title: Hepatocellular Carcinoma in Children and Adolescents: Clinical Characteristics and Treatment.
abstract: Hepatocellular carcinoma (HCC) occurs rarely in children and adolescents (C&A), and its clinical characteristics, prognostic factors, and treatment were rarely explored.
  
  
  
  This retrospective study focused on 65 HCC patients aged ≤20 years from August 1994 to August 2012. Cox regression models and Kaplan-Meier curves were used to investigate prognostic factors and compare overall survival (OS), respectively.
  
  
  
  We found 61.5% of patients to have multiple tumors, 30.8% to have portal vein tumor thrombus, and 16.9% to have distant metastasis. Diameter of tumors was 10.2 ± 4.1 cm. OS at 5 years was 15.8%. Multivariate analyses showed initial treatment (P < 0.001) to be a predictor for OS. For moderate-stage HCC, the median OS of patients who underwent resection was longer than that of patients who underwent transarterial chemoembolization (TACE) or supportive treatment (ST) (P < 0.001). For advanced-stage HCC, the median OS of patients who underwent TACE was longer than that of patients who underwent ST (P = 0.045).
  
  
  
  HCC in C&A tends to be more advanced than that in adults, and resection remains the mainstay of treatment for those patients. Moreover, compared with ST, TACE may benefit C&A with moderate- and advanced-stage HCC, which needs further study.
authors.affiliation: Department of Hepatobiliary Oncology, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.
authors.forename: Juncheng
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Oncology, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.
authors.forename: Yize
authors.initials: Y
authors.lastname: Mao
authors.affiliation: Department of Hepatobiliary Oncology, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.|Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310020, China.
authors.forename: Yongcheng
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary Oncology, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.
authors.forename: Zhenxin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Oncology, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.
authors.forename: Minshan
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Oncology, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China. laoxm@sysucc.org.cn.
authors.forename: Xiangming
authors.initials: X
authors.lastname: Lao
authors.affiliation: Department of Hepatobiliary Oncology, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China. lishp@sysucc.org.cn.
authors.forename: Shengping
authors.initials: S
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Children and adolescents; Hepatocellular carcinoma; Prognosis; Resection; Transarterial chemoembolization