Different presentation of hepatitis B-related hepatocellular carcinoma in a cohort of 1863 young and old patients — implications for screening
Article first published online: 18 MAR 2004
Alimentary Pharmacology & Therapeutics
Volume 19, Issue 7, pages 771–777, April 2004
How to Cite
Lam, C.-M., Chan, A. O. O., Ho, P., Ng, I. O.-L., Lo, C. M., Liu, C. L., Poon, R. T. P. and Fan, S. T. (2004), Different presentation of hepatitis B-related hepatocellular carcinoma in a cohort of 1863 young and old patients — implications for screening. Alimentary Pharmacology & Therapeutics, 19: 771–777. doi: 10.1111/j.1365-2036.2004.01912.x
- Issue published online: 18 MAR 2004
- Article first published online: 18 MAR 2004
- Accepted for publication 29 January 2004
Aim : To compare the clinico-pathological features of hepatitis B virus-related hepatocellular carcinoma in young and old patients.
Methods : The clinico-pathological characteristics of hepatitis B virus-related hepatocellular carcinoma were compared in 1863 consecutive patients (121 patients, ≤40 years; 1742 patients, > 40 years) seen at a single institution over the last 13 years.
Results : Young patients presented more often with pain (P < 0.0001), hepatomegaly (P = 0.01) and ruptured hepatocellular carcinoma (P = 0.02), whereas old patients presented with ankle oedema (P = 0.001), ascites (P = 0.002) and by routine screening (P = 0.035). Liver function, Child–Pugh grading and indocyanine green test were better preserved in young patients. They also had a higher α-foetoprotein concentration (P = 0.001), larger tumour size (P = 0.001) and more frequent metastasis (P = 0.008), but a similar surgical resection rate (33.6% vs. 28%), to old patients. There was no difference between the two groups in the overall post-resection survival rate, but there was a shorter survival in young patients with unresectable disease (3.6 months vs. 4.6 months, P = 0.004).
Conclusion : Young patients with hepatocellular carcinoma often show a later presentation, but a higher resectability rate and similar survival rates, than old patients. The screening programme should include young hepatitis B virus carriers, even in the absence of cirrhosis.