Clinical characteristics
From January 2009 to June 2019, a total of 35 children with POST-TEXT III and IV hepatoblastoma were treated, including 24 males and 11 females, with an average age of 23.89 ± 22.87 months (2-91 months). Serum AFP was significantly higher than normal in all cases, of which only 1 (2.9%) case was <1000ug/L, 8 (22.8%) cases were1000-100,000 ug/L, and 26 (74.3%) cases were > 100000ug/L. There were 1, 31, and 3 cases of PRETEXT II, III, and IV, including 5 cases of lung metastasis. Tumor biopsy was performed in 27 patients (77.1%). The tumor volume before treatment was 105.23-1235.06 cm3, with an average volume of 568.99 ± 285.56 cm3.
There were 34 and 1 cases of POST-TEXT III and IV, respectively. One case of PRETEXT II was upgraded to POST-TEXT IV, and 3 cases of PRETEXT IV were downgraded to POST-TEXT III (Table 1). Neoadjuvant chemotherapy was performed in 8 patients (22.9%) within 2 cycles; 22 patients (62.9%) within 4 cycles; 5 patients (14.3%) within 6 cycles. The relationship between tumor preoperative cycles and stage is shown in Table 1. The tumor volume after chemotherapy was 20.66-1235.77 cm3, with an average volume of 272.64 ± 2569.19 cm3, of which the volume was reduced by 30 cases (85.7%), and the average size was reduced by 67.45% ± 14.98%; the volume was increased by 5 cases (14.3%), and the average size was increased by 92.14 % ± 74.71%. The relationship between tumor volume change and stage is shown in Table 1.