IDDF2023-ABS-0031 Outcomes of liver transplantation for pediatric hepatoblastoma: a single-center study

BackgroundHepatoblastoma (HB) is the most common liver malignancy in children, and liver transplantation (LT) has been accepted as a curative treatment for unresectable HB. There are few data reporting outcomes of LT for HB in China. The primary objective was to evaluate the outcomes of liver transplantation in HB, and the secondary objective was to assess the clinical parameters that influence the outcomes of liver transplantation in HB.MethodsWe retrospectively analyzed a cohort comprising of 44 HB children who underwent LT in our center (2016.1-2022.8). Their baseline clinical characteristics were analyzed, and independent predictors for outcomes were also assessed.ResultsDuring the study period, 20 patients underwent primary liver transplantation (PLT), and 24 patients accepted salvage liver transplantation (SLT). The 5-year event-free survival (EFS) and overall survival (OS) after LT were 60.0% and 79.4%, respectively (IDDF2023-ABS-0031 Figure 1. Overall survival and event free survival of LT group (n=44)). Except for multifocal liver tumor (p=0.030) and intraoperative blood loss (p=0.026), there was no significant difference in clinical characteristics between PLT and SLT groups. The EFS (p=0.7133) (IDDF2023-ABS-0031 Figure 2. Event free survival in patients underwent PLT(n=22) versus SLT(n=24), from the time of LT) and OS (p=0.6048) (IDDF2023-ABS-0031 Figure 3. Overall survival in patients underwent PLT(n=22) versus SLT(n=24), from the time of LT) were not significantly different between PLT and SLT groups. Univariate and multivariate analysis identified that serum α-fetoprotein (AFP) level before LT was an independent risk factor of EFS after LT (p=0.032), and distal metastasis before LT was an independent risk factor of OS after LT (p=0.023). Patients with serum AFP>=1000ng/ml before LT showed significantly worse EFS (p=0.0092) (IDDF2023-ABS-0031 Figure 4. Event free survival in patients with AFP (before LT)=1000ng/ml, from the time of LT). Patients with distal metastasis before LT showed significantly worse OS (p=0.0072) (IDDF2023-ABS-0031 Figure 5. Overall survival in patients with distal metastasis(before LT) versus without distal metastasis, from the time of LT). All the disease relapsed within 12 months after LT, among which 10 patients recurred only in the lung. All achieved disease-free survival with their metastases completely regressed by chemotherapy or resected by surgery.ConclusionsLT achieved good outcomes f