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2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT)

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Abstract

Imaging is crucial in the assessment of children with a primary hepatic malignancy. Since its inception in 1992, the PRETEXT (PRE-Treatment EXTent of tumor) system has become the primary method of risk stratification for hepatoblastoma and pediatric hepatocellular carcinoma in numerous cooperative group trials across the world. The PRETEXT system is made of two components: the PRETEXT group and the annotation factors. The PRETEXT group describes the extent of tumor within the liver while the annotation factors help to describe associated features such as vascular involvement (either portal vein or hepatic vein/inferior vena cava), extrahepatic disease, multifocality, tumor rupture and metastatic disease (to both the lungs and lymph nodes). This manuscript is written by members of the Children’s Oncology Group (COG) in North America, the International Childhood Liver Tumors Strategy Group (SIOPEL) in Europe, and the Japanese Study Group for Pediatric Liver Tumor (JPLT; now part of the Japan Children’s Cancer Group) and represents an international consensus update to the 2005 PRETEXT definitions. These definitions will be used in the forthcoming Trial to Pediatric Hepatic International Tumor Trial (PHITT).

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Author information

Authors and Affiliations

  1. Department of Radiology, Cincinnati Children’s Hospital, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA

    Alexander J. Towbin

  2. Division of Pediatric Surgery, Primary Children’s Hospital, University of Utah, Salt Lake City, UT, USA

    Rebecka L. Meyers

  3. Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

    Helen Woodley

  4. Department of Radiology, National Center for Child Health and Development, Tokyo, Japan

    Osamu Miyazaki

  5. Departments of Surgery and Oncology, Boston Children’s Hospital/Dana Farber Cancer Institute, Boston, MA, USA

    Christopher B. Weldon

  6. Department of Oncology, Birmingham Women’s and Children’s Hospital, Birmingham, UK

    Bruce Morland

  7. Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, Japan

    Eiso Hiyama

  8. Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, Gdansk, Poland

    Piotr Czauderna

  9. Department of Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK

    Derek J. Roebuck

  10. Division of General and Thoracic Surgery, Cincinnati Children’s Hospital, Cincinnati, OH, USA

    Greg M. Tiao

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  1. Alexander J. Towbin
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Correspondence to Alexander J. Towbin.

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Towbin, A.J., Meyers, R.L., Woodley, H. et al. 2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatr Radiol 48, 536–554 (2018). https://doi.org/10.1007/s00247-018-4078-z

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  • DOI: https://doi.org/10.1007/s00247-018-4078-z

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