Abstract:
BACKGROUND:Impact of R1 (microscopically margin-positive) resection on survival of patients with hepatoblastoma (HB) remains debatable. This study aimed to compare the long-term outcomes of R0 (microscopically margin-negative) and R1 resection for HB in children after hepatectomy. METHODS:We retrospectively reviewed files of children with HB who underwent resection at our institution between September 1, 2005, and November 30, 2017. Survival analyses and prognostic factors were evaluated using Kaplan-Meier curves and Cox regression models. RESULTS:Of 259 patients, 218 (84.2%) underwent R0 and 41 (15.8%) R1 resection. After adjusting for confounding factors, R1 resection demonstrated non-significantly lower overall survival (OS: hazard ratio [HR] = 0.75; 95% CI 0.34-1.64) and shorter event-free survival (EFS: HR = 0.97; 95% CI 0.53-1.78) rates than R0 resection. However, stratified analysis showed significantly increased risk of poor OS and EFS in patients with metastasis and mixed epithelial/mesenchymal pathologic subtype in R1 compared with R0 resection (P values for interactions < 0.05). There was no significant difference between R0 resection with metastasis and R1 resection with metastasis in the incidence of local recurrence (P = 0.494); however, a significant difference in the incidence of local recurrence was seen between R0 and R1 resection for subgroups with mixed pathologic subtypes (P = 0.035). CONCLUSIONS:With effective chemotherapy, microscopic margin status may not be associated with survival outcome in children with HB undergoing hepatectomy. However, stratified analysis showed that R1 resection might be associated with decreased survival in children with mixed epithelial/mesenchymal HB, compared with R0 resection, and not affect survival outcomes in those with an epithelial subtype and without metastasis.
journal_name
Int J Clin Oncoljournal_title
International journal of clinical oncologyauthors
Ren X,Li H,Diao M,Xu H,Li Ldoi
10.1007/s10147-019-01573-0subject
Has Abstractpub_date
2020-04-01 00:00:00pages
765-773issue
4eissn
1341-9625issn
1437-7772pii
10.1007/s10147-019-01573-0journal_volume
25pub_type
杂志文章abstract:BACKGROUND:Alternative anti-androgen therapy (AAT) with flutamide after combined androgen blockade (CAB) therapy with bicalutamide for metastatic prostate cancer is common. However, no studies have compared enzalutamide without AAT with enzalutamide after AAT with flutamide as treatment for castration-resistant prostat...
journal_title:International journal of clinical oncology
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journal_title:International journal of clinical oncology
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journal_title:International journal of clinical oncology
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journal_title:International journal of clinical oncology
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journal_title:International journal of clinical oncology
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doi:10.1007/s10147-006-0607-0
更新日期:2006-12-01 00:00:00
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更新日期:2012-02-01 00:00:00
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更新日期:2009-10-01 00:00:00
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journal_title:International journal of clinical oncology
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journal_title:International journal of clinical oncology
pub_type: 杂志文章,评审
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journal_title:International journal of clinical oncology
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journal_title:International journal of clinical oncology
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更新日期:2010-04-01 00:00:00
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journal_title:International journal of clinical oncology
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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journal_title:International journal of clinical oncology
pub_type: 杂志文章,评审
doi:10.1007/s10147-006-0586-1
更新日期:2006-08-01 00:00:00
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journal_title:International journal of clinical oncology
pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:International journal of clinical oncology
pub_type: 临床试验,杂志文章
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