Comparison of childhood hepatic malignancies in a hepatitis B hyper-endemic area.
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.
Chen
Jeng-Chang
JC
Department of Surgery, Chang Gung Children's Hospital, 5 Fu-Shin Street, Kweishan, 333, Taoyuan, Taiwan, China.
Chang
Ming-Ling
ML
Lin
Jer-Nan
JN
Lai
Hong-Shiee
HS
Chen
Chiu-Chiang
CC
Chen
Wei-Jao
WJ
Hung
Wen-Tsung
WT
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