Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
World J Surg. 2011 May;35(5):1063-71. doi: 10.1007/s00268-011-1017-7.
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.
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.
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).
Hepatitis B virus-related HCC was common in the 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.
有关青年人肝细胞癌(HCC)肝切除术的报道较少,青年人行肝切除的意义尚不清楚。本研究旨在回顾性分析青年人 HCC 患者行肝切除的临床病理特征和结局。
1987 年 1 月至 2007 年 12 月期间,610 例行根治性肝切除术的 HCC 患者中,年龄<40 岁的 13 例患者定义为青年组。由于青年组患者均无丙型肝炎病毒抗体(HCVAb),故选择年龄>40 岁且无 HCVAb 的 246 例患者作为老年组。比较两组患者的临床病理特征和肝切除术后结局。
青年组中,7 例患者乙型肝炎表面抗原阳性,3 例患者乙型肝炎核心抗体阳性。与老年组相比,青年组肝功能较好,但 HCC 分期较晚,肿瘤较大,门静脉侵犯发生率较高。与老年组相比,青年组更倾向于选择大范围肝切除术。两组术后并发症发生率无显著差异。青年组的总生存时间优于老年组(p=0.057)。
本研究报道的青年患者中,乙型肝炎病毒相关 HCC 较为常见。尽管青年患者 HCC 分期较晚,但青年组与老年组在并发症发生率和总生存率方面无显著差异。对青年患者行积极的肝切除术有助于提高生存率,应予以推荐。