Clinicopathologic features of hepatocellular carcinoma in young patients

Abstract

To investigate clinicopathologic characteristics of hepatocellular carcinoma (HCC) in young adults, excised tumors from 21 patients younger than 45 years (young group) were compared with findings in tumors from 204 patients older than 45 (old group). In the young group HCC showed (1) a high incidence of positive hepatitis B virus surface antigen (HBsAg) (young 71.4% versus old 20.1%); (2) relatively well-preserved hepatocellular function (indocyanine green test; young 10.7 +/- 8.8% versus old 20.6 +/- 10.8%); (3) low incidence of histologically verified concomitant cirrhosis (young 52.4% versus old 78.4%); and (4) a more advanced stage of the disease in TNM classification (Stage III; young 52.4% versus old 18.1%). With respect to survival rates achieved by surgery, there was no statistically significant difference between the two groups. Thus, hepatitis B virus may relate to the occurrence of HCC in the young patients. Despite the advanced stage in the young group, survival rate after surgery was comparable with that achieved in the old group. These observations mean that a close periodic surveillance of young adults with a positive HBsAg is required to detect HCC at an early stage. Treatment of patients with HBsAg using interferon or vidarabine and hepatitis B vaccine should be made to convert HBsAg to negative in these individuals.

Hepatocellular Carcinoma in Young Adults: The Clinical Characteristics, Prognosis, and Findings of a Patient Survival Analysis

“…Periodic follow-ups for liver dysfunction had been performed in only five patients (25%). Our present findings agree with a previous observation that most cases of HCC in young adults are not detected until the tumors are already at an advanced stage [6]. Fifteen of 20 patients were positive for HBsAg.…”

Clinicopathological characteristics and prognostic factors in young patients after hepatectomy for hepatocellular carcinoma

“…Many young patients with HCC have HBs-Ag, that is, up to 71.4 to 100% [3-5,7-11,14]. Meanwhile, cases of HCV-Ab-positivity plus HCC among younger patients are reported at rates of 0 to 10% [4,5,7-10,12,14], which is much lower than the range for older patients.…”

“…Generally, there are few opportunities for discovery of malignant tumors in younger patients, and thus they tend to present with a highly advanced malignancy at the time of diagnosis; nonetheless, younger patients can expect long-term survival. The definition of what constitutes a “young patient” differs between studies [3-12]. HCC is fairly rare in younger individuals, with an occurrence rate of only 0.6 to 2.7% in those under 40 years of age, according to Japanese reports [12-14].…”

Clinicopathologic Features and Prognosis of Young Patients With Hepatocellular Carcinoma in a Large German Cohort

“…The age classification was heterogeneous in different publications defining young patients as younger than 30, 5,6 45, 14 in Child-Pugh status A. Furthermore, most investigations in this age group were done in the HBV-endemic Asian Pacific region, where HBV was more common in younger than in older patients.…”

“…Furthermore, most investigations in this age group were done in the HBV-endemic Asian Pacific region, where HBV was more common in younger than in older patients. [5][6][7]10,14,15 In our young collective, the number of patients without underlying liver disease was higher than in these Asian collectives.…”