Evaluation of hepatic resection in adolescent and young adult patients with hepatocellular carcinoma

Abstract

Abstract Background In Japan, primary hepatocellular carcinoma (HCC) often develops against a background of chronic hepatitis, such as persistent hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. Patients with HCC are commonly in their 50s or 60s. It is extremely rare to find HCC patients in their 40s or younger. In Japan, such cases are reported to constitute only 0.23% of all cases. The adolescent and young adult (AYA) population refers to people aged 15–39 years. Patients with cancer in the AYA population may present special clinical features and biologic characteristics. In this study, we evaluated hepatic resection of AYA hepatocellular carcinoma at our facility. Materials and Methods We analyzed 978 patients who underwent hepatectomy at our institute between 1994 and 2022. We categorized the patients into two groups: the AYA group and the non-AYA group. Patient demographics, operative details, perioperative outcomes, pathologic details, clinicopathological findings, overall survival (OS) and recurrence-free survival (RFS) were compared. Results Eight patients—five males and three females—were less than 40 years old. The incidence of AYA hepatocellular carcinoma was 0.8%. Six patients had a history of hepatitis B. Four patients had a history of liver cirrhosis. Two patients experienced recurrent HCC. One patient died a year and a half after surgery. The percentage of HBV-positive patients was significantly greater in the AYA group than in the non-AYA group, and the tumor diameter was significantly greater in the AYA group. There were no significant differences in tumor marker levels, vascular invasion, differentiation, overall survival rate, or recurrence-free survival rate between the AYA group and the non-AYA group. Conclusion The outcome of resection for AYA HCC is good. Detection of AYA HCC in the early stage and hepatectomy are recommended.