVs are abundant in the human genome and are biologically active elements that have been associated with multiple malignancies and proposed as immunologic targets in a subset of tumors. A sub-family of HERVs, HERV-K(HML-2) (HERV-K), have been shown to be tightly regulated in fetal development, making investigation of these elements in pediatric tumors paramount. METHODS We first created a HERVK-FASTA file utilizing 91 previously described HML-2 proviruses. We then concatenated the file onto the GRCh38.95 cDNA library from Ensembl. We used this reference database to evaluate existing RNA-seq data from 10 hepatoblastoma tumors and 3 normal liver controls (GEO accession ID: GSE8977575). Quantification and differential proviral expression analysis between hepatoblastoma and normal liver controls was performed using the pseudo-alignment program Salmon and DESeq2, respectively. RESULTS HERV-K mRNA was expressed in hepatoblastoma from multiple proviral loci. All expressed HERV-K proviral loci were upregulated in hepatoblastoma compared to normal liver controls. Five HERV-K proviruses (1q21.3, 3q27.2, 7q22.2, 12q24.33 and 17p13.1) were significantly differentially expressed (p-adjusted value <0.05, |log2 fold change| > 1.5) across conditions. The provirus at 17p13.1 had an approximately 300-fold increased expression in hepatoblastoma as compared to normal liver. This was in part due to the near absence of HERV-K mRNA at the 17p13.1 locus in fully differentiated liver samples. CONCLUSIONS Our investigation demonstrates that HERV-K is expressed from multiple loci in hepatoblastoma and that the expression is increased for several proviruses compared to normal liver controls. Our results suggest that HERV-K mRNA expression may be useful as a biomarker in hepatoblastoma, given the large differential expression profiles in hepatoblastoma, with very low mRNA levels in liver control samples.
Collapse
Affiliation(s)
- David F Grabski
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia; Myles H. Thaler Center for AIDS and Human Retrovirus Research, University of Virginia, Charlottesville, Virginia
| | - Aakrosh Ratan
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Laurie R Gray
- Myles H. Thaler Center for AIDS and Human Retrovirus Research, University of Virginia, Charlottesville, Virginia; Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Stefan Bekiranov
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - David Rekosh
- Myles H. Thaler Center for AIDS and Human Retrovirus Research, University of Virginia, Charlottesville, Virginia; Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Marie-Louise Hammarskjold
- Myles H. Thaler Center for AIDS and Human Retrovirus Research, University of Virginia, Charlottesville, Virginia; Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Sara K Rasmussen
- Myles H. Thaler Center for AIDS and Human Retrovirus Research, University of Virginia, Charlottesville, Virginia; Seattle Children's Hospital, Division of Transplantation, University of Washington Department of Surgery, 4800 Sand Point Way, Seattle, WA 98105.
| |
Collapse
|
10
|
Sindhi R, Rohan V, Bukowinski A, Tadros S, de Ville de Goyet J, Rapkin L, Ranganathan S. Liver Transplantation for Pediatric Liver Cancer. Cancers (Basel) 2020; 12:cancers12030720. [PMID: 32204368 PMCID: PMC7140094 DOI: 10.3390/cancers12030720] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 02/06/2023] Open
Abstract
Unresectable hepatocellular carcinoma (HCC) was first removed successfully with total hepatectomy and liver transplantation (LT) in a child over five decades ago. Since then, children with unresectable liver cancer have benefitted greatly from LT and a confluence of several equally important endeavors. Regional and trans-continental collaborations have accelerated the development and standardization of chemotherapy regimens, which provide disease control to enable LT, and also serve as a test of unresectability. In the process, tumor histology, imaging protocols, and tumor staging have also matured to better assess response and LT candidacy. Significant trends include a steady increase in the incidence of and use of LT for hepatoblastoma, and a significant improvement in survival after LT for HCC with each decade. Although LT is curative for most unresectable primary liver sarcomas, such as embryonal sarcoma, the malignant rhabdoid tumor appears relapse-prone despite chemotherapy and LT. Pediatric liver tumors remain rare, and diagnostic uncertainty in some settings can potentially delay treatment or lead to the selection of less effective chemotherapy. We review the current knowledge relevant to diagnosis, LT candidacy, and post-transplant outcomes for these tumors, emphasizing recent observations made from large registries or larger series.
Collapse
Affiliation(s)
- Rakesh Sindhi
- Hillman Center for Pediatric Transplantation, UPMC-Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USA; (A.B.); (S.T.)
- Correspondence: ; Tel.: +1-412-692-7123
| | - Vinayak Rohan
- Medical University of South Carolina, Charleston, SC 29403, USA;
| | - Andrew Bukowinski
- Hillman Center for Pediatric Transplantation, UPMC-Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USA; (A.B.); (S.T.)
| | - Sameh Tadros
- Hillman Center for Pediatric Transplantation, UPMC-Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USA; (A.B.); (S.T.)
| | - Jean de Ville de Goyet
- Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), 90127 Palermo, Italy;
| | - Louis Rapkin
- Department of Hematology/Oncology, UPMC-Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USA;
| | - Sarangarajan Ranganathan
- Department of Pathology, Children’s Hospital Medical Center of Cincinnati, Cincinnati, OH 45229, USA;
| |
Collapse
|
11
|
Filin AV, Kim EF, Charchyan ER, Metelin AV, Dymova OV, Kachanov DY, Moiseenko RA, Khovrin VV, Kryzhanovskaya EY, Kazakova OV, Ryabov AB, Bazarov DV. [Liver transplantation for hepatoblastoma in children]. Khirurgiia (Mosk) 2020:5-13. [PMID: 33210501 DOI: 10.17116/hirurgia20201115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To improve the outcomes in children with hepatoblastoma. MATERIAL AND METHODS There were 160 children with focal liver lesions who underwent surgery at the department of liver transplantation in 2008-2019. Patients with malignant tumors made up 77% (n=123). Hepatoblastoma (HB) prevailed (86%, n=106). Liver transplantation was performed in 19 (18%) patients with HB. Median follow-up after transplantation was 24.3 months by December 2019. Follow-up period did not exceed 4 years in more than 2/3 of patients. RESULTS Overall and disease-free 10-year survival was 87.1% and 82.7%, respectively. Similar values were observed after resections (91.1% and 86.6%). At the same time, actuarial 4-year survival after liver transplantation for HB was 68%. CONCLUSION Improvement of treatment outcomes may be achieved through multidisciplinary interaction ensuring timely drug therapy and liver transplantation.
Collapse
Affiliation(s)
- A V Filin
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - E F Kim
- Moscow City Hospital of Oncology No. 62, Moscow, Russia
| | - E R Charchyan
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - A V Metelin
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - O V Dymova
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - D Yu Kachanov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - R A Moiseenko
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - V V Khovrin
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | | | - O V Kazakova
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - A B Ryabov
- Herzen Moscow Oncology Research Center, Moscow, Russia
| | - D V Bazarov
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| |
Collapse
|