Andrew Fleming

87 statements · 3 topics

Liver Tumors (Hepatoblastoma/HCC) · guest expert

Featured statements

I think again, just kind of the biggest takeaway is there is no threshold for disease burden that precludes you from aggressively trying to achieve no evidence of disease uh in children with hepatblastoma.
quote · Hepatoblastoma
On logistic regression for three-year mortality, uh only achieving no evidence of disease was associated with a significant decrease in patient mortality.
quote · Hepatoblastoma
no evidence of disease is defined as a normal AFP and the absence of detectable radiographic disease on interval surveillance imaging.
quote · Liver Tumors (Hepatoblastoma/HCC)
Complete surgical resection has been determined uh to be necessary for patient survival.
quote · Liver Tumors (Hepatoblastoma/HCC)
PRETEXT group in combination with presence/absence of metastatic disease, alpha fetoprotein at diagnosis, PRETEXT modifiers, patient age and resectability at diagnosis can be used to risk stratify patients according to the AHEAD 1531 clinical trial
guideline · Metastatic Disease
Median of three nodules per patient contained pathologically confirmed viable hepatoblastoma, confirming a high degree of concordance between radiographic evidence of disease and pathological confirmation of disease
clinical · Metastatic Disease

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Andrew's statements about Hepatoblastoma 29 statements

Open the Hepatoblastoma collection →

BOB Ped Surg 2023 - Andrew Fleming, AAP - Presentation

Statement Hepatoblastoma is the most common pediatric liver cancer Open
Statement The number of contiguous hepatic sections uninvolved by tumor can be used radiographically to determine the pre-treatment extent of disease, making the PRETEXT group Open
Statement PRETEXT group in combination with presence/absence of metastatic disease, alpha fetoprotein at diagnosis, PRETEXT modifiers, patient age and resectability at diagnosis can be used to risk stratify patients according to the AHEAD 1531 clinical trial Open
Quotation Complete surgical resection has been determined uh to be necessary for patient survival. Open
Statement Complete surgical resection has been determined to be necessary for patient survival Open
Statement Cisplatin based chemotherapies have improved rates of resectability and subsequently survival for hepatoblastoma patients Open
Statement The reported survival benefits of pulmonary metastasectomy for hepatoblastoma have varied in the literature Open
Statement No evidence of disease is defined as a normal AFP and the absence of detectable radiographic disease on interval surveillance imaging Open
Quotation no evidence of disease is defined as a normal AFP and the absence of detectable radiographic disease on interval surveillance imaging. Open
Statement Among 50 patients included for analysis, 24 were determined to be high risk Open
Statement All patients received chemotherapy and 41 patients were successfully able to be rendered no evidence of disease status Open
Quotation Our group takes a fairly aggressive approach to pulmonary metastasectomy for these patients, including bilateral uh reoperative pulmonary resections if necessary. Open
Statement 14 patients underwent a total of 31 pulmonary procedures, having a median of four nodules resected per patient Open
Statement Median of three nodules per patient contained pathologically confirmed viable hepatoblastoma, confirming a high degree of concordance between radiographic evidence of disease and pathological confirmation of disease Open
Quotation On logistic regression for three-year mortality, uh only achieving no evidence of disease was associated with a significant decrease in patient mortality. Open
Statement On logistic regression for three-year mortality, only achieving no evidence of disease was associated with a significant decrease in patient mortality Open
Statement The overall survival of the entire cohort is quite high Open
Statement The event-free survival is lower than overall survival due to relapse events after achieving no evidence of disease Open
Statement The overall survival and event-free survival of the group in whom we were unable to render them no evidence of disease is significantly lower, with no patients in these cohorts surviving past two years Open
Quotation no patients in these cohorts uh surviving past two years. Open
Statement The overall survival is similar between high risk and not high risk patients who were able to be rendered no evidence of disease status Open
Statement The event-free survival remains significantly lower for the high-risk no evidence of disease group due to five high-risk patients who relapsed Open
Statement Three of five high-risk patients who relapsed were successfully salvaged using a combination of chemotherapy and further pulmonary resections Open
Statement Repeated pulmonary metastasectomy and/or complex local control strategies to obtain no evidence of disease benefit high risk patients Open
Statement No evidence of disease status is necessary for survival in patients with hepatoblastoma Open

Journal of Pediatric Article Review: June 2023, AAP Issue

Statement Once NED status was achieved, 10-year overall survival among high-risk hepatoblastoma patients was similar to patients who were not high-risk Open
Quotation Once no evidence of disease status was achieved, the 10 year overall survival. Among patients that were high risk from the get-go was actually similar to patients that were not high risk, which I think again kind of emphasizes that if you are able to get children to that point, they can have long-term survival despite being stratified into a very high-risk group from the beginning. Open
Statement There is no threshold for disease burden that precludes aggressive pursuit of no-evidence-of-disease status in children with hepatoblastoma Open
Quotation I think again, just kind of the biggest takeaway is there is no threshold for disease burden that precludes you from aggressively trying to achieve no evidence of disease uh in children with hepatblastoma. Open
Andrew's statements about Liver Tumors (Hepatoblastoma/HCC) 33 statements

Open the Liver Tumors (Hepatoblastoma/HCC) collection →

BOB Ped Surg 2023 - Andrew Fleming, AAP - Presentation

Statement Hepatoblastoma is the most common pediatric liver cancer Open
Statement The number of contiguous hepatic sections uninvolved by tumor can be used radiographically to determine the pre-treatment extent of disease, making the PRETEXT group Open
Statement PRETEXT group in combination with presence/absence of metastatic disease, alpha fetoprotein at diagnosis, PRETEXT modifiers, patient age and resectability at diagnosis can be used to risk stratify patients according to the AHEAD 1531 clinical trial Open
Quotation Complete surgical resection has been determined uh to be necessary for patient survival. Open
Statement Complete surgical resection has been determined to be necessary for patient survival Open
Statement Cisplatin based chemotherapies have improved rates of resectability and subsequently survival for hepatoblastoma patients Open
Statement The reported survival benefits of pulmonary metastasectomy for hepatoblastoma have varied in the literature Open
Statement No evidence of disease is defined as a normal AFP and the absence of detectable radiographic disease on interval surveillance imaging Open
Quotation no evidence of disease is defined as a normal AFP and the absence of detectable radiographic disease on interval surveillance imaging. Open
Statement Among 50 patients included for analysis, 24 were determined to be high risk Open
Statement All patients received chemotherapy and 41 patients were successfully able to be rendered no evidence of disease status Open
Quotation Our group takes a fairly aggressive approach to pulmonary metastasectomy for these patients, including bilateral uh reoperative pulmonary resections if necessary. Open
Statement 14 patients underwent a total of 31 pulmonary procedures, having a median of four nodules resected per patient Open
Statement Median of three nodules per patient contained pathologically confirmed viable hepatoblastoma, confirming a high degree of concordance between radiographic evidence of disease and pathological confirmation of disease Open
Statement On logistic regression for three-year mortality, only achieving no evidence of disease was associated with a significant decrease in patient mortality Open
Quotation On logistic regression for three-year mortality, uh only achieving no evidence of disease was associated with a significant decrease in patient mortality. Open
Statement The overall survival of the entire cohort is quite high Open
Statement The event-free survival is lower than overall survival due to relapse events after achieving no evidence of disease Open
Statement The overall survival and event-free survival of the group in whom we were unable to render them no evidence of disease is significantly lower, with no patients in these cohorts surviving past two years Open
Quotation no patients in these cohorts uh surviving past two years. Open
Statement The overall survival is similar between high risk and not high risk patients who were able to be rendered no evidence of disease status Open
Statement The event-free survival remains significantly lower for the high-risk no evidence of disease group due to five high-risk patients who relapsed Open
Statement Three of five high-risk patients who relapsed were successfully salvaged using a combination of chemotherapy and further pulmonary resections Open
Statement No evidence of disease status is necessary for survival in patients with hepatoblastoma Open
Statement Repeated pulmonary metastasectomy and/or complex local control strategies to obtain no evidence of disease benefit high risk patients Open

Journal of Pediatric Article Review: June 2023, AAP Issue

Statement Once NED status was achieved, 10-year overall survival among high-risk hepatoblastoma patients was similar to patients who were not high-risk Open
Quotation Once no evidence of disease status was achieved, the 10 year overall survival. Among patients that were high risk from the get-go was actually similar to patients that were not high risk, which I think again kind of emphasizes that if you are able to get children to that point, they can have long-term survival despite being stratified into a very high-risk group from the beginning. Open
Quotation Once no evidence of disease status was achieved, the 10 year overall survival. Among patients that were high risk from the get-go was actually similar to patients that were not high risk, which I think again kind of emphasizes that if you are able to get children to that point, they can have long-term survival despite being stratified into a very high-risk group from the beginning. Open
Statement Once NED status was achieved, 10-year overall survival among high-risk hepatoblastoma patients was similar to patients who were not high-risk Open
Quotation I think again, just kind of the biggest takeaway is there is no threshold for disease burden that precludes you from aggressively trying to achieve no evidence of disease uh in children with hepatblastoma. Open
Quotation I think again, just kind of the biggest takeaway is there is no threshold for disease burden that precludes you from aggressively trying to achieve no evidence of disease uh in children with hepatblastoma. Open
Statement There is no threshold for disease burden that precludes aggressive pursuit of no-evidence-of-disease status in children with hepatoblastoma Open
Statement There is no threshold for disease burden that precludes aggressive pursuit of no-evidence-of-disease status in children with hepatoblastoma Open
Andrew's statements about Metastatic Disease 25 statements

Open the Metastatic Disease collection →

BOB Ped Surg 2023 - Andrew Fleming, AAP - Presentation

Statement Hepatoblastoma is the most common pediatric liver cancer Open
Statement The number of contiguous hepatic sections uninvolved by tumor can be used radiographically to determine the pre-treatment extent of disease, making the PRETEXT group Open
Statement PRETEXT group in combination with presence/absence of metastatic disease, alpha fetoprotein at diagnosis, PRETEXT modifiers, patient age and resectability at diagnosis can be used to risk stratify patients according to the AHEAD 1531 clinical trial Open
Quotation Complete surgical resection has been determined uh to be necessary for patient survival. Open
Statement Complete surgical resection has been determined to be necessary for patient survival Open
Statement Cisplatin based chemotherapies have improved rates of resectability and subsequently survival for hepatoblastoma patients Open
Statement The reported survival benefits of pulmonary metastasectomy for hepatoblastoma have varied in the literature Open
Quotation no evidence of disease is defined as a normal AFP and the absence of detectable radiographic disease on interval surveillance imaging. Open
Statement No evidence of disease is defined as a normal AFP and the absence of detectable radiographic disease on interval surveillance imaging Open
Statement Among 50 patients included for analysis, 24 were determined to be high risk Open
Statement All patients received chemotherapy and 41 patients were successfully able to be rendered no evidence of disease status Open
Statement 14 patients underwent a total of 31 pulmonary procedures, having a median of four nodules resected per patient Open
Quotation Our group takes a fairly aggressive approach to pulmonary metastasectomy for these patients, including bilateral uh reoperative pulmonary resections if necessary. Open
Statement Median of three nodules per patient contained pathologically confirmed viable hepatoblastoma, confirming a high degree of concordance between radiographic evidence of disease and pathological confirmation of disease Open
Quotation On logistic regression for three-year mortality, uh only achieving no evidence of disease was associated with a significant decrease in patient mortality. Open
Statement On logistic regression for three-year mortality, only achieving no evidence of disease was associated with a significant decrease in patient mortality Open
Statement The overall survival of the entire cohort is quite high Open
Statement The event-free survival is lower than overall survival due to relapse events after achieving no evidence of disease Open
Statement The overall survival and event-free survival of the group in whom we were unable to render them no evidence of disease is significantly lower, with no patients in these cohorts surviving past two years Open
Quotation no patients in these cohorts uh surviving past two years. Open
Statement The overall survival is similar between high risk and not high risk patients who were able to be rendered no evidence of disease status Open
Statement The event-free survival remains significantly lower for the high-risk no evidence of disease group due to five high-risk patients who relapsed Open
Statement Three of five high-risk patients who relapsed were successfully salvaged using a combination of chemotherapy and further pulmonary resections Open
Statement Repeated pulmonary metastasectomy and/or complex local control strategies to obtain no evidence of disease benefit high risk patients Open
Statement No evidence of disease status is necessary for survival in patients with hepatoblastoma Open