Clinicopathological features and outcomes of young patients with hepatocellular carcinoma after hepatectomy

World J Surg. 2011 May;35(5):1063-71. doi: 10.1007/s00268-011-1017-7.

Abstract

Background: There are few reports about hepatectomy for young patients with hepatocellular carcinoma (HCC), and the significance of resection for young patients remains unknown. The present study aimed to investigate retrospectively the clinicopathological features and outcomes after hepatectomy of young HCC patients.

Methods: Among 610 patients who underwent curative hepatectomy for HCC between January 1987 and December 2007, 13 patients younger than 40 years of age were defined as the young group. Because none of the young group had hepatitis C virus antibodies (HCVAb), 246 patients aged above 40 years without HCVAb were defined as the older group. The clinicopathological findings and outcomes after hepatectomy were compared between the two groups.

Results: In the young group, 7 patients had hepatitis B surface antigen and 3 other patients had hepatitis B core antibodies. The young group had better liver function but more advanced HCC, with a large tumor size and a high incidence of portal vein invasion compared with the older group. Major hepatectomy was more frequently chosen in the young group than in the older group. There was no significant difference in the incidences of postoperative complications. The overall survival tended to be better in the young group than in the older group (p=0.057).

Conclusions: Hepatitis B virus-related HCC was common in the younger group of patients reported here. Although the young patients had advanced HCC, there were no significant differences in the complication rate and the overall survival rate of the young and older groups. Aggressive hepatic resection for young patients would contribute to improved survival and should be recommended.

MeSH terms

  • Adolescent
  • Adult
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / surgery*
  • Carcinoma, Hepatocellular / virology
  • Disease-Free Survival
  • Female
  • Hepatectomy
  • Hepatitis B / complications
  • Hepatitis C / complications
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / surgery*
  • Liver Neoplasms / virology
  • Male
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult