AFP and metastatic neoplasm: Metastatic disease at presentation, PRETEXT IV, age > 5 years and some other clinical and histopathological characteristics were also found to correlate with poor outcomes.[12] De Ioris et al[13] also identified patients with HB and low serum AFP (< 100 ng/mL) as high-risk subgroup with extensive disease at diagnosis, poor response to therapy, and poor survival.