AFP and metastatic neoplasm: The initial CHIC univariate analysis identified several factors associated with poor outcomes in children with HB: PRETEXT IV, macrovascular hepatic or portal involvement, contiguous extrahepatic disease, multifocality of the primary tumor, metastatic disease, tumor rupture, low alpha–fetoprotein (AFP) levels (<100 ng/mL) or high AFP levels (>1 million ng/mL) at diagnosis, age (≥8 years), low birth weight (<1500 gr), prematurity, and comorbidities (Beckwith-Wiedemann syndrome) [3].