Hepatic tumors in Iranian children: Characteristics and survival predictors.

Background: Hepatic tumors are rare in children. This study was conducted to determine the characteristics of liver masses in children and identify the independent predictors of their survival.

Methods: Medical records of children aged <18 years with a confirmed diagnosis of hepatic tumor diagnosed between January 2008 and December 2023 at two referral centers affiliated to Shiraz University of Medical Sciences, southern Iran, were reviewed.

Results: There were 153 children with hepatic tumors. The median age of the patients was 2 (IQR, 1-5) years. Abdominal pain and distension, and presence of a palpable mass and fever were the most common signs and symptoms at presentation. The most common tumor was hepatoblastoma (64.5 %) followed by hepatocellular carcinoma (HCC, 9.9 %). Right hepatectomy and hepatic segmentectomy were the most common surgical approach used. Children with hepatoblastoma were significantly (p < 0.001) younger than those with HCC. The risk of hepatoblastoma in males was twice that in females. Jaundice was not common in those with hepatoblastoma but it was in HCC. About a quarter of patients died. After adjusting for covariates, abdominal pain (adj OR = 4.90) and distension (adj OR = 3.17), and a diagnosis of HCC (adj OR = 13.63) were independent predictors of a poor prognosis.

Conclusions: The characteristics of pediatric hepatic tumors in our study were similar to those reported in most studies. Abdominal pain and distension and presence of HCC or jaundice were independent predictors of a poor prognosis.