title: Liver resection for young patients with large hepatocellular carcinoma: a single center experience from China.
abstract: BACKGROUND
  To investigate retrospectively the clinicopathological characteristics and outcomes of young patients with large hepatocellular carcinoma after hepatectomy.
  
  
  METHODS
  From January 2003 to December 2012, a total of 153 patients with large hepatocellular carcinoma (HCC) who received liver resection were included in the study. The clinicopathological features were analyzed retrospectively. The perioperative data were compared between those aged <40 years (the young group) and those aged >40 years (the older group). Prognostic factors and long-term survival were evaluated.
  
  
  RESULTS
  The young group had more hepatitis B virus-related HCC than the older group (87.2% vs 66.3%, P = 0.031). In the young group, 15 patients (21.5%) were overweight (body mass index 25 to 29.9 kg/m2) or obese (body mass index ≥30 kg/m2), and 38 patients (45.8%) were overweight or obese in the older group (P = 0.032). Other clinicopathological characteristics were similar between the two groups. The perioperative data showed that the older group had more pulmonary infection after hepatectomy. Vascular invasion and high Edmondson-Steiner grade were the independent prognostic factors for long-term survival. There was no statistical difference between the young group and the older group in overall survival and disease-free survival (P = 0.109 and P = 0.087, respectively).
  
  
  CONCLUSIONS
  Liver resection for young patients with large HCC was safe and efficacious and should be recommended.
authors.forename: Xi-yu
authors.initials: XY
authors.lastname: Liu
authors.affiliation: Department of surgery, Yiwu Affiliated Hospital of Zhejiang University School of Medicine, east building in huajiachi campus,kaixuan road 268, 310020 Hangzhou, Zhejiang, China. zjxujiangfeng@hotmail.com.
authors.forename: Jiang-feng
authors.initials: JF
authors.lastname: Xu
mesh_terms: D000328:Adult; D000367:Age Factors; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate