Hepatoblastoma risk “strikingly” high in very low birth weight infants

Results of a new study confirm previously reported findings that children with very low birth weight have a dramatically increased risk of developing hepatoblastoma. The researchers say this suggests “the etiology may differ between children with very low birth weight and children with normal birthweight.”

Using California’s population-based cancer registry, researchers identified 113 children, ages birth to 4 years old, with hepatoblastoma. They located birth certificates for 99 of these case children and randomly matched four control children to each case patient. According to a report in the March 1st in the journal Cancer, very low birth weight (VLBW; < 1500 grams) children had a "strikingly" elevated risk of hepatoblastoma, with an odds ratio of 50.57 in univariate analysis. On multivariate analysis, VLBW was "the only variable that remained statistically significant, with a slightly lower but still remarkably large" odds ratio of 40.80, according to the team. "A closer look at the data showed that the trend was driven mainly by an increase in the number of hepatoblastoma patients with extremely low birth weights (< 1000 grams)," the researchers note.Commenting on the study, co-author Julie Von Behren, a research scientist in the Environmental Health Investigations Branch of the California Department of Health Services said: "Little is known about these rare malignancies in children. By conducting this study in such a populous state (California) we had a large enough sample size to confirm the suspected association between low birth weight and hepatoblastoma." There was also a trend toward later age at diagnosis in VLBW children compared with other children, a finding that suggests "differing etiologic mechanisms in the development of hepatoblastoma," according to the researchers. "This association raises questions about the role of factors that contribute to prematurity, such as in utero exposures, and the possible role of the medical treatments of these infants," Ms. Von Behren said. "A larger study that includes biospecimen analyses will be required to examine the relations between hepatoblastoma risk, environmental exposures, and relevant metabolic polymorphisms," she and her colleagues conclude. (Source: Cancer 2004;100:1070-1076: Reuters Health: Megan Rauscher: March 2004: Oncolink)