Mortality Trends in Pediatric Hepatoblastoma: A Brazilian and Global Perspective.

Background: Hepatoblastoma is a rare malignant liver tumor that accounts for 1-2% of pediatric cancers. Despite its low incidence, it is a significant cause of cancer-related mortality in early childhood. Methods: This ecological study analyzed hepatoblastoma mortality in Brazilian children and adolescents (2008-2023) using data from the Mortality Information System (SIM/DATASUS). Mortality rates were calculated using official population estimates. Temporal trends were assessed using Prais-Winsten regression. Age and sex differences were analyzed using the chi-square test. Global mortality estimates (2008-2021) were obtained from the Global Burden of Disease Study for descriptive comparison. Results: A total of 267 deaths were recorded, most (66.7%) in children aged 0-4 years. Males accounted for 61.4% of cases. Although no significant mortality trends were observed for younger age groups, a significant annual decline was found among adolescents aged 15-19 years (Annual Percent Change (APC) = -38.4%, p = 0.016). Regional disparities were evident, with the Southeast presenting the highest number of deaths. Globally, the estimated number of deaths and age-specific mortality rate (ASMR) decreased over time, particularly among children under five. Conclusions: Hepatoblastoma remains a significant cause of mortality in early childhood. While Brazilian mortality rates remained stable in younger groups, mortality in adolescents showed a marked reduction. Global estimates suggest a progressive reduction in mortality.