Iranian Journal of Pathology

A Clinicopathological Study with Risk-Stratified Staging of Pediatric Hepatoblastoma: A 5-Year Experience from a Tertiary Cancer Center

Document Type : Original Research

Authors

Geetha V PATIL Oklay 1
Akina Prakash 1
Akshatha C 1
Ashwini Nargund 1
Libin Babu Cherian 1
Balu S 1
Arun Kumar A R 2

1 Department of Pathology, Kidwai Memorial Institute of Oncology, Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka, India

2 Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka, India

https://doi.org/10.30699/ijp.2023.1972340.3005
Abstract
Background & Objective: Hepatoblastoma encompasses 1% of pediatric malignancies and is the most common liver malignancy in children. Ninety percent of cases are under 5 years of age. Clinical and pathological risk stratification forms a crucial role in determining the treatment strategy. This study aimed to assess the clinicopathological profile of hepatoblastoma with risk stratification and follow-up in children.
Methods: A retrospective evaluation was performed on all pediatric patients recognized with hepatoblastoma between 2016 and 2020 in our institution. Clinical, radiological, biochemical, pathological, and treatment data were analyzed. Cases were stratified based on the SIOPEL protocol and compared with the outcome.
Results: The median age of all children was 1 year, the male-to-female ratio was 2.3:1, and elevated α-fetoprotein (AFP) was observed in all cases. SIOPEL risk stratification showed that 50% of children are at high risk. The histopathological types were fetal (30%), embryonal (20%), and macrotrabecular (5%) patterns under epithelial type and mixed epithelial and mesenchymal type (45%) with 1 case showing teratoid features. During the follow-up period, of the 7 children who died, 6 belonged to the high-risk SIOPEL category, and 5 had a mixed epithelial and mesenchymal pattern.
Conclusion: Our study found a significant correlation between clinicopathological data, histopathological patterns, and outcomes. Accordingly, histopathological patterns could be considered one of the criteria for risk stratification. Histopathological risk stratification indicators (such as SIOPEL and PRETEXT) have strong prognostic and predictive outcomes; hence, our study emphasizes such parameters to aid oncologists.

Keywords

CHIC, COG
Hepatoblastoma
PRETEXT
SIOPEL

Subjects

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Iranian Journal of Pathology
Volume 18, Issue 2
Spring 2023
Pages 165-172

  • Receive Date 01 December 2022
  • Revise Date 02 January 2023
  • Accept Date 12 January 2023

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