Clinical Characteristics of Hepatocellular Carcinoma in Young People

Choi, Won; Han, Kwang Hyub; Moon, Hee Yong; Paik, Yong Han; Lee, Kwan Sik; Chon, Chae Yoon; Moon, Young Myoung

Abstract

BACKGROUND/AIMS: Most of hepatocellular carcinoma (HCC) develops during 6th and 7th decade, and HCC development at the age under 40 is unusual. To understand the usefulness of HCC screening test and to determine guidelines for the treatment in young age patients group, we compared the clinical characteristics and prognosis of the patients with HCC retrospectively between patients under 40 and patients over 40. METHODS: A retrospective analysis of the clinical data and survival rate was performed for 603 patients who were admitted to Yonsei medical center from April 1991 through April 1994. We divided the patients into two groups: young age group (< or =40 years) and senior group ( 40 years). RESULTS: Among 603 patients examined, the number of patients in young age group was 67 (11.1%) and their male to female ratio was 10.2:1. Most patients (93%) had subjective symptoms at admission and sixty-four (95.5%) of 67 young HCC patients were HBsAg-positive. However, none of them was anti-HCV-positive. Elevated serum alphafetoprotein level (>400 ng/ml) was more common in the young age group (77.6%) than in the senior group (63.9%). According to the gross type, massive type was more common in the young age group (42.4% vs. 27.9%). The association of cirrhosis was less common in young age group than in the senior group (59.7% vs. 71.6%). The cumulative survival rate of 1, 2, and 3 year in the young age group was 35.4%, 29.2%, and 16.6%, respectively. Such rates were similar to those of the senior group. CONCLUSIONS: HCC development in young age group was closely related with hepatitis B viral infection and HCC screening test may be needed in young male patients with chronic hepatitis B.