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Hepatocellular carcinoma in children

S W Moore1, P B Hesseling, G Wessels

  • 1Department of Paediatric Surgery, University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa.

Pediatric Surgery International
|April 1, 1997
PubMed
Summary

Hepatocellular carcinoma (HCC) is a rare childhood cancer. Aggressive chemotherapy and surgery may improve survival for some pediatric HCC patients, highlighting the importance of hepatitis B prevention.

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Area of Science:

  • Pediatric Oncology
  • Hepatocellular Carcinoma Research
  • Cancer Epidemiology

Background:

  • Hepatocellular carcinoma (HCC) is more prevalent in Sub-Saharan Africa and the Orient.
  • HCC is an uncommon malignancy in childhood.
  • This study reviews pediatric HCC cases treated at Tygerberg Hospital.

Purpose of the Study:

  • To review the clinical presentation, treatment, and outcomes of pediatric HCC.
  • To evaluate the effectiveness of chemotherapy and surgical resection in treating advanced-stage pediatric HCC.
  • To emphasize the role of hepatitis B in HCC development and prevention.

Main Methods:

  • Retrospective review of six pediatric HCC cases treated between 1983-1990.
  • Analysis of patient demographics, clinical presentation, tumor morphology, and serological markers (Hepatitis B surface antigen [HbsAg], alpha-fetoprotein [AFP]).
  • Evaluation of treatment responses to chemotherapy (doxorubicin/cisplatinum) and surgical outcomes.

Main Results:

  • Patients presented with discomfort and hepatomegaly; three were HbsAg positive, and three had elevated AFP levels.
  • Tumor morphology varied, including adult-type pleomorphic, differentiated, and fibrolamellar subtypes.
  • Mean 2-year survival was 33%, and 5-year survival was 16.6%. Two patients with specific tumor characteristics responded well to chemotherapy and surgery, with one long-term survivor.

Conclusions:

  • Pediatric HCC is a rare, aggressive tumor with high mortality.
  • Combination therapy with aggressive chemotherapy and surgical resection can improve survival in select cases.
  • Hepatitis B prevention is crucial for reducing the incidence of HCC.

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