Related Experiment Videos
Hepatocellular carcinoma in childhood. Clinical manifestations and prognosis
1Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Republic of China.
Insights
Pediatric hepatocellular carcinoma (HCC) in Taiwan showed a poor prognosis, with most children diagnosed at advanced stages. Surgical resection, though rarely possible, offered a better outlook for these young cancer patients.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Malignancies
Background:
- Hepatocellular carcinoma (HCC) is a rare but aggressive malignancy in children.
- Understanding the clinical presentation and outcomes of pediatric HCC is crucial for improving patient survival.
Observation:
- A study at National Taiwan University Hospital (1964-1989) analyzed 71 children (3-17 years) with HCC.
- Most patients presented with advanced disease, characterized by abdominal pain, mass, anorexia, and fever.
- Male predominance (3.2:1) and poor overall survival (10% >1 year) were noted.
Findings:
- Hepatosplenomegaly and ascites were common physical signs.
- Resectability rate was low at 9.8%.
- Favorable prognostic factors included resectability and absence of jaundice.
Implications:
- Pediatric HCC carries a grave prognosis, emphasizing the need for early detection.
- Surgical resection, when feasible, should be prioritized to improve survival outcomes.
- Further research into novel therapeutic strategies for pediatric HCC is warranted.
Abstract:
From December 1964 to November 1989, 71 children from 3 to 17 years of age with the eventual diagnosis of hepatocellular carcinoma (HCC) presented at the National Taiwan University Hospital (Taipei, Taiwan, Republic of China). Forty-three of them had pathologic proof, whereas 28 were diagnosed on a clinical and laboratory basis. A male predominance (M:F = 3.2:1) was noticed. Most patients presented in a late, advanced stage. Abdominal pain and abdominal mass were the major symptoms and signs, followed by anorexia, fever, and internal bleeding. Hydrocele, purpura, and obstructive jaundice were rare presenting symptoms. Hepatosplenomegaly, superficial venous engorgement, and ascites were the main physical signs. The prognosis for such children with HCC was very poor. Only 10% of the patients survived longer than 1 year after the onset of the initial symptom. Among 49 patients who could be followed, only two had long-term survival of over 5 years. One patient had a small HCC with internal bleeding, whereas the other had a large HCC with abdominal distention. Both received surgical resection, and a resection was repeated for tumor recurrence in the patient with the large mass. The resectability of these 71 patients was low (9.8%). Resectability and nonicterus seemed to be the factors indicating favourable prognosis. Observation indicated that the prognosis for children with symptomatic HCC is grave but surgical resection, whenever possible, should be carried out.