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Outcome of staging chest CT and identification of factors associated with lung metastasis in children with hepatoblastoma

  • Oncology
  • Published:
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Abstract

Objectives

To evaluate the outcome of staging chest CT and to identify clinicoradiological factors predictive of lung metastasis in patients with hepatoblastoma based on the 2017 PRE-Treatment EXTent of tumor (PRETEXT) system.

Methods

This bi-center study retrospectively identified patients diagnosed with hepatoblastoma between January 1998 and September 2019 in two tertiary hospitals. The primary outcome was the proportion of the patients who had lung metastasis at staging chest CT. The diagnostic accuracy of staging chest CT was calculated based on the 2017 PRETEXT criteria. The secondary outcome was the identification of factors predictive of lung metastasis using multivariable logistic regression.

Results

In total, 123 patients (median age, 1 year; interquartile range, 0–4 years; 59 female) were included. Among those, 28% (35/123; 95% confidence interval [CI], 21–37%) had lung metastasis at staging chest CT. The overall accuracy of staging chest CT was 96.8%. The proportion of lung metastasis in patients with stage I, II, III, and IV was 0%, 24% (12 of 49; 95% CI, 14–38%), 23% (9 of 40; 95% CI, 12–38%), and 56% (14 of 25; 95% CI, 37–73%), respectively. Multifocality (adjusted odds ratio, 6.7; 95% CI, 2.7–17.5; p < .001) and male sex (adjusted odds ratio, 3.1; 95% CI, 1.2–8.6; p = .02) were associated with the presence of lung metastasis.

Conclusions

Twenty-eight percent of the patients with hepatoblastoma had lung metastasis at staging chest CT. Multifocality and male sex were predictive factors for lung metastasis on staging chest CT.

Key Points

• The proportion of lung metastasis in patients with hepatoblastoma was 28%.

• The overall accuracy of staging chest CT was 97% based on the 2017 PRETEXT system.

• Hepatic tumor multifocality and male sex were predictors of lung metastasis.

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Abbreviations

AFP:

Alpha-fetoprotein

CT:

Computed tomography

OR:

Odds ratio

PRETEXT system:

PRE-Treatment EXTent of tumor system

STROBE:

Strengthening the Reporting of Observational Studies in Epidemiology

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Funding

This study was supported by a grant (2020IE0016) from Asan Medical Center Children’s Hospital (Heart Institute), Seoul, Korea, and the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2020R1G1A1004591).

Author information

Author notes

  1. Pyeong Hwa Kim and Jisun Hwang contributed equally to this work (joint first authorship).

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Pyeong Hwa Kim, Hee Mang Yoon, Ah Young Jung, Young Ah Cho & Jin Seong Lee

  2. Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do, Republic of Korea

    Jisun Hwang

  3. Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyun Joo Shin, Haesung Yoon & Mi-Jung Lee

  4. Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Kyung-Nam Koh & Hyery Kim

  5. Department of Pediatric Surgery, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Jung-Man Namgoong & Dae Yeon Kim

Authors
  1. Pyeong Hwa Kim
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  2. Jisun Hwang
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  3. Hee Mang Yoon
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  8. Young Ah Cho
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  9. Jin Seong Lee
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  10. Kyung-Nam Koh
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  11. Hyery Kim
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Corresponding author

Correspondence to Hee Mang Yoon.

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Guarantor

The scientific guarantor of this publication is Hee Mang Yoon.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects have been reported in our previous study (HM Yoon Et al Prognostic factors for event-free survival in pediatric patients with hepatoblastoma base on the 2017 PRETEXT and CHIC-HS systems. 2019. Cancers).

Methodology

• retrospective

• observational

• multicenter study

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Kim, P.H., Hwang, J., Yoon, H.M. et al. Outcome of staging chest CT and identification of factors associated with lung metastasis in children with hepatoblastoma. Eur Radiol 31, 8850–8857 (2021). https://doi.org/10.1007/s00330-021-08047-w

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  • DOI: https://doi.org/10.1007/s00330-021-08047-w

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