Open AccessFibrolamellar hepatocellular carcinoma in the USA, 2000–2010: A detailed report on frequency, treatment and outcome based on the Surveillance, Epidemiology, and End Results database
Author(s) -
Eggert Tobias,
McGlynn Katherine A,
Duffy Austin,
Manns Michael P,
Greten Tim F,
Altekruse Sean F
Publication year - 2013
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640613501507
Subject(s) - medicine , hepatocellular carcinoma , epidemiology , incidence (geometry) , surveillance, epidemiology, and end results , gastroenterology , milan criteria , cancer , pathology , cancer registry , liver transplantation , transplantation , physics , optics
Objective Epidemiological and clinical information on fibrolamellar hepatocellular carcinoma (fHCC) is scarce. We performed a Surveillance, Epidemiology and End Results (SEER) database analysis with the aim of collecting information to better understand the biology and clinical aspects of this rare disease. Design Incidence trends, race‐ and age‐specific rates, tumor size, first course surgery and five‐year relative survival of 191 US cases (SEER) diagnosed with fHCC during 2000–2010 were compared to cases with hepatocellular carcinoma (HCC), HCC‐not otherwise specified (HCC‐NOS) and other HCC‐types. Results While HCC‐NOS incidence rates increased by 5.2% annually from 2000–2008 ( p < 0.05) before leveling, the 1.3% change in fHCC incidence was not statistically significant. The rates of fHCC were similar across ethnic groups while HCC‐NOS incidence rates were higher among non‐whites. Although 16% of fHCC patients had primary tumors ≤5 cm compared to 37% of HCC‐NOS cases five‐year survival was better among fHCC (34%) than HCC‐NOS cases (16%). Fibrolamellar HCC cases of 0–39 years of age were more likely to receive radiofrequency ablation, transplant or resection than HCC‐NOS cases of that age. Survival was similar among fibrolamellar and HCC‐NOS cases receiving surgery. Conclusion In this largest case series, fibrolamellar and HCC‐NOS age‐ and race‐specific incidence rates and time trends differed. Despite larger tumor size than HCC‐NOS cases fibrolamellar cases received surgery more often and had better survival rates. Differences in co‐morbidity may influence treatment. Studies of fHCC biology, including by age, are recommended.