Long-term hepatic outcomes in survivors of stage 4S and 4 XXXX in infancy.

@entity1 @entity82 @entity648 @entity4383 @entity521
BACKGROUND: @entity1 with stage 4 and 4S @entity521 ( @entity521 ) have a superior prognosis to older @entity1 . However, they often require intensive therapy including abdominal radiation. We aimed to investigate the long-term hepatic outcomes in @entity1 with stage 4S and 4 @entity521 . METHODS: We reviewed the charts of 38 @entity1 diagnosed with stage 4S and 4 @entity521 between 1984 and 2002. We included only those with available follow-up 5 years following diagnosis. We assessed hepatic imaging and function (transaminases, @entity648 , alkaline phosphatase) at all available time points from diagnosis. Abnormalities present at more than 5 years from diagnosis were considered persistent late changes. RESULTS: We identified 15 stage 4S and 12 stage 4 @entity1 . Twelve of 15 stage 4S @entity1 had hepatic involvement at diagnosis, 8 of whom required abdominal radiation. Five of eight demonstrated late imaging changes. Two of four with hepatic metastases but no radiation demonstrated late imaging changes. The late imaging changes resolved over time and without intervention in 3/7 survivors. The persistent lesions included liver @entity82 (1) and @entity4383 ( @entity4383 ) (3). Five of 12 stage 4 @entity521 @entity1 had hepatic involvement at diagnosis; none required radiation or had late hepatic imaging changes. CONCLUSIONS: In stage 4S @entity521 , adverse hepatic effects are infrequent, may resolve over time, and occur with or without radiation. @entity4383 should be considered in those with persistent late imaging changes. Adverse hepatic outcomes after liver involvement or radiation in @entity1 with stage 4 @entity521 rarely occur.
