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Clinicopathological Features and Outcomes of Young Patients with Hepatocellular Carcinoma after Hepatectomy

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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 inthe 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.

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References

  1. El-serag HB (2002) Hepatocellular carcinoma: an epidemiologic view. J Clin Gastroenterol 35:S72–S78

    Article  PubMed  Google Scholar 

  2. Parkin DM (2001) Global cancer statistics in the year 2000. Lancet Oncol 2:533–543

    Article  PubMed  CAS  Google Scholar 

  3. Shiratori Y, Yoshida H, Omata M (2001) Different clinicopathological features of hepatocellular carcinoma in relation to causative agents. J Gastroenterol 36:73–78

    Article  PubMed  CAS  Google Scholar 

  4. Kiyosawa K, Uemura T, Ichijo T et al (2004) Hepatocellular carcinoma: recent trends in Japan. Gastroenterology 127:S17–S26

    Article  PubMed  Google Scholar 

  5. Stroffolini T, Andreone P, Andriulli A et al (1998) Characteristics of hepatocellular carcinoma in Italy. J Hepatol 29:944–953

    Article  PubMed  CAS  Google Scholar 

  6. Cho SJ, Yoon JH, Hwang SS et al (2007) Do young hepatocellular carcinoma patients with relatively good liver function have poorer outcomes than elderly patients? J Gastroenterol Hepatol 22:1226–1231

    Article  PubMed  Google Scholar 

  7. Chen CH, Chang TT, Cheng KS et al (2006) Do young hepatocellular carcinoma patients have worse prognosis? The paradox of age as a prognostic factor in the survival of hepatocellular carcinoma patients. Liver Int 26:766–773

    Article  PubMed  Google Scholar 

  8. Aramaki M, Kawano K, Sasaki A et al (2005) Hepatocellular carcinoma in young adults. Hepatogastroenterology 52:1795–1797

    PubMed  Google Scholar 

  9. Yamazaki Y, Kakizaki S, Sohara N et al (2007) Hepatocellular carcinoma in young adults: the clinical characteristics, prognosis, and findings of a patient survival analysis. Dig Dis Sci 52:1103–1107

    Article  PubMed  Google Scholar 

  10. Ng IO, Ng MM, Lai EC et al (1996) Pathologic features and patient survival in hepatocellular carcinoma in relation to age. J Surg Oncol 61:134–137

    Article  PubMed  CAS  Google Scholar 

  11. Lam CM, Chan AO, Ho P et al (2004) Different presentation of hepatitis B-related hepatocellular carcinoma in a cohort of 1863 young and old patients—implications for screening. Aliment Pharmacol Ther 19:771–777

    Article  PubMed  Google Scholar 

  12. Chang PE, Ong WC, Lui HF et al (2008) Is the prognosis of young patients with hepatocellular carcinoma poorer than the prognosis of older patients? A comparative analysis of clinical characteristics, prognostic features, and survival outcome. J Gastroenterol 43:881–888

    Article  PubMed  Google Scholar 

  13. Shimada M, Takenaka K, Fujiwara Y et al (1998) Risk factors linked to postoperative morbidity in patients with hepatocellularcarcinoma. Br J Surg 85:195–198

    Article  PubMed  CAS  Google Scholar 

  14. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  Google Scholar 

  15. Lack EE, Neace C, Vawter GF (1983) Hepatocellular carcinoma. Review of 32 cases in childhood and adolescence. Cancer 52:1510–1515

    Article  PubMed  CAS  Google Scholar 

  16. Liver Cancer Study Group of Japan (2003) The general rules for the clinical and pathological study of primary liver cancer. Second English edition. Kanehara, Tokyo

    Google Scholar 

  17. Bruix J, Sherman M (2005) AASLD practice guideline: management of hepatocellular carcinoma. Hepatology 42:1208–1236

    Article  PubMed  Google Scholar 

  18. De Bac C, Stroffolini T, Gaeta GB et al (1994) Pathogenic factors in cirrhosis with and without hepatocellular carcinoma: a multicenter Italian study. Hepatology 20:1225–1230

    Article  PubMed  Google Scholar 

  19. Schoniger-Hekele M, Muller C, Kutilek M et al (2001) Hepatocellular carcinoma in central Europe: prognostic features and survival. Gut 48:103–109

    Article  PubMed  CAS  Google Scholar 

  20. Kew MC (1981) Clinical, pathologic, and etiologic heterogeneity in hepatocellular carcinoma: evidence from southern Africa. Hepatology 1:366–369

    Article  PubMed  CAS  Google Scholar 

  21. Merican I, Guan R, Amarapuka D et al (2000) Chronic hepatitis B virus infection in Asian countries. J Gastroenterol Hepatol 15:1356–1361

    Article  PubMed  CAS  Google Scholar 

  22. Lai CL, Yuen MF (2007) The natural history of chronic hepatitis B. J Viral Hepat 14(Suppl 1):6–10

    PubMed  Google Scholar 

  23. Ko CY, Hsu HC, Shen MR et al (2008) Epigenetic silencing of CCAAT/enhancer-binding protein delta activity by YY1/polycomb group/DNA methyltransferase complex. J Biol Chem 283:30919–30932

    Article  PubMed  CAS  Google Scholar 

  24. Agrawal S, Hofmann WK, Tidow N et al (2007) The C/EBPdelta tumor suppressor is silenced by hypermethylation in acute myeloid leukemia. Blood 109:3895–3905

    Article  PubMed  CAS  Google Scholar 

  25. Weber A, Boger R, Vick B et al (2010) Hepatocyte-specific deletion of the antiapoptotic protein myeloid cell leukemia-1 triggers proliferation and hepatocarcinogenesis in mice. Hepatology 51:1226–1236

    PubMed  Google Scholar 

  26. Fried M, Kalra J, Iardi CF et al (1987) Hepatocellular carcinoma in a long-term survivor of acute lymphocytic leukemia. Cancer 60:2548–2552

    Article  PubMed  CAS  Google Scholar 

  27. Guariso G, Fiorio S, Altavilla G et al (1998) Congenital absence of the portal vein associated with nodular hyperplasia of the liver and cystic dysplasia of the kidney. Eur J Paediatr 157:287–290

    Article  CAS  Google Scholar 

  28. Matsuoka Y, Ohtomo K, Okubo T et al (1992) Congenital absence of the portal vein. Gastrointest Radiol 17:31–33

    Article  PubMed  CAS  Google Scholar 

  29. Bannasch P (1996) Pathogenesis of hepatocellular carcinoma: sequential cellular, molecular and metabolic changes. Prog Liver Dis 14:161–197

    PubMed  CAS  Google Scholar 

  30. Tso PL, Bringaze WL 3rd, Dauterive AH et al (1987) Gastric carcinoma in the young. Cancer 59:1362–1365

    Article  PubMed  CAS  Google Scholar 

  31. de la Monte SM, Hutchins GM, Moore GW (1988) Influence of age on the metastatic behavior of breast carcinoma. Hum Pathol 19:529–534

    Article  Google Scholar 

  32. Theuer CP, Kurosaki T, Taylor TH et al (1998) Unique features of gastric carcinoma in the young: a population-based analysis. Cancer 83:25–33

    Article  PubMed  CAS  Google Scholar 

  33. Msika S, Benhamiche AM, Jouve JL et al (2000) Prognostic factors after curative resection for gastric cancer. A population-based study. Eur J Cancer 36:390–396

    Article  PubMed  CAS  Google Scholar 

  34. The Cancer of the Liver Italian Program (CLIP) investigators (1998) A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients. Hepatology 28:751–755

    Article  Google Scholar 

  35. Kudo M, Chung H, Osaki Y (2003) Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score). J Gastroenterol 38:207–215

    Article  PubMed  Google Scholar 

  36. Huang ZQ, Xu LN, Yang T et al (2009) Hepatic resection: an analysis of the impact of operative and perioperative factors on morbidity and mortality rates in 2008 consecutive hepatectomy cases. Chin Med J 122:2268–2277

    PubMed  Google Scholar 

  37. Shimada M, Yamashita Y, Hamatsu T et al (2000) Surgical indications for advanced hepatocellular carcinoma. Hepatogastroenterology 47:1095–1099

    PubMed  CAS  Google Scholar 

  38. Llovet JM (2005) Updated treatment approach to hepatocellular carcinoma. J Gastroenterol 40:225–235

    Article  PubMed  Google Scholar 

  39. Taketomi A, Toshima T, Kitagawa D et al (2010) Predictors of extrahepatic recurrence after curative hepatectomy for hepatocellular carcinoma. Ann Surg Oncol 17:2740–2746

    Article  PubMed  Google Scholar 

  40. Yoon YS, Kim HK, Kim J et al (2010) Long-term survival and prognostic factors after pulmonary metastasectomy in hepatocellular carcinoma. Ann Surg Oncol 17:2795–2801

    Article  PubMed  Google Scholar 

  41. He J, Zeng ZC, Tang ZY et al (2009) Clinical features and prognostic factor in patients with bone metastases from hepatocellular carcinoma receiving external beam radiotherapy. Cancer 115:2710–2720

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kazuki Takeishi, Ken Shirabe, Jun Muto, Takeo Toshima, Akinobu Taketomi & Yoshihiko Maehara

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  1. Kazuki Takeishi
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  2. Ken Shirabe
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  3. Jun Muto
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  4. Takeo Toshima
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  5. Akinobu Taketomi
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  6. Yoshihiko Maehara
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Correspondence to Kazuki Takeishi.

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Takeishi, K., Shirabe, K., Muto, J. et al. Clinicopathological Features and Outcomes of Young Patients with Hepatocellular Carcinoma after Hepatectomy. World J Surg 35, 1063–1071 (2011). https://doi.org/10.1007/s00268-011-1017-7

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