Do young hepatocellular carcinoma patients with relatively good liver function have poorer outcomes than elderly patients?
OBJECTIVE
The risk of hepatocellular carcinoma (HCC) is known to be age dependent; the influence of age on prognosis is, however, controversial. The aim of this study was to compare the tumor characteristics and survival rates of young and old HCC patients, with respect to tumor stage.


METHODS
We reviewed the clinical data and survival times of 71 young HCC patients from 1987 to 2003 and compared these with those of their older counterparts (n = 239). Patients were categorized into three age groups: group A, age <30 years (n = 71); group B, age >/=30 to <61 years (n = 168); and group C, age >/=61 years (n = 81). Kaplan-Meier methods and Cox proportional hazards regression were used to analyze survival.


RESULTS
The overall survival time of group A was shorter than groups B or C (P = 0.0071). Survival was not different in the three groups in subgroup analysis according to several tumor staging systems (e.g. Japan Integrated Staging score, Cancer of the Liver Italian Program scoring system and Barcelona Clinic Liver Cancer staging classification). The multivariate hazard ratio of group B was 0.840 (95% confidence interval [CI] 0.490-1.440) and that of group C was 0.770 (95% CI 0.410-1.446) in reference to group A.


CONCLUSIONS
Young HCC patients showed a poorer prognosis than older HCC patients because they have a more advanced tumor stage at diagnosis. However, age was not an independent prognostic factor when stages were matched. Therefore, we suggest that periodic surveillance in young chronic hepatitis B virus carriers would improve outcomes.
Cho
Soo-Jeong
SJ
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Yoon
Jung-Hwan
JH
Hwang
Seung-Sik
SS
Lee
Hyo-Suk
HS
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D015996:Survival Rate