Neonatal medical exposures and characteristics of low birth weight hepatoblastoma cases: A report from the Children's Oncology Group

Lucie M. Turcotte, Michael K. Georgieff, Julie A. Ross, James H. Feusner, Gail E. Tomlinson, Marcio H. Malogolowkin, Mark D. Krailo, Nicole Miller, Rachel Fonstad, Logan G. Spector

Research output: Contribution to journalArticle

Abstract

Background: Hepatoblastoma is a malignancy of young children. Low birth weight is associated with significantly increased risk of hepatoblastoma and neonatal medical exposures are hypothesized as contributors. This study represents the largest case-control study of hepatoblastoma to date and aimed to define the role of neonatal exposures in hepatoblastoma risk among low birth weight children. Procedure: Incident hepatoblastoma cases who were born <2,500g (N=60), diagnosed between 2000 and 2008, were identified through the Children's Oncology Group. Controls were recruited through state birth registries (N=51). Neonatal medical exposures were abstracted from medical records. Subjects from the Vermont Oxford Network were used for further comparisons, as were existing reports on neonatal medical exposures. Results: Case-control comparisons were hindered by poor matching within birth weight strata. Cases were smaller and received more aggressive neonatal treatment compared to controls, and reflected high correlation levels between birth weight and treatments. Similar difficulty was encountered when comparing cases to Vermont Oxford Network subjects; cases were smaller and required more aggressive neonatal therapy. Furthermore, it appears hepatoblastoma cases were exposed to a greater number of diagnostic X-rays than in case series previously reported in the neonatal literature. Conclusions: This study presents the largest case series of hepatoblastoma in <2,500g birth weight infants with accompanying neonatal medical exposure data. Findings confirm that birth weight is highly correlated with exposure intensity, and neonatal exposures are themselves highly correlated, which hampers the identification of a causal exposure among hepatoblastoma cases. Experimental models or genetic susceptibility testing may be more revealing of etiology.

Original languageEnglish (US)
Pages (from-to)2018-2023
Number of pages6
JournalPediatric Blood and Cancer
Volume61
Issue number11
DOIs
StatePublished - Nov 1 2014

Fingerprint

Hepatoblastoma
Low Birth Weight Infant
Birth Weight
Genetic Testing
Genetic Predisposition to Disease
Radiography
Medical Records
Registries
Case-Control Studies
Theoretical Models
Therapeutics
Parturition

Keywords

  • Case-control study
  • Exposure
  • Hepatoblastoma
  • Low birth weight
  • NICU

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Neonatal medical exposures and characteristics of low birth weight hepatoblastoma cases : A report from the Children's Oncology Group. / Turcotte, Lucie M.; Georgieff, Michael K.; Ross, Julie A.; Feusner, James H.; Tomlinson, Gail E.; Malogolowkin, Marcio H.; Krailo, Mark D.; Miller, Nicole; Fonstad, Rachel; Spector, Logan G.

In: Pediatric Blood and Cancer, Vol. 61, No. 11, 01.11.2014, p. 2018-2023.

Research output: Contribution to journalArticle

Turcotte, LM, Georgieff, MK, Ross, JA, Feusner, JH, Tomlinson, GE, Malogolowkin, MH, Krailo, MD, Miller, N, Fonstad, R & Spector, LG 2014, 'Neonatal medical exposures and characteristics of low birth weight hepatoblastoma cases: A report from the Children's Oncology Group', Pediatric Blood and Cancer, vol. 61, no. 11, pp. 2018-2023. https://doi.org/10.1002/pbc.25128
Turcotte, Lucie M. ; Georgieff, Michael K. ; Ross, Julie A. ; Feusner, James H. ; Tomlinson, Gail E. ; Malogolowkin, Marcio H. ; Krailo, Mark D. ; Miller, Nicole ; Fonstad, Rachel ; Spector, Logan G. / Neonatal medical exposures and characteristics of low birth weight hepatoblastoma cases : A report from the Children's Oncology Group. In: Pediatric Blood and Cancer. 2014 ; Vol. 61, No. 11. pp. 2018-2023.
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AU - Feusner, James H.

AU - Tomlinson, Gail E.

AU - Malogolowkin, Marcio H.

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N2 - Background: Hepatoblastoma is a malignancy of young children. Low birth weight is associated with significantly increased risk of hepatoblastoma and neonatal medical exposures are hypothesized as contributors. This study represents the largest case-control study of hepatoblastoma to date and aimed to define the role of neonatal exposures in hepatoblastoma risk among low birth weight children. Procedure: Incident hepatoblastoma cases who were born <2,500g (N=60), diagnosed between 2000 and 2008, were identified through the Children's Oncology Group. Controls were recruited through state birth registries (N=51). Neonatal medical exposures were abstracted from medical records. Subjects from the Vermont Oxford Network were used for further comparisons, as were existing reports on neonatal medical exposures. Results: Case-control comparisons were hindered by poor matching within birth weight strata. Cases were smaller and received more aggressive neonatal treatment compared to controls, and reflected high correlation levels between birth weight and treatments. Similar difficulty was encountered when comparing cases to Vermont Oxford Network subjects; cases were smaller and required more aggressive neonatal therapy. Furthermore, it appears hepatoblastoma cases were exposed to a greater number of diagnostic X-rays than in case series previously reported in the neonatal literature. Conclusions: This study presents the largest case series of hepatoblastoma in <2,500g birth weight infants with accompanying neonatal medical exposure data. Findings confirm that birth weight is highly correlated with exposure intensity, and neonatal exposures are themselves highly correlated, which hampers the identification of a causal exposure among hepatoblastoma cases. Experimental models or genetic susceptibility testing may be more revealing of etiology.

AB - Background: Hepatoblastoma is a malignancy of young children. Low birth weight is associated with significantly increased risk of hepatoblastoma and neonatal medical exposures are hypothesized as contributors. This study represents the largest case-control study of hepatoblastoma to date and aimed to define the role of neonatal exposures in hepatoblastoma risk among low birth weight children. Procedure: Incident hepatoblastoma cases who were born <2,500g (N=60), diagnosed between 2000 and 2008, were identified through the Children's Oncology Group. Controls were recruited through state birth registries (N=51). Neonatal medical exposures were abstracted from medical records. Subjects from the Vermont Oxford Network were used for further comparisons, as were existing reports on neonatal medical exposures. Results: Case-control comparisons were hindered by poor matching within birth weight strata. Cases were smaller and received more aggressive neonatal treatment compared to controls, and reflected high correlation levels between birth weight and treatments. Similar difficulty was encountered when comparing cases to Vermont Oxford Network subjects; cases were smaller and required more aggressive neonatal therapy. Furthermore, it appears hepatoblastoma cases were exposed to a greater number of diagnostic X-rays than in case series previously reported in the neonatal literature. Conclusions: This study presents the largest case series of hepatoblastoma in <2,500g birth weight infants with accompanying neonatal medical exposure data. Findings confirm that birth weight is highly correlated with exposure intensity, and neonatal exposures are themselves highly correlated, which hampers the identification of a causal exposure among hepatoblastoma cases. Experimental models or genetic susceptibility testing may be more revealing of etiology.

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