Comparison of the Risk Stratification Systems of CHIC and New CCCG in the Prognostic Evaluation of Hepatoblastoma

LI Zhen; JIANG Hong; WANG Wenqing; WANG Yuanqi; HUANG Libin; LIU Juncheng; XUE Hongman

doi:10.11714/jsysu.med.YX20250133

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Comparison of the Risk Stratification Systems of CHIC and New CCCG in the Prognostic Evaluation of Hepatoblastoma

Clinical Research | 更新时间：2026-04-03

- Comparison of the Risk Stratification Systems of CHIC and New CCCG in the Prognostic Evaluation of Hepatoblastoma
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 47, Issue 2, Pages: 346-353(2026)
- 作者机构：
  
  1.中山大学附属第七医院儿童重症监护室，广东深圳 518107
  2.中山大学附属第一医院小儿外科，广东广州 510062
  3.中山大学附属第七医院胃肠外科，广东深圳 518107
  4.中山大学附属第一医院肝外科，广东广州 510062
  5.中山大学附属第一医院儿科二科，广东广州 510062
  6.中山大学附属第七医院儿童血液肿瘤专科，广东深圳 518107
- 作者简介：
  
  XUE Hongman； E-mail：xuehm5@mail.sysu.edu.cn
- 基金信息：
- DOI：10.11714/jsysu.med.YX20250133
  CLC： R735.7
- Received：20 September 2025，
  
  Revised：2026-02-10，
  
  Accepted：11 February 2026，
  
  Published：20 March 2026
- 稿件说明：
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李珍,蒋宏,王文青等.儿童肝肿瘤国际协作组和中国儿童肿瘤组新危险度分层在肝母细胞瘤预后评估中的应用比较[J].中山大学学报（医学科学版）,2026,47(02):346-353.

LI Zhen,JIANG Hong,WANG Wenqing,et al.Comparison of the Risk Stratification Systems of CHIC and New CCCG in the Prognostic Evaluation of Hepatoblastoma[J].Journal of Sun Yat-sen University(Medical Sciences),2026,47(02):346-353.
李珍,蒋宏,王文青等.儿童肝肿瘤国际协作组和中国儿童肿瘤组新危险度分层在肝母细胞瘤预后评估中的应用比较[J].中山大学学报（医学科学版）,2026,47(02):346-353. DOI： 10.11714/jsysu.med.YX20250133.

LI Zhen,JIANG Hong,WANG Wenqing,et al.Comparison of the Risk Stratification Systems of CHIC and New CCCG in the Prognostic Evaluation of Hepatoblastoma[J].Journal of Sun Yat-sen University(Medical Sciences),2026,47(02):346-353. DOI： 10.11714/jsysu.med.YX20250133.

摘要

目的

比较儿童肝肿瘤国际协作组（CHIC）和新中国抗癌协会小儿肿瘤专业委员会（CCCG）肝母细胞瘤（HB）危险度分层对中国HB患儿的预后预测效应和化疗指导价值，以期确定适合中国HB患儿的危险度分层。

方法

本研究回顾性分析2010年2月至2023年9月于中山大学附属第一医院初次诊断年龄＜18岁的403例HB患儿的临床资料，比较CHIC和新CCCG危险度分层的预后预测效应和化疗指导价值。使用SPSS 27.0进行统计分析。

结果

①按照新CCCG危险度分层，并且采用和未采用CCCG-HB-2016化疗方案分层化疗的患儿5年无事件生存率（EFS%）分别为82.5%和67.7%（

0.002），5年总生存率（OS%）分别为91.5%和85.1%（

=0.038）。按照CHIC危险度分层，并且采用和未采用CCCG-HB-2016化疗方案分层化疗的患儿5年EFS分别为80.3%和68.5%（

=0.030），5年OS分别为90.9%和85.8%（

=0.151）。②按照新CCCG危险度分层采用CCCG-HB-2016化疗方案分层化疗的患儿极低危（6例）、低危（20例）、中危（61例）、高危组（69例）5年EFS分别为 100%、94.1%、94.7%、66.2%（

＜0.001），5年OS分别为 100%、100%、96.5%、82.0%（

=0.017）；按照CHIC危险度分层采用CCCG-HB-2016化疗方案分层化疗的患儿极低危（32例）、低危（22例）、中危（37例）、高危组（54例）5年EFS分别为93.8%、95.2%、76.1%、66.8%（

=0.003），5年OS分别为 93.1%、100%、89.5%、85.6%（

=0.190）。③按照CCCG-HB-2016化疗方案分层化疗者，CHIC和新CCCG危险度分层EFS对比极低危、低危、中危、高危组的

值分别为0.537、0.879、0.023、0.934。采用CCCG-HB-2016化疗方案分层化疗者，新CCCG危险度分层中危组相比于CHIC危险度分层中危组5年EFS具有显著优势（94.7%

. 76.1%）。

结论

新CCCG相比于CHIC危险度分层，对中国HB患儿预后预测效应和化疗指导价值可能更优，中危组预后更优。

Abstract

Objective

To compare the Children's Hepatic tumors International Collaboration （CHIC） and the new Chinese Children's Cancer Group （CCCG） hepatoblastoma （HB） risk stratification systems in terms of their prognostic prediction efficacy and chemotherapy guidance value for Chinese children with HB， aiming to identify the risk stratification system more suitable for Chinese HB patients.

Methods

This retrospective study analyzed the clinical data of 403 pediatric patients with HB aged ＜ 18 years who were initially diagnosed at The First Affiliated Hospital of Sun Yat-sen University between February 2010 and September 2023. The prognostic predictive efficacy and chemotherapy-guided value of the CHIC and CCCG risk stratification systems was compared. Statistical analysis was performed using SPSS 27.0.

Results

①Using the new CCCG risk stratification， the 5-year event-free survival （EFS） rates for children who received versus did not receive risk-stratified chemotherapy according to the CCCG-HB-2016 protocol were 82.5% and 67.7% （

=0.002）， respectively， and the 5-year overall survival （OS） rates were 91.5% and 85.1% （

=0.038）. Using CHIC risk stratification， the corresponding 5-year EFS rates for children who received versus did not receive risk-stratified chemotherapy according to the CCCG-HB-2016 protocol were 80.3% and 68.5% （

=0.030）， and the 5-year OS rates were 90.9% and 85.8% （

=0.151）. ②Among children treated with the CCCG-HB-2016 protocol stratified by the new CCCG system， the 5-year EFS rates for the very low-risk （6 cases）， low-risk （20 cases）， intermediate-risk （61 cases）， and high-risk （69 cases） groups were 100%， 94.1%， 94.7%， and 66.2% （

＜0.001）， respectively， and the 5-year OS rates were 100%， 100%， 96.5%， and 82.0% （

=0.017）. Among children treated with the CCCG-HB-2016 protocol stratified by the CHIC system， the 5-year EFS rates for the very low-risk （32 cases）， low-risk （22 cases）， intermediate-risk （37 cases）， and high-risk （54 cases） groups were 93.8%， 95.2%， 76.1%， and 66.8% （

=0.003）， respectively， and the 5-year OS rates were 93.1%， 100%， 89.5%， and 85.6% （

=0.190）. ③For patients receiving CCCG-HB-2016 risk-stratified chemotherapy， the

-values for EFS comparisons between the CHIC and new CCCG systems within the very low-risk

， low-risk， intermediate-risk， and high-risk groups were 0.537， 0.879， 0.023， and 0.934， respectively. Among patients who received stratified chemotherapy according to the CCCG-HB-2016 regimen， the intermediate-risk group in the new CCCG risk stratification system exhibited a significant advantage in 5-year event-free survival （EFS） compared with the intermediate-risk group in the CHIC risk stratification system （94.7%

. 76.1%）.

Conclusion

Compared to the CHIC risk stratification， the new CCCG stratification may offer better prognostic prediction and guidance value for chemotherapy in Chinese HB patients， with the intermediate-risk group showing superior outcomes.

关键词

Keywords

references

Allan BJ ， Parikh PP ， Diaz S ， et al . Predictors of survival and incidence of hepatoblastoma in the paediatric population ［J］. HPB （Oxford）， 2013 ， 15 （ 10 ）： 741 - 746 .

任巧利，李艳超 . 肿瘤来源外泌体miR-106a对肝母细胞瘤及其免疫微环境的影响［J］. 实用医学杂志， 2022 ， 38 （ 19 ）： 2400 - 2406 .

Ren QL ， Li YC . Effects of tumor-derived exosome miR-106a on hepatoblastoma and immune microenvironment ［J］. J Pract Med ， 2022 ， 38 （ 19 ）： 2400 - 2406 .

Spector LG ， Birch J . The epidemiology of hepatoblastoma ［J］. Pediatr Blood Cancer ， 2012 ， 59 （ 5 ）： 776 - 779 .

Li Z ， Jiang H ， Wang YQ ， et al . The importance of age as a prognostic predictor of childhood hepatoblastoma： an analysis of single-center childhood hepatoblastoma in China ［J］. BMC Pediatr ， 2025 ， 25 （ 1 ）： 166 .

Li X ， Xue J ， Tang X ， et al . Prognostic factors and treatment outcomes of hepatoblastoma in children： a SEER database analysis ［J］. Eur J Pediatr ， 2025 ， 184 （ 11 ）： 666 .

Meyers RL ， Maibach R ， Hiyama E ， et al . Risk-stratified staging in paediatric hepatoblastoma： a unified analysis from the Children's Hepatic tumors International Collaboration ［J］. Lancet Oncol ， 2017 ， 18 （ 1 ）： 122 - 131 .

Huang J ， Hu Y ， Jiang H ， et al . CHIC risk stratification system for predicting the survival of children with hepatoblastoma： data from children with hepatoblastoma in China ［J］. Front Oncol ， 2020 ， 10 ： 552079 .

中国抗癌协会小儿肿瘤专业委员会，中华医学会小儿外科分会肿瘤专业组 . 儿童肝母细胞瘤多学科诊疗专家共识（CCCG-HB-2016）［J］. 中华小儿外科杂志， 2017 ， 38 （ 10 ）： 733 - 739 .

Chinese Children's Cancer Group Hepatoblastoma Committee ， Pediatric Surgical Oncology Group of Chinese Pediatric Society ， Chinese Medical Association . Expert consensus on multidisciplinary diagnosis and treatment of hepatoblastoma in children （CCCG-HB-2016）［J］. Chin J Pediatr Surg ， 2017 ， 38 （ 10 ）： 733 - 739 .

Haeberle B ， Rangaswami A ， Krailo M ， et al . The importance of age as prognostic factor for the outcome of patients with hepatoblastoma： analysis from the Children's Hepatic Tumors International Collaboration （CHIC） database ［J］. Pediatr Blood Cancer ， 2020 ， 67 （ 8 ）： e28350 .

Maibach R ， Roebuck D ， Brugieres L ， et al . Prognostic stratification for children with hepatoblastoma： the SIOPEL experience ［J］. Eur J Cancer ， 2012 ， 48 （ 10 ）： 1543 - 1549 .

Tang MJ ， Ma XL ， He XL ， et al . A multicenter prospective study on the management of hepatoblastoma in children： a report from the Chinese Children’s Cancer Group ［J］. World J Pediatr ， 2024 ， 20 （ 6 ）： 590 - 601 .

Feng J ， Polychronidis G ， Heger U ， et al . Incidence trends and survival prediction of hepatoblastoma in children： a population-based study ［J］. Cancer Commun （Lond）， 2019 ， 39 （ 1 ）： 62 .

Yuan XJ ， Wang HM ， Jiang H ， et al . Multidisciplinary effort in treating children with hepatoblastoma in China ［J］. Cancer Lett ， 2016 ， 375 （ 1 ）： 39 - 46 .

Hiyama E ， Hishiki T ， Watanabe K ， et al . Outcome and late complications of hepatoblastomas treated using the Japanese Study Group for Pediatric Liver Tumor 2 Protocol ［J］. J Clin Oncol ， 2020 ， 38 （ 22 ）： 2488 - 2498 .

Hishiki T ， Ida K ， Watanabe K ， et al . Treatment of intermediate-risk hepatoblastoma using a Combined Cisplatin and Doxorubicin （PLADO） regimen and optimized surgical resection ［J］. Pediatr Blood Cancer ， 2025 ， 72 （ 8 ）： e31770 .

Ding M ， Ma C ， Lin Y ， et al . Therapeutic targeting de novo purine biosynthesis driven by β-catenin-dependent PPAT upregulation in hepatoblastoma ［J］. Cell Death Dis ， 2025 ， 16 （ 1 ）： 179 .

Fan L ， Na J ， Shi T ， et al . Hepatoblastoma： from molecular mechanisms to therapeutic strategies ［J］. Curr Oncol ， 2025 ， 32 （ 3 ）： 149 .

Yang J ， Davidoff AM ， Murphy AJ . From preneoplastic lesion to heterogenous tumor： recent insights into hepatoblastoma biology and therapeutic opportunities ［J］. Mol Cancer ， 2025 ， 24 （ 1 ）： 198 .

Aronson DC ， Schnater JM ， Staalman CR ， et al . Predictive value of the pretreatment extent of disease system in hepatoblastoma： results from the International Society of Pediatric Oncology Liver Tumor Study Group SIOPEL-1 study ［J］. J Clin Oncol ， 2005 ， 23 （ 6 ）： 1245 - 1252 .

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