Do young hepatocellular carcinoma patients have worse prognosis? The paradox of age as a prognostic factor in the survival of hepatocellular carcinoma patients.
OBJECTIVE
Our previous study showed that male hepatocellular carcinoma (HCC) patients below 40 years of age had the worst survival in the initial several years, but had the best prognosis thereafter. Thus, it seems that age has a paradoxical influence on the prognosis. To further clarify the issue of age on HCC prognosis, we initiated this study.


METHODS
A total of 11,312 HCC cases from seven medical centers from 1986 to 2002 were included. We analyzed the 1-year survival and survival after 1 year.


RESULTS
Male gender, age younger than 40 years old and hepatitis B virus (HBV) were associated with worse 1-year survival. In contrast, male gender, age younger than 40 years old and HBV were associated with better survival after 1 year. Higher percentage of the young HCC patients had a tumor size larger than 3 cm. 83.7% of HCC patients below 40 years of age were male and 89.8% of them were HBV carriers.


CONCLUSIONS
If we encountered a young HCC patient, the patient will probably be a male HBV carrier. He would probably have larger tumor and is more likely to expire within 1 year than the older HCC patients. However, if the young HCC patient can survive for more than 1 year, he would probably have better survival in the following years than the older patients.
Chen
Chien-Hung
CH
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Chang
Ting-Tsung
TT
Cheng
Ken-Sheng
KS
Su
Wei-Wen
WW
Yang
Sheng-Shun
SS
Lin
Hans Hsienhong
HH
Wu
Shun-Sheng
SS
Lee
Chuan-Mo
CM
Changchien
Chi-Sin
CS
Chen
Chien-Jen
CJ
Sheu
Jin-Chuan
JC
Chen
Ding-Shinn
DS
Lu
Sheng-Nan
SN
D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000503:physiopathology* / Q000821:virology*; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors
D015415:Biomarkers; D014408:Biomarkers, Tumor