title: The impact of family history of hepatocellular carcinoma on its patients' survival.
abstract: BACKGROUND
  Family history of hepatocellular carcinoma (HCC) has been identified as a risk factor for the development of the disease. The aim of this study is to evaluate the impact of such a history on HCC patients' survival.
  
  
  METHODS
  Data of all HCC patients (n=4532) managed at our center from 1989 to 2008 were prospectively collected. The patients were quizzed on their various characteristics including family HCC history.
  
  
  RESULTS
  Totally 475 (10.48%) patients had a family history of HCC. They presented the disease at a significantly earlier age (median 53 vs 59 years, P<0.0001) and at an earlier stage (the United Network for Organ Sharing staging system). They had significantly better liver function in terms of Child-Pugh classification and serum albumin and bilirubin levels. Significantly more of them presented the disease without symptoms (44.0% vs 29.4%, P<0.0001). They also had significantly better overall survival under these specifications: patients in the whole study cohort, patients who had minor hepatectomy, patients with stage I disease, patients with stage II disease, and patients with stage III disease.
  
  
  CONCLUSIONS
  Contrary to what is generally believed, we found in this study cohort that patients with a family history of HCC had better overall survival than those without such a history. We believe this was in part due to earlier diagnosis of the disease and better liver function in this group of patients. However, the effects of genetic factors on the risk of HCC cannot be overlooked and are yet to be identified.
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China.
authors.forename: Wing Chiu
authors.initials: WC
authors.lastname: Dai
authors.forename: Sheung Tat
authors.initials: ST
authors.lastname: Fan
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
authors.forename: Kenneth S H
authors.initials: KS
authors.lastname: Chok
authors.forename: Albert C Y
authors.initials: AC
authors.lastname: Chan
authors.forename: Simon H Y
authors.initials: SH
authors.lastname: Tsang
authors.forename: Ronnie T P
authors.initials: RT
authors.lastname: Poon
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000235:genetics* / Q000401:mortality* / Q000473:pathology; D055088:Early Detection of Cancer; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000235:genetics* / Q000401:mortality* / Q000473:pathology; D008487:Medical History Taking; D008875:Middle Aged; D009367:Neoplasm Staging; D010375:Pedigree; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult