The rate of liver cancer diagnoses in the United States increases with age. As of 2021, those aged 75 to 79 years had the highest rates of liver cancer. Risk factors for liver cancer include smoking, drinking alcohol, being overweight or obese, and having diabetes. Who is most likely to get liver cancer? Liver cancer in the United States is much more common among men than women. In 2021, there were 12.3 new liver cancer diagnoses among men per 100,000 population, compared to just five new diagnoses per 100,000 women. Concerning race and ethnicity, non-Hispanic American Indians and Alaska Natives and Hispanic have the highest rates of new liver cancer diagnoses. The five-year survival rate for liver cancer in the United States is around 22 percent, however, this rate is much higher among non-Hispanic Asian and Pacific Islanders than other races and ethnicities. Non-Hispanic Asian and Pacific Islanders have a 33 percent chance of surviving the next five years after a liver cancer diagnosis. Deaths from liver cancer In 2020, there were an estimated 20,262 deaths in the United States due to liver cancer. However, the death rate for liver cancer has decreased over the past few years. In the period 1999 to 2020, the death rate for liver cancer reached a high of five deaths per 100,000 population in 2015 but dropped to 4.6 deaths per 100,000 population by 2020. It is estimated that in 2024, there will be over 19,000 liver and intrahepatic bile duct cancer deaths among men in the United States and 10,700 such deaths among women.

In 2021, there were over 5.5 thousand registrations of newly diagnosed liver cancer in England. With a total of 617 cases in this year, the age group most affected by liver cancer in terms of number of cases was that of 70 to 74 year old men. It should of course be noted that the number of people in England in each age group varies and is therefore not necessarily a reflection of susceptibility to liver cancer.

According to the data, the rate of liver cancer diagnoses among men in 2021 was around 12 per 100,000 population, while it was five per 100,000 population among women. This statistic depicts the rate of new U.S. liver cancer diagnoses in 2021, by gender.

In 2021, 686 individuals in Scotland were diagnosed with liver cancer. The most affected age group was those aged 70 to 74 years with 134 cases, followed by the age group 75 to 79 years with 116 cases. This statistic depicts the number of newly diagnosed liver cancer cases in Scotland in 2021, by age

BackgroundLiver cancer due to hepatitis C (LCDHC) is one of the leading causes of cancer-related deaths worldwide, and the burden of LCDHC is increasing. We aimed to report the burden of LCDHC at the global, regional, and national levels in 204 countries from 1990 to 2019, stratified by etiology, sex, age, and Sociodemographic Index.MethodsData on LCDHC were available from the Global Burden of Disease, Injuries, and Risk Factors (GBD) study 2019. Numbers and age-standardized mortality, incidence, and disability-adjusted life year (DALY) rates per 100,000 population were estimated through a systematic analysis of modeled data from the GBD 2019 study. The trends in the LCDHC burden were assessed using the annual percentage change.ResultsGlobally, in 2019, there were 152,225 new cases, 141,810 deaths, and 2,878,024 DALYs due to LCDHC. From 1990 to 2019, the number of incidences, mortality, and DALY cases increased by 80.68%, 67.50%, and 37.20%, respectively. However, the age-standardized incidence, mortality, and DALY rate had a decreasing trend during this period. In 2019, the highest age-standardized incidence rates (ASIRs) of LCDHC were found in high-income Asia Pacific, North Africa and the Middle East, and Central Asia. At the regional level, Mongolia, Egypt, and Japan had the three highest ASIRs in 2019. The incidence rates of LCDHC were higher in men and increased with age, with a peak incidence in the 95+ age group for women and the 85–89 age group for men in 2019. A nonlinear association was found between the age-standardized rates of LCDHC and sociodemographic index values at the regional and national levels.ConclusionsAlthough the age-standardized rates of LCDHC have decreased, the absolute numbers of incident cases, deaths, and DALYs have increased, indicating that LCDHC remains a significant global burden. In addition, the burden of LCDHC varies geographically. Male and older adult/s individuals have a higher burden of LCDHC. Our findings provide insight into the global burden trend of LCDHC. Policymakers should establish appropriate methods to achieve the HCV elimination target by 2030 and reducing the burden of LCDHC.

Papumpare district in the west Arunachal region in India had age adjusted incidence rate of liver cancer cases among male of over 35 cases per million male adults between the years 2012 and 2016. Whereas, the age incidence rate of liver cancer among women in that region was over 14 cases per million females in the country.

This record contains raw data related to article “Incidence and predictors of hepatocellular carcinoma in patients with autoimmune hepatitis"

Abstract

In the period 2013 to 2017, over 58 percent of those aged between 15 and 44 years who were diagnosed with liver cancer in England survived for at least one year after being diagnosed, while 37 percent survived for five years. Over the period provided, the older age groups have a lower survival rate than the younger age groups.

Age-standardized incidence-based mortality rates, and annual percent changes in primary liver cancer rates, 1978–2018.

Fatty Liver Disease, encompassing both Alcoholic Fatty Liver Disease (AFLD) and Non-Alcoholic Fatty Liver Disease (NAFLD), has emerged as a major global health concern. AFLD is directly linked to excessive alcohol consumption, whereas NAFLD is associated with metabolic disorders such as obesity, diabetes, and dyslipidemia. Both conditions can progress to liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) if left unmanaged. Cirrhosis, the end-stage of chronic liver disease, contributes significantly to global morbidity and mortality.

The study behind the AFLD dataset aims to explore the long-term health outcomes of individuals diagnosed with fatty liver disease compared to a matched control group. Specifically, the study follows subjects forward to evaluate metabolic conditions, cardiovascular outcomes, and mortality rates. By analyzing this dataset, researchers can identify key risk factors for disease progression and mortality, allowing for better prevention and intervention strategies. Study Design and Data Description

The dataset consists of 18,012 individuals, categorized into two primary groups: 1. AFLD Cases: Individuals diagnosed with Alcoholic Fatty Liver Disease. 2. Matched Controls: Individuals without AFLD, but matched on factors such as age, gender, and BMI.

By selecting a control group with similar demographics, the study aims to isolate the effects of AFLD on long-term health outcomes. The inclusion criteria for AFLD cases likely involve diagnostic confirmation via imaging, liver function tests, and clinical assessment. Control subjects were chosen to ensure comparability, minimizing confounding effects.

Data Collection Methodology The dataset represents a longitudinal cohort study, meaning subjects were tracked over time to observe health outcomes. Follow-up data include: • Time to death (futime) or last known contact. • Mortality status (status), where 0 = alive at last follow-up and 1 = deceased.

This method allows to investigate the progression of AFLD, the development of metabolic complications, and survival trends.

Dataset Variables and Importance The AFLD dataset includes 10 key variables, each providing valuable insights: 1. id: A unique identifier for each subject. 2. age: Age at study entry, a crucial factor influencing metabolic and liver health. 3. male: A binary variable (0 = female, 1 = male), allowing gender-based comparisons. 4. weight (kg): A key metabolic marker, though missing for some participants. 5. height (cm): Helps in calculating BMI. 6. bmi (Body Mass Index): Derived from weight and height, it is a major risk factor for metabolic and liver diseases. 7. case.id: The matched AFLD case ID for each control. 8. futime: Follow-up duration in days, essential for survival analysis. 9. status: Survival outcome, distinguishing between deceased and surviving subjects.

Each variable plays a crucial role in understanding disease progression, mortality risks, and comorbid conditions.

This repository enables external validation of the artificial neural network published in our article with the same title using the pretrained ANN as described in the manuscript.

The parameters included in the model are:

Demographics - Gender = 'MALE' or 'FEMALE' - BCLC = Barcelona Clinic Liver Cancer staging system (values: A, B, C, D) - Age = age at second TACE, in years

Etiology / concomitant disease - Nicotine abuse, Obesity, Diabetes, Etiology alcohol (in case of liver cirrhosis due to alcohol abuse), Etiology HBV (in case of liver cirrhosis due to chronic hepatitis B infection), Etiology HCV (in case of liver cirrhosis due to chronic hepatitis C infection), Etiology NASH (in case of NASH), Etiology unknown (in case of liver cirrhosis of unknown etiology). All these parameters can take values: 0 = false and 1 = true.

Tumor related - Baseline tumor number = number of tumor lesions at baseline - Diffuse tumor = diffuse tumor growth pattern (values: 0 = nodular pattern and 1 = diffuse pattern) - Tumor size 1st, Tumor size 2nd: mRECIST evaluation of cross-sectional imaging prior to first and prior to second TACE - Treatment response: radiological response after first TACE (values: 0 = false and 1 = true)

Laboratory / liver function - Sodium 1st, Sodium 2nd, Bilirubin 1st, Bilirubin 2nd, Albumin 1st, Albumin 2nd, AST 1st, AST 2nd, ALT 1st, ALT 2nd, INR 1st, INR 2nd, Thrombocyte count 1st, Thrombocyte count 2nd, AFP 1st, AFP 2nd: laboratory values prior to first and prior to second TACE - Child Pugh score 1st, Child Pugh score 2nd, MELD score 1st, MELD score 2nd: Child Pugh and MELD score prior to first and prior to second TACE

Sarcopenia - SMI 1st, SMI 2nd: skeletal muscle index/psoas muscle index measured at the level of the L3 vertebrae prior to first and prior to second TACE

Type of TACE: - TACE = 'cTACE' or 'DEB-TACE'

Imaging used for response evaluation prior to second TACE: - Imaging = 'CT' or 'MRI'

BackgroundNASH-associated liver cancer (NALC) is a significant contributor to global cancer mortality, closely linked to the increasing prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). This study comprehensively examines the global burden of NALC from 1990 to 2021.MethodsThis study used data from the Global Burden of Disease (GBD) 2021 database to analyze NALC death and age-standardized death rates (ASDR) globally and regionally from 1990 to 2021. We applied Joinpoint regression analysis to assess temporal trends, calculating the annual percent change (APC) and average annual percent change (AAPC). Decomposition analysis was performed to break down mortality changes into contributions from population aging, growth, and epidemiological changes. A frontier analysis was used to evaluate the relationship between NALC burden and sociodemographic development using the Socio-Demographic Index (SDI). Prediction analysis of NALC deaths and ASDR from 2021 to 2045 were estimated using the Nordpred model.ResultsFrom 1990 to 2021, the global burden of NALC deaths increased significantly, with the ASDR rising from 0.38 per 100,000 in 1990 to 0.48 per 100,000 in 2021. Age-specific data in 2021 revealed that NALC deaths peaked in the 65–69 age group for men and 70–74 age group for women. Decomposition analysis indicated that population growth was the most significant contributor to the global NALC death toll, followed by population aging and epidemiological changes. Frontier analysis showed that countries like Mongolia and Gambia were farthest from the disease burden frontier, while Morocco and Ukraine were closest. Prediction analysis suggest a significant increase in NALC deaths by 2045 compared to 2021, with a larger rise in deaths among women.ConclusionThrough this study, a data-driven approach is provided to reduce the global disease burden of NALC. Essential data support for public health prevention strategies is offered, helping guide the development of targeted government interventions. Trends across global regions, countries, age groups, and genders have been analyzed, providing valuable insights for the formulation of evidence-based policies aimed at mitigating the impact of NALC worldwide.

BackgroundThe global burden of liver cancer among adolescents and young adults (AYAs) has often been underestimated, despite significant shifts in its etiology. This study analyzes the disease burden of liver cancer in AYAs from 1990 to 2021 and forecasts trends up to 2040 using data from the Global Burden of Disease Study 2021. Our goal is to provide insights that can inform resource allocation and policy planning.MethodsIncidence, mortality, and disability-adjusted life years (DALYs) data were extracted and estimated annual percentage changes calculated to assess trends. Correlation between age-standardized rates and sociodemographic index (SDI) was analyzed using Spearman correlation, and future trends were predicted using the Bayesian age-period-cohort model.FindingsGlobally, there were 24,348 new liver cancer cases and 19,270 deaths among AYAs in 2021, with decreases in age-standardized rates for incidence, mortality, and DALYs from 1990 to 2021. East Asia bears the highest burden, with males experiencing significantly higher rates than females. The burden increases with age, peaking at 35–39 years. Higher SDI is associated with lower incidence, mortality, and DALYs. While HBV remains the leading cause, NASH is the fastest-growing contributor to liver cancer incidence and mortality. Projections indicate a continued decline in liver cancer burden among AYAs, though female cases are expected to rise.InterpretationDespite a gradual decline in liver cancer burden among AYAs, NASH is emerging as a significant and rising cause of incidence and mortality. Regional and gender disparities persist, highlighting the need for tailored prevention and healthcare strategies to alleviate the liver cancer AYA's burden globally.

The Cancer Genome Atlas Liver Hepatocellular Carcinoma (TCGA-LIHC) data collection is part of a larger effort to build a research community focused on connecting cancer phenotypes to genotypes by providing clinical images matched to subjects from The Cancer Genome Atlas (TCGA). Clinical, genetic, and pathological data resides in the Genomic Data Commons (GDC) Data Portal while the radiological data is stored on The Cancer Imaging Archive (TCIA).

Matched TCGA patient identifiers allow researchers to explore the TCGA/TCIA databases for correlations between tissue genotype, radiological phenotype and patient outcomes. Tissues for TCGA were collected from many sites all over the world in order to reach their accrual targets, usually around 500 specimens per cancer type. For this reason the image data sets are also extremely heterogeneous in terms of scanner modalities, manufacturers and acquisition protocols. In most cases the images were acquired as part of routine care and not as part of a controlled research study or clinical trial.

CIP TCGA Radiology Initiative

Imaging Source Site (ISS) Groups are being populated and governed by participants from institutions that have provided imaging data to the archive for a given cancer type. Modeled after TCGA analysis groups, ISS groups are given the opportunity to publish a marker paper for a given cancer type per the guidelines in the table above. This opportunity will generate increased participation in building these multi-institutional data sets as they become an open community resource. Learn more about the CIP TCGA Radiology Initiative.

This statistic displays the age-standardized rate of liver cancer among males in Canada between 1988 and 2013, with a forecast for 2014 to 2017. In 2017, the incidence rate for liver cancer cases was predicted to reach 9.9 per 100,000 population among males. Cancer is one of the leading causes of premature death and almost half the individuals in Canada will develop this disease during their lifetime.

Market Overview:

The 7 major metastatic hepatocellular carcinoma markets are expected to exhibit a CAGR of 13.63% during 2024-2034.

The metastatic hepatocellular carcinoma market has been comprehensively analyzed in IMARC's new report titled "Metastatic Hepatocellular Carcinoma Market: Epidemiology, Industry Trends, Share, Size, Growth, Opportunity, and Forecast 2024-2034". Metastatic hepatocellular carcinoma (HCC) is an advanced stage of liver cancer characterized by the spread of malignant cells from the liver to various other parts of the body. It primarily originates in the liver's hepatocytes, and its metastatic form indicates a more aggressive and challenging disease state. The symptoms of the ailment can vary, often including abdominal pain, unexplained weight loss, fatigue, jaundice (yellowing of the eyes and skin), and stomach swelling due to fluid accumulation. These indications are frequently non-specific and may overlap with numerous other health conditions, making an accurate diagnosis crucial. The diagnosis of metastatic HCC involves a combination of medical history assessment, physical examination, and imaging techniques like computed tomography scans, magnetic resonance imaging, and positron emission tomography scans. Additionally, blood tests are performed to measure the levels of alpha-fetoprotein (AFP) and several other markers associated with liver function that can aid in diagnosis and monitoring.

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The escalating cases of various risk factors, like chronic alcohol consumption, exposure to aflatoxins, obesity, diabetes, genetic predisposition, etc., are primarily driving the metastatic hepatocellular carcinoma market. In addition to this, the inflating utilization of advanced therapeutic agents, including tyrosine kinase inhibitors, immune checkpoint inhibitors, and multi-kinase inhibitors, aimed at effectively managing disease progression and curtailing further deterioration, is creating a positive outlook for the market. Moreover, the widespread adoption of minimally invasive procedures and surgical interventions, such as radiofrequency ablation, transarterial chemoembolization, and liver transplantation, is also bolstering the market growth. These interventions play a pivotal role in arresting the malignancy's advancement and improving the quality of life for individuals suffering from the illness. Apart from this, the rising usage of palliative care strategies, since they are designed to alleviate symptoms, enhance patient comfort, and provide comprehensive support, is acting as another significant growth-inducing factor. Additionally, the emerging popularity of novel diagnostic techniques, like liquid biopsy, which detects cancer-related genetic material circulating in the bloodstream, thereby aiding in early detection and monitoring of disease progression, is also augmenting the market growth. Furthermore, the increasing application of personalized immunotherapy, an innovative approach that harnesses the patient's immune system to selectively target and eliminate cancer cells, is expected to drive the metastatic hepatocellular carcinoma market during the forecast period.

IMARC Group's new report provides an exhaustive analysis of the metastatic hepatocellular carcinoma market in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan. This includes treatment practices, in-market, and pipeline drugs, share of individual therapies, market performance across the seven major markets, market performance of key companies and their drugs, etc. The report also provides the current and future patient pool across the seven major markets. According to the report the United States has the largest patient pool for metastatic hepatocellular carcinoma and also represents the largest market for its treatment. Furthermore, the current treatment practice/algorithm, market drivers, challenges, opportunities, reimbursement scenario and unmet medical needs, etc. have also been provided in the report. This report is a must-read for manufacturers, investors, business strategists, researchers, consultants, and all those who have any kind of stake or are planning to foray into the metastatic hepatocellular carcinoma market in any manner.

Time Period of the Study

• Base Year: 2023
• Historical Period: 2018-2023
• Market Forecast: 2024-2034

Countries Covered

• United States
• Germany
• France
• United Kingdom
• Italy
• Spain
• Japan
  

Analysis Covered Across Each Country

• Historical, current, and future epidemiology scenario
• Historical, current, and future performance of the metastatic hepatocellular carcinoma market
• Historical, current, and future performance of various therapeutic categories in the market
• Sales of various drugs across the metastatic hepatocellular carcinoma market
• Reimbursement scenario in the market
• In-market and pipeline drugs

Competitive Landscape:

This report also provides a detailed analysis of the current metastatic hepatocellular carcinoma marketed drugs and late-stage pipeline drugs.

In-Market Drugs

• Drug Overview
• Mechanism of Action
• Regulatory Status
• Clinical Trial Results
• Drug Uptake and Market Performance
  

Late-Stage Pipeline Drugs

• Drug Overview
• Mechanism of Action
• Regulatory Status
• Clinical Trial Results
• Drug Uptake and Market Performance
  

*Kindly note that the drugs in the above table only represent a partial list of marketed/pipeline drugs, and the complete list has been provided in the report.

Key Questions Answered in this Report:

Market Insights

• How has the metastatic hepatocellular carcinoma market performed so far and how will it perform in the coming years?
• What are the markets shares of various therapeutic segments in 2023 and how are they expected to perform till 2034?
• What was the country-wise size of the metastatic hepatocellular carcinoma market across the seven major markets in 2023 and what will it look like in 2034?
• What is the growth rate of the metastatic hepatocellular carcinoma market across the seven major markets and what will be the expected growth over the next ten years?
• What are the key unmet needs in the market?
  

Epidemiology Insights

• What is the number of prevalent cases (2018-2034) of metastatic hepatocellular carcinoma across the seven major markets?
• What is the number of prevalent cases (2018-2034) of metastatic hepatocellular carcinoma by age across the seven major markets?
• What is the number of prevalent cases (2018-2034) of metastatic hepatocellular carcinoma by gender across the seven major markets?
• How many patients are diagnosed (2018-2034) with metastatic hepatocellular carcinoma across the seven major markets?
• What is the size of the metastatic hepatocellular carcinoma patient pool (2018-2023) across the seven major markets?
• What would be the forecasted patient pool (2024-2034) across the seven major markets?
• What are the key factors driving the epidemiological trend of metastatic hepatocellular carcinoma?
• What will be the growth rate of patients across the seven major markets?
  

Metastatic Hepatocellular Carcinoma: Current Treatment Scenario, Marketed Drugs and Emerging Therapies

• What are the current marketed drugs and what are their market performance?
• What are the key pipeline drugs and how are they expected to perform in the coming years?
• How safe are the current marketed drugs and what

This statistic shows the rate of death from liver cancer in the U.S. among adults aged 25 years and older from 2000 to 2016, by age. In 2016, there were 19.5 deaths from liver cancer among those aged 55 to 64 years per 100,000 standard U.S. population.

In order to identify the function of the tumor suppressor CYLD in liver, we generate a liver specific disruption of this gene in mouse (liver specific CYLD KO mice). In our analysis it was revealed that these mice initially develop fibrosis and finally they develop spontaneous liver cancer after 1 year of age. We performed CGH analysis in 8 different tumor foci from the tumor livers of 4 different CYLD liver specific KO animals, in comparison to wild type reference liver DNA. From every tumor liver, two cancer foci was microdissected. Cancer foci samples with IDs: DS-071_01 and DS-071_02 are from liver specific CYLD KO animal #1, DS-071_03 and DS-071_04 are from liver specific CYLD KO animal #2, DS-071_05 and DS-071_06 are from liver specific CYLD KO animal #3, DS-071_07 and DS-071_08 are from liver specific CYLD KO animal #4. Liver genomic DNA from cancer samples and from a reference wild type liver was extracted (Qiagen) and CGH analysis was performed to determine DNA copy number changes (IMGM Laboratories, Germany). This analysis revealed a large number of amplifications and deletions ranging from 0,62Mb to 14,8Mb in all chromosomes.

Nonalcoholic steatohepatitis (NASH) is related to metabolic dysregulation and the perturbation of endoplasmic reticulum (ER) homeostasis that frequently develops into hepatocellular carcinoma (HCC). Gp78 is E3 ligase, which regulates endoplasmic reticulum-associated degradation (ERAD) by ubiquitinylation of misfolded ER proteins. Here, we report that upon ageing (12 months), gp78-/- mice developed obesity, recapitulating age-related human NASH. Liver histology of gp78-/- mice revealed typical steatosis, hepatic inflammation and fibrosis, followed by progression to hepatocellular tumors. Acute ER stress revealed that loss of gp78 results in up regulation of unfolded protein response (UPR) pathways and SREBP-1 regulating de novo lipogenesis, responsible for fatty liver. Tissue array of human hepatocellular carcinoma (HCC) demonstrated that the expression of gp78 was inversely correlated with clinical grades of cancer. Here, we have described the generation of the first preclinical experimental model system which spontaneously develops age-related NASH and HCC, linking ERAD to hepatosteatosis, cirrhosis, and cancer. It suggests that gp78 is a regulator of normal liver homeostasis and a tumor suppressor in human liver.

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Demographic Summary of Available Imaging

Characteristic	Value (N = 190)
Age (months)	Mean ± SD: 25.3 ± 29 Median (IQR): 17 (10-30.2) Range: 0-189
Sex	Male: 120 (63%) Female: 70 (37%)
Race	Not Available
Ethnicity	Not Available

This collection contains data from the National Cancer Institute Clinical Trial NCT00980460, "Risk-Based Therapy in Treating Younger Patients With Newly Diagnosed Liver Cancer." It was sponsored by NCI's Children’s Oncology Group (COG) under study number AHEP0731. This phase III trial studies the side effects and how well risk-based therapy works in treating younger patients with newly diagnosed liver cancer. Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.

Trial Description

Surgery, chemotherapy drugs (cancer fighting medicines), and when necessary, liver transplant, are the main current treatments for hepatoblastoma. The stage of the cancer is one factor used to decide the best treatment. Treating patients according to the risk group they are in may help get rid of the cancer, keep it from coming back, and decrease the side effects of chemotherapy.

Hepatoblastoma treatment with curative intent requires surgical resection, but only about a third of newly diagnosed patients with hepatoblastoma have resectable disease at diagnosis. Patients who have upfront resection typically receive a total of 4–6 cycles of adjuvant chemotherapy post-surgery, with the combination of cisplatin, fluorouracil, and vincristine. The aim is to investigate whether event-free survival in children with hepatoblastoma who had complete resection at diagnosis could be maintained with two cycles of adjuvant chemotherapy. This multicentre, phase 3 trial was designed to test a risk-based treatment approach for children with hepatoblastoma, to diminish toxicity in low-risk patients, improve survival in intermediate-risk patients, and identify new agents that may be used in high-risk and recurrent patients. Patients were staged for risk classification using the Children’s Oncology Group staging guidelines before the initiation of chemotherapy, with stage IV indicating metastatic disease. Pretreatment extent of disease (PRETEXT) grouping also was performed at the time of diagnosis and with any subsequent abdominal computed tomography or magnetic resonance imaging and was used to guide the surgical management but was not used for risk classification. The response rate and outcome to the combination of vincristine and irinotecan administered in an upfront window to children newly diagnosed with high-risk hepatoblastoma was determined.

For Low-Risk patients CT chest was used for metastatic tumor response assessment. Abdominal Ultrasound was obtained at baseline. For Intermediate- and High-Risk patients abdominal ultrasound, CT and/or MRI was used for primary tumor response assessment and CT chest for metastatic tumor response assessment.

Trial Outcomes

Results of the trial for Low-Risk patients have been reported in the following publication:

Katzenstein, H. M., Langham, M. R., Malogolowkin, M. H., Krailo, M. D., Towbin, A. J., McCarville, M. B., Finegold, M. J., Ranganathan, S., Dunn, S., McGahren, E. D., Tiao, G. M., O’Neill, A. F., Qayed, M., Furman, W. L., Xia, C., Rodriguez-Galindo, C., & Meyers, R. L. (2019). Minimal adjuvant chemotherapy for children with hepatoblastoma resected at diagnosis (AHEP0731): a Children’s Oncology Group, multicentre, phase 3 trial. The Lancet Oncology, 20(5), 719–727. DOI: https://doi.org/10.1016/s1470-2045(18)30895-7. Epub 2019 Apr 8. Erratum in: Lancet Oncol. 2019 May;20(5):e243. PMID: 30975630; PMCID: PMC6499702. Epub 2019 Apr 8. Erratum in: Lancet Oncol. 2019 May;20(5):e243. PMID: 30975630; PMCID: PMC6499702.