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Predisposing Conditions to Pediatric Hepatocellular Carcinoma and Association With Outcomes: Single-center Experience

Elizabeth Cowell1, Kalyani Patel2, Andras Heczey3

  • 1Department of Pediatrics.

Journal of Pediatric Gastroenterology and Nutrition
|January 25, 2019
PubMed

Insights

Most children with hepatocellular carcinoma (HCC) lack predisposing liver disease. These children are diagnosed later with advanced disease and have significantly poorer survival outcomes.

Area of Science:

  • Pediatric Oncology
  • Hepatology
  • Cancer Research

Background:

  • Hepatocellular carcinoma (HCC) in children is often associated with chronic liver diseases.
  • Characteristics and outcomes of pediatric HCC, especially in relation to predisposing conditions, require further elucidation.

Purpose of the Study:

  • To characterize pediatric hepatocellular carcinoma (HCC) patients.
  • To define outcomes in children with HCC, particularly concerning predisposing liver disease.

Main Methods:

  • Retrospective review of 61 pediatric HCC cases (age ≤21) managed between 1996-2016.
  • Subgroup analysis based on presence or absence of predisposing conditions.
  • Survival analysis using Kaplan-Meier method.

Main Results:

  • 44% of patients had predisposing conditions (e.g., cirrhosis, steatosis, genetic disorders).
  • De novo HCC (no predisposing condition) patients were diagnosed at a later age (10.2 vs 7.2 years) with larger tumors (>4cm, 100% vs 20%).
  • Patients with de novo HCC had significantly decreased overall survival compared to those with predisposing conditions.

Conclusions:

  • The majority of pediatric HCC cases occur without predisposing liver disease.
  • Children with de novo HCC present with more advanced disease and have worse survival.
  • Timely diagnosis and treatment strategies are crucial for improving outcomes in pediatric HCC.
Abstract

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