Towards an international pediatric liver tumor consensus classification: Proceedings of the Los Angeles COG liver tumors symposium

Dolores López-Terrada, Rita Alaggio, Maria T. De Dávila, Piotr Czauderna, Eiso Hiyama, Howard Katzenstein, Ivo Leuschner, Marcio Malogolowkin, Rebecka Meyers, Sarangarajan Ranganathan, Yukichi Tanaka, Gail Tomlinson, Monique Fabrè, Arthur Zimmermann, Milton J. Finegold

Research output: Contribution to journalArticlepeer-review

246 Scopus citations


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 Société Internationale d'Oncologie Pédiatrique, Gesellschaft für Pädiatrische Onkologie und Hämatologie, 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.

Original languageEnglish (US)
Pages (from-to)472-491
Number of pages20
JournalModern Pathology
Issue number3
StatePublished - Mar 2014


  • Hepatoblastoma
  • Pathology
  • Pediatric liver cancer classification
  • Prognosis

ASJC Scopus subject areas

  • General Medicine


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