Clinicopathological comparison of resectable hepatocellular carcinoma between the young and the elderly patients

Hepatocellular carcinoma (HCC) is one of the most common cancers in many parts of the world. In Taiwan it is the leading cause of death in male cancer patients. The peak age of onset of HCC varies according to geographic barriers, which indicates different hepatocarcinogenesis among different age groups. This study aims to evaluate whether there exists significantly different clinicopathological features between young and elderly HCC patients.

During a six-year period, a total of 248 patients with HCC underwent liver curative resection at Veterans General Hospital-Taipei, Taiwan. Among them, 22 patients were younger than 40 years of age, and 43 patients were older than 70 years of age. Important clinicopathological characteristics of the patients (including sex, family history of HCC, smoking habits and alcohol consumption patterns, hepatitis B or C infection, indocyanine-green retention rate at 15 minutes (ICGR-15), serum alpha-fetoprotein value, tumor size, tumor number, tumor venous invasion, capsular formation, tumor staging, cirrhosis, and tumor DNA ploidy) and postresectional prognosis were compared between young and elderly HCC patients.

The frequency of presence of family history (22.7% versus 4.7%), hepatitis B surface antigen carrier rate (81.8% versus 48.8%), and patients with large-sized tumors (31.8% versus 7.0%) were significantly higher in young patients than in elderly patients. The male:female ratio (4.5:1 versus 42:1), degree of liver damage (reflected by the ICGR-15 value, 5.6 +/- 5.0% versus 13.1 +/- 8.8%) and the incidences of liver cirrhosis (18.2% versus 48.8%) were significantly lower in young patients than in elderly patients. However, there were no significant differences in postresectional survival rates between these two groups.

There are age-related differences in clinicopathological characteristics of HCC patients. Accordingly, different mechanisms of hepatocarcinogenesis may exist between young and elderly HCC patients.