Another article you should know abou by Cecilia Gigena
“Aggressive Pursuit of No Evidence of Disease Status in Hepatoblastoma Improves Survival: An observational study” Fleming A et.al.
Authors: Andrew M. Fleming, Andrew J. Murphy, Suraj Sarvode Mothi, Rodrigo B. Interiano 2, Amos Loh 3, Mary E. McCarville, Zachary Abramson, Sara A. Mansfield, Hafeez Abdelhafeez, Andrew M. Davidoff, Ankush Gosain, Jessica A. Gartrell, Wayne L. Furman, Max R. Langham Jr.
Full Article: https://www.jpedsurg.org/article/S0022-3468(23)00142-2/fulltext
Abstract
Background
The utility of repeated surgical interventions in hepatoblastoma to achieve no evidence of disease (NED) is not well-defined. We examined the effect of aggressive pursuit of NED status on event-free (EFS) and overall survival (OS) in hepatoblastoma with subgroup analysis of high-risk patients.
Methods
Hospital records were queried for patients with hepatoblastoma from 2005 to 2021. Primary outcomes were OS and EFS stratified by risk and NED status. Group comparisons were performed using univariate analysis and simple logistic regression. Survival differences were compared with log-rank tests.
Results
Fifty consecutive patients with hepatoblastoma were treated. Forty-one (82%) were rendered NED. NED was inversely correlated with 5-year mortality (OR 0.006; CI 0.001–0.056; P < .01). Ten-year OS (P < .01) and EFS (P < .01) were improved by achieving NED. Ten-year OS was similar between 24 high-risk and 26 not high-risk patients when NED was attained (P = .83). Fourteen high-risk patients underwent a median of 2.5 pulmonary metastasectomies, 7 for unilateral disease, and 7 for bilateral, with a median of 4.5 nodules resected. Five high-risk patients relapsed, and three were salvaged.
Conclusions
NED status is necessary for survival in hepatoblastoma. Repeated pulmonary metastasectomy and/or complex local control strategies to obtain NED can achieve long-term survival in high-risk patients.
Level of evidence
Level III – Treatment Study - Retrospective Comparative Study.
Type: video · posted 2023-06-28 Canonical: https://library.globalcastmd.com/watch/aggressive-pursuit-of-no-evidence-of-disease-status-in-hepatoblastoma-improves-survival-6771 ## Chapters - [0:00](https://library.globalcastmd.com/watch/aggressive-pursuit-of-no-evidence-of-disease-status-in-hepatoblastoma-improves-survival-6771?t=0) Study Overview and Key Findings ## Statements - "The study was a retrospective observational study conducted at Cincinnati Children's Hospital from 2005 to 2021" — Cecilia Gigena (clinical) [0:00](https://library.globalcastmd.com/watch/aggressive-pursuit-of-no-evidence-of-disease-status-in-hepatoblastoma-improves-survival-6771?t=0) - "The study aim was to examine the effect of aggressive pursuit of no evidence of disease status on overall survival and event free status" — Cecilia Gigena (clinical) [0:20](https://library.globalcastmd.com/watch/aggressive-pursuit-of-no-evidence-of-disease-status-in-hepatoblastoma-improves-survival-6771?t=20) - "The study included 50 patients with hepatoblastoma" — Cecilia Gigena (epidemiological) [0:35](https://library.globalcastmd.com/watch/aggressive-pursuit-of-no-evidence-of-disease-status-in-hepatoblastoma-improves-survival-6771?t=35) - "41 patients were rendered to no evidence of disease status" — Cecilia Gigena (clinical) [0:42](https://library.globalcastmd.com/watch/aggressive-pursuit-of-no-evidence-of-disease-status-in-hepatoblastoma-improves-survival-6771?t=42) - "Overall survival and event free status were significantly improved in both high risk and non-high risk patients who achieved no evidence of disease status" — Cecilia Gigena (clinical) [0:48](https://library.globalcastmd.com/watch/aggressive-pursuit-of-no-evidence-of-disease-status-in-hepatoblastoma-improves-survival-6771?t=48) - "Pursuing no evidence of disease status is better for overall survival in hepatoblastoma patients" — Cecilia Gigena (opinion) [0:58](https://library.globalcastmd.com/watch/aggressive-pursuit-of-no-evidence-of-disease-status-in-hepatoblastoma-improves-survival-6771?t=58) --- Not medical advice · citation policy: https://library.globalcastmd.com/ai