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Different presentation of hepatitis B‐related hepatocellular carcinoma in a cohort of 1863 young and old patients — implications for screening
Author(s) -
Lam C.M.,
Chan A. O. O.,
Ho P.,
Ng I. O.L.,
Lo C. M.,
Liu C. L.,
Poon R. T. P.,
Fan S. T.
Publication year - 2004
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2004.01912.x
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , cirrhosis , ascites , hepatitis b virus , hepatitis b , hepatitis , liver function , pathological , survival rate , carcinoma , cohort , virus , immunology
Summary 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.