Hepatocellular carcinoma in children: Clinical review and comparison with adult cases

Chen, Jeng-Chang; Chen, Chiu-Chiang; Chen, Wei-Jao; Lai, Hong‐Shiee; Hung, Wen-Tsung; Lee, Po‐Huang

doi:10.1016/s0022-3468(98)90005-7

Cited by 85 publications

(89 citation statements)

References 22 publications

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“…Most of the reports from the United States are case series or questionnaires of physicians. 11,[18][19][20][21] There are hospital-based case series 9,22,23 and epidemiologic analysis of hepatocellular carcinoma from the cancer registry 24 of China. The data presented here, which are based on nationwide death certificate data (NCHS) and population-based registries (SEER), provide a more complete and representative overview than can be obtained from case series.…”

Section: Discussionmentioning

confidence: 99%

“…This contrasts with previous reports, in which a stronger male predominance for both hepatoblastoma and hepatocellular carcinoma has been observed. 11,[18][19][20][21]23,24 Risk factors for hepatoblastoma are not well characterized. Hepatoblastoma has been shown to be associated with Beckwith-Weidmann syndrome 25,26 hemihypertrophy, and familial adenomatous polyposis, none of which have unique ICD-9 codes.…”

Section: Discussionmentioning

confidence: 99%

“…43 Survival rates are better with surgical resection plus transplantation in selected groups of individuals [41][42][43] compared with resection alone and better for resection compared with no resection both in adults 41 and in children. 41,44 Newer techniques such as intrahepatic chemoembolization have been shown to be promising in children with unresectable tumors. 45 The United Network for Organ Sharing (UNOS) has operated the Organ Procurement and Transplantation Network (OPTN) under contract with the Health Resources and Services Administration of the U.S. Department of Health and Human Services since 1986.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Primary Hepatic Malignancies in U.S. Children

et al. 2003

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The epidemiology of primary hepatic malignancies in U.S. children is poorly characterized. We analyzed the incidence, mortality, and characteristics of primary hepatic malignancies in U.S. residents less than 20 years of age. Fatal primary hepatic malignancies in persons less than 20 years of age, between 1979 and 1996, were identified using the multiple-cause-ofdeath database (National Center for Health Statistics). Histologically confirmed primary hepatic malignancies occurring between 1973 and 1997 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Between 1979 and 1996, 918 primary hepatic malignancy deaths (average, 0.7/1,000,000/year) were reported nationally among persons less than 20 years of age; rates were higher among Asians and among foreignborn children. Between 1973 and 1997, 271 primary hepatic malignancy cases were reported to SEER among persons less than 20 years of age, of which 184 (67%) and 83 (31%) were hepatoblastoma and hepatocellular carcinoma, respectively. Among children less than 5 years of age, hepatoblastoma accounted for 91% of primary hepatic malignancy cases, whereas among those 15 to 19 years of age, hepatocellular carcinoma accounted for 87% of cases. Five-year survival for hepatoblastoma was 52%, compared with 18% for hepatocellular carcinoma. In the SEER sites, between 1973 and 1977 and 1993 and 1997, hepatoblastoma rates increased (0.6 to 1.2/1,000,000, respectively), while hepatocellular carcinoma rates decreased (0.45 to 0.29/1,000,000, respectively). In conclusion, histologically confirmed hepatocellular carcinoma was reported in children less than 5 years of age, also, where hepatoblastoma is the predominant primary hepatic malignancy. Hepatocellular carcinoma has worse survival rates than hepatoblastoma, and its incidence has not increased. Better maintenance of databases may provide information about associated factors behind this unexpected occurrence. (HEPATOLOGY 2003;38:560-566.) P rimary hepatic malignancies are rare in children. 1

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Primary Hepatic Malignancies in U.S. Children

et al. 2003

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“…Bilobar, multifocal disease is common and at least half of affected children have metastases or extrahepatic spread at presentation. 35 Whilst some hepatocellular carcinomas respond to PLADO chemotherapy, the tumour is much more chemoresistant than hepatoblastoma. In the SIOPEL-1 study, partial response to PLADO chemotherapy was observed in only half the cases.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

The Role of Liver Transplantation in the Management of Paediatric Liver Tumours

Stringer

2007

annals

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In recent years, considerable progress has been made in the treatment of children with hepatoblastoma largely due to effective pre-operative chemotherapy. Total hepatectomy and liver transplantation has emerged as an effective treatment for the small proportion of children with unresectable hepatoblastoma limited to the liver. A 5-year survival of 70% can be achieved in such cases. In contrast, the results of liver transplantation in children with hepatocellular cancer remain poor because these tumours are usually advanced with evidence of major vascular invasion and/or extrahepatic spread at the time of presentation. An exception is those children in whom the hepatocellular carcinoma is detected during surveillance of chronic liver diseasethey typically have smaller tumours and frequently have a good prognosis after liver transplantation. The role of liver transplantation in children with other primary hepatic malignancies remains uncertain because experience is very limited. Liver transplantation is rarely needed in the management of children with benign liver tumours but, if other treatments have failed, it can be a life-saving intervention.

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“…With 0.96% of HBs Ag carriage, Iran is now considered as a low endemicity country for chronic infection with HBV (15). Diagnosis of HCC is based on clinicopathologic and radiologic findings; however, AFP plays an important role in the early diagnosis and follows up of the patients with cirrhosis (16). Most of our cases had elevated AFP, which most of them were significantly high, therefore, our study confirms the value of AFP in the diagnosis of HCC even in the pediatric age group (17).…”

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confidence: 99%

Pediatric Hepatocellular Carcinoma, a Single Center Study from the South of Iran: Case Series

et al. 2017

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Background: Hepatocellular carcinoma is a rare tumor in children, thus, there are not many studies regarding clinicopathologic findings of this tumor and no report regarding this tumor in this age group from Iran. Objectives: In this study, we tried to find out the clinicopathologic findings including outcome of hepatocellular carcinoma in the patients under the age of 18. Methods: During the last 10 years (2005 -2016), we collected all hepatocellular carcinoma cases in the affiliated hospitals of Shiraz University of Medical Sciences (as the largest referral center in the South of Iran and the only center of pediatric liver transplantation in the whole country) from the archives of Pathology department. Next all clinical data were subsequently extracted from the patients' hospital charts. Results: We collected 30 cases of hepatocellular carcinoma with the age range of 9 months to 18 years with no significant sex preference. All of the patients, except 3, showed abnormal levels of AFP. The most common underlying cause of liver tumorigenesis was type I tyrosinemia. Conclusions: Hepatocellular carcinoma in children is a rare tumor and is mostly secondary to an underlying liver disease, which is tyrosinemia in our center. Hepatitis B related hepatocellular carcinoma is rare in our country, which seems to be related to successful early neonatal vaccination against this viral disease. This tumor has a poor outcome in children and without liver transplantation, has a very short survival rate.

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Hepatocellular carcinoma in children: Clinical review and comparison with adult cases

Cited by 85 publications

References 22 publications

Epidemiology of Primary Hepatic Malignancies in U.S. Children

Epidemiology of Primary Hepatic Malignancies in U.S. Children

The Role of Liver Transplantation in the Management of Paediatric Liver Tumours

Pediatric Hepatocellular Carcinoma, a Single Center Study from the South of Iran: Case Series

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