Hepatocellular carcinoma during pregnancy: is hepatocellular carcinoma more aggressive in pregnant patients?
OBJECTIVE
Hepatocellular carcinoma (HCC) during pregnancy is a very rare condition and is believed to have a worse prognosis than HCC in non-pregnant women. We evaluated the prognosis and the diagnostic and therapeutic strategies for HCC in pregnant women.


METHODS
We retrospectively analyzed 4 cases in our hospital and 44 cases described in the medical literature since 1957; we also compared the cases reported before 1995 and those reported during/after 1995.


RESULTS
The overall 6-month and 1-, 2-, and 3-year survival rates in the patients reported in the literature were 50, 29.5, 18.2, and 13.6%, respectively (n = 44). The mean ages at diagnosis before and during/after 1995 were 31.4 ± 7.2 and 28.9 ± 4.4 years, respectively (P = 0.113). The following characteristics were significantly more common in the later group: fewer pregnancies; the absence of advanced signs or symptoms; receipt of therapy; tendency to undergo surgery; and higher 6-month and 1-, 2-, and 3-year survival rates. The median survivals of the groups before and during/after 1995 were 18 and 25.5 months, respectively (P < 0.001).


CONCLUSIONS
The morbidity and mortality of HCC during pregnancy has improved over time, as diagnoses have tended to be made earlier and patients have tended to receive surgical and other treatments.
Kwandong Graduate School of Medicine, Gangneung-si, Gangwon-do, Korea.
Kang Kook
KK
Choi
Young Ju
YJ
Hong
Sae Byeol
SB
Choi
Young Nyun
YN
Park
Jin Sub
JS
Choi
Woo Jung
WJ
Lee
Kyung Sik
KS
Kim
D000293:Adolescent; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D055815:Young Adult