Clinical features and prognosis of hepatocellular carcinoma in young patients from a hepatitis B-endemic area.
OBJECTIVE
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. However, the clinical features of young HCC patients have not been fully studied. In the present study, we investigated the prevalence, clinical characteristics and prognosis of young HCC patients.


METHODS
A retrospective analysis was performed for HCC patients in our center using Korean cancer registry data. Among 4234 patients enrolled, there were 38 patients younger than 30 years of age (0.9%). We compared clinical characteristics and survival data of these patients (group I) with those of sex-matched, randomly selected HCC patients aged 30-59 years (group II; n = 231) and 60 years or older (group III; n = 147).


RESULTS
Group I showed distinct features compared with groups II and III as follows: low frequency of smoking history, high positive rate of hepatitis B s antigen, no association with anti-hepatitis C virus antibody, high frequency of alpha-fetoprotein > or = 400 ng/mL, well-preserved liver function, larger tumor size, more advanced tumor-node-metastasis (TNM) stage and Cancer of the Liver Italian Program (CLIP) score and more frequent application of surgical resection and chemotherapy as initial treatment. The overall survival of group I was worse than that of group II, but similar to that of group III. Multivariate analysis showed that TNM stage and CLIP score, not age itself, were independent predictive factors for survival.


CONCLUSIONS
The results suggest that young HCC patients tend to have a poor prognosis owing to advanced tumor stage, despite well-preserved liver function and aggressive treatment. Further studies regarding the role of HCC screening in young people may be useful, especially in hepatitis B virus carriers from high endemic areas.
Kim
Jeong Hwan
JH
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Choi
Moon Seok
MS
Lee
Hyuk
H
Kim
Do Young
DY
Lee
Joon Hyeok
JH
Koh
Kwang Cheol
KC
Yoo
Byung Chul
BC
Paik
Seung Woon
SW
Rhee
Jong Chul
JC
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis