title: Comparison of childhood hepatic malignancies in a hepatitis B hyper-endemic area.
abstract: OBJECTIVE
  To examine the differences of clinical behaviors between hepatocellular carcinomas (HCC) and hepatoblastomas (HB) in children.
  
  
  METHODS
  From 1979 to 1997, we collected 73 HCC and 54 HB from two major medical centers in Taiwan. Demog-raphic, laboratory and radiological data, and survival curves were statistically compared.
  
  
  RESULTS
  HCC clinically differed from HB in mean age (10.6 vs 2.5 years; P<0.001), status of hepatitis B infection (56/56 vs 4/35, P<0.001) and accompanying liver cirrhosis (26/40 vs 0/30, P<0.001), portal vein thrombi (22/56 vs 5/38, P = 0.006) and para-aortic lymphadenopathy (10/56 vs 1/38, P = 0.026). Due to a higher recurrence rate (7/12 vs 2/13, P = 0.041), stage I HCC compared poorly in survivals with stage I HB (P = 0.0183). Chemotherapy could only benefit HB as evidenced by 66.7% of resectability conversion and improve survivals for advanced HB, even with unsuccessful conversion. The survival difference between stage I HB and advanced HB with delayed complete resection was of borderline insignificance (P = 0.0507).
  
  
  CONCLUSIONS
  HCC and HB were preliminarily distinguishable by some clinical clues. Delayed resection after chemotherapy was only possible for HB. However, further studies are needed to strengthen our observation that appropriate reliance upon chemotherapy to subsequently resect advanced HB could achieve the comparable survival to that of stage I HB.
authors.affiliation: Department of Surgery, Chang Gung Children's Hospital, 5 Fu-Shin Street, Kweishan, 333, Taoyuan, Taiwan, China.
authors.forename: Jeng-Chang
authors.initials: JC
authors.lastname: Chen
authors.forename: Ming-Ling
authors.initials: ML
authors.lastname: Chang
authors.forename: Jer-Nan
authors.initials: JN
authors.lastname: Lin
authors.forename: Hong-Shiee
authors.initials: HS
authors.lastname: Lai
authors.forename: Chiu-Chiang
authors.initials: CC
authors.lastname: Chen
authors.forename: Wei-Jao
authors.initials: WJ
authors.lastname: Chen
authors.forename: Wen-Tsung
authors.initials: WT
authors.lastname: Hung
mesh_terms: D000293:Adolescent; D006528:Carcinoma, Hepatocellular / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases / Q000706:statistics & numerical data; D005260:Female; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D018197:Hepatoblastoma / Q000401:mortality*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000401:mortality*; D008297:Male; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology