Towards an international pediatric liver tumor consensus classification: proceedings of the Los Angeles COG liver tumors symposium
Towards an international pediatric liver tumor consensus classification: proceedings of the Los Angeles COG liver tumors symposium
复制标题
DOI：
10.1038/modpathol.2013.80
复制
发表时间：
2014-03-01
期刊：
影响因子：
7.5
通讯作者：
Finegold, Milton J.
中科院分区：
文献类型：
--
作者：
Lopez-Terrada, Dolores;Alaggio, Rita;Finegold, Milton J.
肝脏肿瘤在儿童中很少见，由于缺乏目前的共识分类系统，其诊断可能具有挑战性。作为儿科协作治疗方案的一部分，对这些肿瘤进行系统的中心组织病理学审查，可以识别具有不同临床相关性的组织学亚型。因此，组织病理学已被纳入儿童肿瘤组（COG）的协议，并仅在美国，作为一个风险分层参数和患者管理。因此，COG肝脏肿瘤委员会于2011年3月主办了国际病理学研讨会，讨论儿科肝脏肿瘤的组织病理学和分类，特别是肝母细胞瘤，并致力于国际合作项目所需的国际儿科肝脏肿瘤共识分类。22名儿科肝脏肿瘤病理学家和专家，包括担任COG、欧洲国际儿科肿瘤学会、儿科肿瘤学和血液学协会和日本儿科肝脏肿瘤研究小组方案中心审查员的人员，以及该领域的儿科肿瘤学家和外科医生，回顾了50多例小儿肝肿瘤病例，讨论了经典和新报告的实体，以及其分类标准。这次研讨会代表了第一个合作步骤，以制定一个分类，可能会导致一个共同的治疗分层系统纳入肿瘤组织病理学。标准化的、有临床意义的分类也是必要的，以便整合新的生物学参数，并转向基于患者特征和肿瘤遗传学的临床算法，这将改善未来的患者管理和结果。
Liver tumors are rare in children, and their diagnoses may be challenging particularly because of the lack of a current consensus classification system. Systematic central histopathological review of these tumors performed as part of the pediatric collaborative therapeutic protocols has allowed the identification of histologic subtypes with distinct clinical associations. As a result, histopathology has been incorporated within the Children's Oncology Group (COG) protocols, and only in the United States, as a risk-stratification parameter and for patient management. Therefore, the COG Liver Tumor Committee sponsored an International Pathology Symposium in March 2011 to discuss the histopathology and classification of pediatric liver tumors, and hepatoblastoma in particular, and work towards an International Pediatric Liver Tumors Consensus Classification that would be required for international collaborative projects. Twenty-two pathologists and experts in pediatric liver tumors, including those serving as central reviewers for the COG, European Societe Internationale d'Oncologie Pediatrique, Gesellschaft fur Padiatrische Onkologie und Hamatologie, and Japanese Study Group for Pediatric Liver Tumors protocols, as well as pediatric oncologists and surgeons specialized in this field, reviewed more than 50 pediatric liver tumor cases and discussed classic and newly reported entities, as well as criteria for their classification. This symposium represented the first collaborative step to develop a classification that may lead to a common treatment-stratification system incorporating tumor histopathology. A standardized, clinically meaningful classification will also be necessary to allow the integration of new biological parameters and to move towards clinical algorithms based on patient characteristics and tumor genetics, which should improve future patient management and outcome.