Evidence map›Paper›PMID 40996219›Full record

ArticleAnnals of surgery2025

Implementation of Comprehensive Surgical Guidelines for Hepatoblastoma: Analysis of the Children's Oncology Group AHEP0731 Phase III Trial.

Zachary J Kastenberg, Sanjeev A Vasudevan, Lucy Dolmadjian, Max R Langham, Jin Piao, Gregory M Tiao, Stephen P Dunn, Eugene D McGahren, Alexander J Towbin, M Beth McCarville and 12 more

Abstract read
In one paragraph

Article in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Zachary J KastenbergDepartment of Surgery, University of Utah School of Medicine and Primary Children's Hospital, Salt Lake City, UT.ORCID 0000-0002-2561-7539
Sanjeev A VasudevanTexas Children's Hospital, Baylor College of Medicine, Houston, TX.
Lucy DolmadjianChildren's Oncology Group, Monrovia CA.
Max R LanghamSt. Jude Children's Research Hospital, Memphis, TN.
Jin PiaoUniversity of Southern California Keck School of Medicine, Los Angeles, CA.
Gregory M TiaoCincinnati Children's Hospital Medical Center, Cincinnati, OH.
Stephen P DunnNemours Children's Hospital, Wilmington, DE.
Eugene D McGahrenUniversity of Virginia Hospital, Charlottesville, VA.
Alexander J TowbinCincinnati Children's Hospital Medical Center, Cincinnati, OH.
M Beth McCarvilleSt. Jude Children's Research Hospital, Memphis, TN.
Marcio H MalogolowkinUniversity of California at Davis Comprehensive Cancer Center, Sacramento, CA.
Wayne L FurmanSt. Jude Children's Research Hospital, Memphis, TN.
Patrick A ThompsonNorth Carolina Children's Hospital and the University of North Carolina, Chapel Hill, NC.
Milton J FinegoldTexas Children's Hospital, Baylor College of Medicine, Houston, TX.
Sarangarajan RanganathanCincinnati Children's Hospital Medical Center, Cincinnati, OH.
Dolores Lopez-TerradaTexas Children's Hospital, Baylor College of Medicine, Houston, TX.
Mark KrailoUniversity of Southern California Keck School of Medicine, Los Angeles, CA.
Carlos Rodriguez-GalindoSt. Jude Children's Research Hospital, Memphis, TN.
Allison F O'NeillDepartment of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA.
Howard M KatzensteinNemours Children's Hospital, Wilmington, DE.
Christopher B WeldonDepartment of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA.
Rebecka L MeyersDepartment of Surgery, University of Utah School of Medicine and Primary Children's Hospital, Salt Lake City, UT.

Funding

NCTN BIQSFP ANBL1531 (NRT)U10CA180886 · NCI · PUBLIC HEALTH INSTITUTE · PI Douglas S. Hawkins · 2014 to 2026
$390.6M
COG FOREIGN ACCRUALU10CA098543 · NCI · NATIONAL CHILDHOOD CANCER FOUNDATION · PI ADAMSON, PETER C. · 2003 to 2013
$335.5M
COG SDMC - Statistics CoreU10CA180899 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI TODD A ALONZO · 2014 to 2026
$132.8M
Children's Oncology Group Statistics &Data Center GrantU10CA098413 · NCI · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI DEVIDAS, MEENAKSHI · 2003 to 2013
$67.5M
Chair's Grant U10CA098543NCI NIH HHS U10 CA098413NCI NIH HHS U10 CA098543NCI NIH HHS U10 CA180886NCI NIH HHS U10 CA180899NCTN Operations Center Grant U10CA180886NCTN Statistics and Data Center U10CA180899Statistics and Data Center Grant U10CA098413
6 · The paper itself

Abstract

objectiveTo evaluate the impact of surgical guidelines on the management of children with hepatoblastoma.

backgroundThe Children's Oncology Group study AHEP0731 was the first pediatric cooperative group trial to propose guidelines for the surgical management of children with hepatoblastoma.

methodsAHEP0731 enrolled children with hepatoblastoma between 2009 and 2018. Surgical guidelines were based upon radiographic extent of disease (PRETEXT, POST-TEXT). Planned non-real-time central review of imaging was completed at diagnosis and after two, four, and six cycles of chemotherapy to determine guideline adherence. Resection rate, event-free survival (EFS), overall survival (OS), and complications were compared between guideline adherent and nonadherent groups.

resultsOf 226 enrolled patients, 221 were evaluable of whom 205 (93%) underwent definitive surgical resection. Guideline adherence for protocol recommended timing of resection was 65% (133/205). The nonadherent group included 44/205 (21%) patients who underwent early resection and 28/205 (14%) patients who underwent late resection or late transplantation. Eighty-five patients met criteria for early referral to a liver transplant center, of whom 55 (65%) were referred within the recommended timeframe. Twelve patients received liver transplants outside of surgical guidelines. There were no significant differences in EFS, OS, or complication rates between adherent and nonadherent groups.

conclusionsImplementation of surgical guidelines, in combination with effective chemotherapy and radiologic staging, produced a higher rate of definitive tumor resection compared to historical trials. Nonadherence with surgical guidelines resulted in liver transplantation in some patients for whom partial hepatectomy might have been an option.

Indexed as

hepatoblastomasurgical guidlines

Identifiers

PMID40996219
PMCPMC13427045

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.