Abstract: Objective The aim of this study was to investigate serum alpha fetoprotein (AFP) level changes in predicting prognosis of children with hepatoblastoma (HB) after radical resection of tumor. Method 105 pediatric patients with HB were encountered in our hospital between January 2018 and December 2020, all underwent radical tumor resection, and were followed-up for five years. Kaplan-Meier was applied for survival analysis, and event-free survival (EFS) and overall survival (OS) were documented. Result Based on PRETEXT staging, there were stage I in 18 cases, stage II in 39 cases, stage III in 41 cases and stage IV in 7 cases in our series; at presentation, serum AFP levels in stage I, stage II, stage III and stage IV were (43261.3±17236.9)μg/L, (47823.4±16921.3)μg/L, (60489.2±18638.3)μg/L and (73482.1±20496.5)μg/L, which decreased to(11.4±0.3)μg/L, (16.5±0.9)μg/L, (28.4±4.6)μg/L and (416.3±12.1)μg/L, respectively, six months after operation; during follow-up, incidences of tumor relapse, metastasis, EFS and OS in stage I were 16.7%, 5.6%, 77.8% and 94. 4%, in stage II were 20.5%, 7.7%, 71.8% and 92.3%, in stage III were 34.1%, 12.2%, 53.7% and 78.0%, and in stage IV were 42.9%, 57.1%, 0.0% and 57.1%. Conclusion Serum AFP levels in pediatric patients with HB is correlated to tumor stages, and those with stage III and stage IV might have even high serum AFP levels, which decreases hard to normal, and indicating poor prognosis.

Key words: Hepatoblastoma, Hepatectomy, Alpha fetoprotein, Survival, Children