Postchemotherapy alpha-fetoprotein and baseline PRETEXT groups in young children with hepatoblastoma in Lima, Peru

Background: Biochemical markers and anatomical staging describe different aspects of hepatoblastoma and require interpretation according to treatment timing. Objective: To assess the association between postchemotherapy serum alpha-fetoprotein (AFP) categories and baseline pretreatment extent of tumor (PRETEXT) groups in young children with hepatoblastoma at a referral hospital in Lima, Peru. Methods: A retrospective analytical record review included 30 eligible patients from 37 identified during 2018–2024. Age, sex, baseline and postchemotherapy AFP, baseline PRETEXT group, and pulmonary metastasis were extracted from clinical records. Frequencies and percentages described the sample. Associations were assessed using the Fisher–Freeman–Halton exact test; Pearson chi-square and Cramér’s V were also calculated. Results: Eighteen patients (60.0%) were male. All patients had baseline AFP >1,000 ng/mL. After neoadjuvant chemotherapy, AFP was <100 ng/mL in 17 patients (56.7%), 100–1,000 ng/mL in three (10.0%), and >1,000 ng/mL in ten (33.3%). PRETEXT groups I, II, III, and IV accounted for 10.0%, 20.0%, 30.0%, and 40.0%, respectively. Pulmonary metastasis was documented in 14 patients (46.7%). The association between postchemotherapy AFP and baseline PRETEXT was not statistically significant (exact p = 0.287; Pearson χ² = 8.131, six degrees of freedom, p = 0.229; Cramér’s V = 0.368). Conclusions: Lower AFP categories were frequent after chemotherapy, including among children with extensive baseline hepatic involvement. These findings describe the joint distribution of biochemical and anatomical findings without establishing an association or prognostic performance.