Abstract: Objective To study the establishment of prognostic risk model of hepatoblastoma in children and the comparison with PRETEXT staging system.Methods One hundred and fourteen Shanxi children with hepatoblastoma between February 2015 and February 2017 were admitted to our hospital,the clinical data of children were analyzed retrospectively. The 3-year overall survival rate was recorded.The Cox risk model was used to analyze the influencing factors of 3-year overall survival rate of children, and the prognosis prediction model was established.The value of prognostic risk model and PRETEXT staging system to judge the 3-year survival rate were analyzed by using receiver operating characteristic curve (ROC) model.Results There were 72 survived in 3 years and 42 died among the 114 children,the 3-year overall survival rate was 63.2%.The Cox regression model analysis showed that the AFP half-life (95%CI=1.262～5.291,HR=2.584),ApoA-I (95%CI=0.327~0.833,HR=0.522), PRETEXT stage (95%CI=1.146~3.596, HR=2.030), pathological classification (95% CI=1.213~2.803,HR=1.844) and distant metastasis (95%CI=2.074~5.096, HR=3.251) were independent factors which affected the 3-year survival rate of children with hepatoblastoma (P<0.05).The risk model of prognosis was obtained,which accorded to the results of Cox multivariate regression analysis.Risk factor (R)=0.949(half-life of AFP)-0.650(ApoA-I)+0.708(PRETEXT stage)+0.612(pathological classification) +1.179(metastasis).The results of ROC analysis showed that the R and PRETEXT stages were of high value in judging the 3-year survival rate (P<0.05).The area under curve (AUC) of R to judge 3-year survival rate was 0.806,which was higher than 0.663 of PRETEXT stage.Conclusion The prognosis risk model based on Cox multiple factor regression and the PRETEXT stage can help to judge the 3-year survival rate of children with hepatoblastoma, and the accuracy of prognosis risk model is higher.

Key words: Hepatoblastoma, Prognostic risk model, PRETEXT staging system, Predictive value